Sex Ratio Research Articles

Heat-related risk in outdoor workers in the context of climate change: a systematic review

Abstract Background Climate change is one of the paramount challenges in the current global health setting. From an occupational health perspective, outdoor workers are amongst the most vulnerable populations to climate change and heat-related risk. A systematic review was performed, aiming to assess heat-related health outcomes in outdoor workers. Methods The research query was structured using the Population, Intervention, Comparison and Outcome (PICO) model, and including synonyms and Medical Subject Headings (MeSH) terms for the following keywords: “outdoor workers”, “climate change”, and “occupational risk”. The systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements, screening three databases (PubMed, Web of Science, and Scopus). Results After duplicate removal and title and abstract screening, the final screening by full-text resulted in 10 included studies. The included studies were performed mostly on construction (included in 5 studies, 50.0%) and agriculture (in 5 studies, 50.0%) workers. Eight studies (80.0%) had a majority of male workers, while one (10.0%) had a majority of female workers, and one study (10.0%) did not report on the gender ratio. Four of the included studies (40.0%) reported a high prevalence of heat-related symptoms, ranging from 64.0% to 90.3% of workers. Three studies (30.0%) showcased a prevalence of heat-related symptoms in less than 50% of workers (ranging from 11.6% to 47.5%). Three studies (30.0%) evaluated odds ratio, highlighting an increased odds ratio of heat-related symptoms in outdoor workers. Conclusions This systematic review highlights heat-related stress in outdoor workers as an important occupational risk. Mitigation and prevention strategies should be developed and implemented at a company, national, and supra-national level, to ensure the safety and wellbeing of outdoor workers worldwide. Key messages • A systematic review was performed to assess risks related to climate change in outdoor workers. Heat-related symptoms were reported with a high prevalence, ranging from 64.0% to 90.3% of workers. • Mitigation and prevention strategies should be developed and implemented at a company, national, and supra-national level, to ensure the safety and wellbeing of outdoor workers worldwide.

Increased feelings of nervousness among older Europeans post-pandemic

Abstract Background Feelings of nervousness are typically associated with situational factors and are temporary, less intense, and manageable with self-care. Study Aim This study examines which situational conditions are significant for feeling nervous among European older adults during the second wave of COVID-19. Methods Using data from Wave 9, COVID-19 Survey 2 (Summer, 2021) of the cross-national panel dataset the Survey of Health, Aging, and Retirement in Europe (SHARE), this study utilizes a sample of 49,253 adults over 50 years old from 27 countries in Europe. Analysis: Binary logistic regression indicates all variables are significant predictors of feeling nervous: Gender [Wald= 498.7, p = 0.001 (<0.05)]; chronic disease [Wald= 1635.002 p = 0.001 (<0.05)], employment [Wald= 164.544, p = 0.001 (<0.05)]; home care [Wald= 138.4, p = 0.001 (<0.05)], technology [Wald= 20.66, p = 0.001 (<0.05)]; social support [Wald= 106.66, p = 0.001 (<0.05)], and financial support [Wald=35.5, p = 0.001 (<0.05)] [Chi-Square=3216.401, df = 6 and p = 0.001 (p < 0.05)]. Findings The odds ratio (OR) for gender is .627 (95% CI .601- .653), for chronic disease, is 2.659 (95% CI: 1.716 - 4.119) and employment is .675 (95% CI: .635-.717) and homecare is (OR)3.47(95% CI: 2.83-4.28); OR for social support is 855(95% CI:.830-.881), financial support 1.779 (95% CI: 1.47-2.15), and technology (OR).956 (95% CI: 938-.975). The model correctly predicted 94% of cases without feeling nervous and 16% of cases where people did feel nervous, giving an overall percentage correct prediction rate of 68%. Implications for Policy and Practice: Knowledge from this study can inform the introduction of public health interventions for older adults targeted toward specific situational circumstances that reduce nervousness. Key messages • While feelings of nervousness can be situational, the impact on mental health can go beyond the contextual environment. • Public health policies can support targeted interventions aimed at developing the coping skills necessary to better respond in times of crisis.

A review of the risk factors for Autism

Abstract Background Autism Spectrum Disorder (or Autism) is a neurodevelopmental and neurological condition, with prevalence of 1 in 100 children globally. This review examines the most common factors associated with Autism. Methods We conducted a scoping review of factors associated with an increased risk of developing Autism. These included genetic predisposition, parental age, gender, birth complications and morbidities due to other medical conditions. Results Evidence from twin studies shows a 90% genetic predisposition towards Autism - with 102 genes strongly associated with Autism, including SCN1A and SLC6A1. There are also genetic syndromes and chromosomal disorders associated with Autism, including Fragile X syndrome and Tuberous Sclerosis complex (TSC). Several studies have demonstrated an increased risk with advanced parental age (>35 years) (e.g., fathers >50 years are 2.2 times more likely to have a child with Autism than those <30 years). Other factors include infections during pregnancy (e.g. immune dysfunction) and gestational diabetes. Prematurity, such as low birth weight (<1500g) and low gestational age (<32 weeks) are also associated with an increased risk of Autism. With regard to gender, boys are more likely to be diagnosed with Autism - gender ratio of 3:1 and 4:1 has been reported in different populations. Abnormalities in brain development during early prenatal or postnatal periods may increase the risk of Autism. These abnormalities can lead to social, communication, and behavioural challenges characteristic of Autism. Conclusions Autism is a complex and heterogeneous condition that likely arises from a combination of factors such as genetic susceptibility and pre- and postnatal factors. An understanding of these factors is important for early detection, intervention, and support for children to improve their quality of life and reduce morbidity. Key messages • Risk factors associated with an increased risk of developing Autism include genetic predisposition, parental age, gender, birth complications and other comorbidities. • There is need to increase awareness of the risk factors of Autism to improve quality of life.

Navigating Toward a Gender-Balanced Culture in Leadership Roles in Higher Tertiary Institutions (HTIs)

The European Commission (EC) and the United Nations advocate the importance of gender equality in their agendas and goals. More specifically, the EC has highlighted the importance of increasing women’s representation in leadership positions, yet in a minority of universities around the globe, there is a gender imbalance. By excluding women from key academic leadership roles, a culture that superficially accepts women into roles that do not challenge the hierarchy is normalized, and a rubber stamp to hegemonic masculinity is established as typical conduct. This study utilizes data from a national survey distributed across all full-time academic and administrative staff in Cyprus’s 13 universities to examine the presence of gender disparities in leadership. The survey was designed based on a comprehensive review of the literature and pilot tested by experts in the field. It was then distributed by university rectors, reaching a total of 337 respondents. The data were analyzed to confirm that the characteristics of an extremely gendered environment, as established by researchers, are found in higher tertiary institutions (HTIs). Secondly, the authors found that the disparities between the leadership skills and traits held most prominently by women in HTIs, as opposed to their male counterparts, enhance the arguments put forward toward gender balance in leadership. Thirdly, the barriers holding women back from voicing their wishes to seek leadership roles in HTIs were identified. Finally, recommendations are made on how to overcome the androgenic environment, to move the needle and have more women seek leadership positions in a culture which preserves hegemonic masculinity. Changing this culture will navigate towards a more balanced working environment for staff and students, and can thus address ethical issues in a more inclusive and gender-balanced environment.

Фармакоэкономический анализ различных методов лечения акне у детей и подростков

Acne is a widespread dermatological disease affecting children and adolescents that requires the use of innovative approaches to its treatment with the purpose of not only improving the patient's condition but also to minimize the treatment costs. The purpose of this research was to analyze the clinical efficacy, safety and economic feasibility of the use of the cold atmospheric plasma (CAP) in the acne therapy. Materials and methods used: the study included 176 pediatric patients aged 10 to 18 y/o (ME 16 y/o, M:F gender ratio 1:1.2) who were divided into groups depending on the severity of acne as follows: G1 with mild acne, G2 with moderate acne, and randomized into subgroups depending on the treatment methods (TM) as follows: TM1 for monotherapy with a combined external drug containing 0.1% adapalene with 2.5% benzoyl peroxide in the form of a gel, TM2 for CAP monotherapy and TM3 for combined therapy consisting of external therapy with a gel containing 0.1% adapalene with 2.5% benzoyl peroxide and the CAP treatment. The severity of acne was assessed using the acne dermatological index (ADI) and the clinical efficacy was assessed by achieving ADI0, ADI75, and ADI50. Skin moisture and pH were measured in all patients both prior to and immediately after the treatment using the PH98110 pH meter (by Kelilong, China). Adverse events (AE) were assessed during the study. The incremental cost-effectiveness ratio (ICER) was used in the pharmacoeconomic analysis. Results: during treatment in the TM1 subgroups, the full clinical effect (DIA0) was achieved in 88.89% of cases with mild acne and in 61.76% of cases with moderate acne, in the TM2 s/g, the full clinical effect was achieved in 95.24% and 68.57% of cases and in the TM3 s/g in 100% and 88.24% of cases, respectively. After the treatment, the skin pH values in patients of the TM1 s/g, G1 and G2 became lower than the reference values, TM2 and TM3 s/gs of both groups returned to normal. Skin moisture after treatment decreased in the TM1 s/g of both groups, remained the same in the TM2 s/g and the TM3 s/g of G1 and approached to normal in the TM2, TM3 s/gs of G2. AEs (lichenification, erythema and/or burning sensation of the skin) were observed in patients of s/gs TM1 and TM3 and were mild (n=24) or moderate (n=25) in severity. The ICER coefficient for the TM1 v TM3 pairwise comparison was 324,254.55 Russian rubles for G1, 184,060.00 Russian rubles for G2, and for the TM2 v TM3 comparison 25,333.33 Russian rubles for G1, 12,800.00 Russian rubles for G2, which is statistically significant (p=0.001 and p=0.04, respectively) and indicates high economic feasibility of using the TM3. Conclusion: the use of CAP in the treatment of mild to moderate acne is effective, safe and cost-effective as well.

Improving Social Equity Within Public Organizations: Authority Differentials as Reference Points for Fostering Diversity and Inclusion Within U.S. Federal Agencies

Fostering diversity and inclusion (D&I) is a major challenge confronting the contemporary American administrative state. The asymmetric distribution of authority within U.S. federal agencies is critical for understanding employee perceptions of agency D&I efforts. Leveraging data from approximately 2.51 million U.S. federal employees across 105 agencies between 2010 and 2019, the statistical evidence demonstrates that authority differentials, reflected by the relative gender and racial balance of supervisory and non-supervisory personnel within U.S. federal agencies, predict employees’ evaluations of agency efforts at fostering D&I. Although these authority differentials have similar effects on employee D&I evaluations for both men and women, minority employees exhibit more sanguine assessments of agency D&I efforts than compared to non-minority colleagues predicated on such authority differentials. The statistical relationship between authority differentials and employees’ agency D&I evaluations is most pronounced for women minority employees, as well as for those holding supervisory positions.

Too few or too many? Exploring the Link between gender dissimilarity and employee absenteeism

Despite well-intentioned gender diversity initiatives aimed at addressing gender imbalances by ensuring minimal female representation in predominantly male groups, such tokenism often exacerbates discrimination and social isolation for these women, potentially leading to absenteeism. Research suggests that the benefits of diversity are realized only when the ratio of women to men reaches a critical threshold that allows for genuine integration and participation. However, this threshold remains uncertain. We integrate tokenism theory with social identity and status characteristics theories to investigate the effects of gender ratios within organizational teams on individual absenteeism. Specifically, we theorize a U-shaped relationship between gender dissimilarity and absenteeism for women, but not for men. Study 1, with a one-year cross-lagged design, encompassing 10,332 blue-collar workers in 1064 teams, supports the U-shaped relationship for women, while the relationship for men was non-significant. In Study 2, we use an experimental design with a sample of 370 female blue-collar workers to explore two potential mechanisms that may together explain the U-shaped gender dissimilarity effect for women. We test whether the gender composition of the work group affects both women’s likelihood of reporting unpleasant experiences and the group’s norms regarding absence. We draw theoretical and practical implications from these findings.

Clinical features of chronic tibial osteomyelitis: a single-center retrospective study of 282 cases in Xinjiang, China.

Chronic osteomyelitis is a highly prevalent and severe orthopaedic complication, representing a critical unresolved issue. The clinical symptoms of osteomyelitis are influenced by various factors, including geography, lifestyle, and pre-existing medical conditions.This study aims to provide theoretical basis for treatment and prevention of osteomyelitis by investigating and analyzing clinical features and pathogen distribution among 282 patients with chronic tibial osteomyelitis in xinjiang. A total of 282 patients with chronic tibial osteomyelitis from January 1, 2012 to January 1, 2022 in the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. All data were collected from electronic medical record (EMR) system including demographics, etiology, risk factors, osteomyelitis location and clinical classification. Farmers, students, unemployed and retirees accounted for a relatively large proportion of the 282 patients. There were 233 males and 49 females with a gender ratio of 4.75:1. The average age was 40.21 ± 15.68 years and was mainly concentrated in 41-50 years, specifically, the mean age of females was slightly older than that of males. Education level was mostly primary and secondary school education, and illiteracy. Risk factors of chronic tibial osteomyelitis included history of smoking and drinking, history of multiple repeated surgeries, and impaired immunity. Frequent clinical symptoms were in the order of pain, local swelling, pus discharge and skin ulceration. Among all inflammatory markers, proportion of positive results were 30.85%, 59.93% and 53.90% for white blood cell (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), respectively. Positive rate of pathogenic microorganism culture was low and the three most common bacteria were Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa) and Escherichia coli (E. coli). The most frequent site of infection was middle tibia. According to Cierny-Mader osteomyelitis classification, the most common types were type IIIA, IVA and IIA. Number of visits due to chronic osteomyelitis increased year by year, with young and middle-aged male farmers and low education level as the main groups. Smoking and drinking were two considerable risk factors that should be attached to a great importance. No significant increase was found in inflammatory markers and lower positive rate of pathogenic microorganism culture was observed. Multi-drug resistant bacteria were common and S. aureus remained the most frequent pathogen. Elevated ESR had certain diagnostic value for osteomyelitis. Type III and type IV osteomyelitis accounted for a large proportion which posed great challenges for clinical diagnosis and treatment.

Outcomes of Surgical Repair of Adult Naso-Orbital-Ethmoid Fractures: A Systematic Review and Meta-Analysis.

Adult naso-orbital-ethmoid (NOE) fractures are estimated to account for 5% of all adult facial fractures without published consensus on management. The purpose of this investigation was to assess the available literature regarding the treatment and outcomes of adult naso-orbital-ethmoid fractures. Cochrane Library, PubMed, Scopus, and CINAHL. Following PRISMA guidelines, databases were searched from inception through July 25, 2024 for studies pertaining to the treatment of NOE fractures. Measures of interest included patient demographics, associated fractures, type of intervention, and complications. A total of 16 studies were included for meta-analysis, consisting of 459 patients. The patients included in the analysis had a mean age of 30.6 years (95% CI: 26.9-34.3 years) with a male-to-female gender ratio of 2.7:1. Operative intervention, specifically open reduction and internal fixation (ORIF) (90.1%; 95: CI: 76.6-98.1%), was the most commonly performed management. Closed reduction has been reported for all three types. The most frequently reported complications included nasolacrimal duct obstruction (38.6%; 95% CI: 10.6-71.7%), postoperative epiphora (24.9%; 95% CI: 6.4-50.4%), and telecanthus (20.9%; 95% CI: 1.7-53.5%). Surgical intervention can be considered for all NOE types. Despite surgical intervention, NOE fractures remain difficult to treat, and inadequate repair may result in complications. Laryngoscope, 2024.

Association of Abdominal Obesity and Diabetes among the Adult Tribal Population in Tamil Nadu

Background: Previously overweight and obesity are considered to be an issue of high-income countries but now increasingly becoming more prevalent in low-income and middle-income countries. Obesity and overweight are growing health issues in India. It is important to determine the quantum of the risk contribution by individual risk factor siuch as abdominal obesity. Aims: To find out the association of abdominal obesity and diabetes among the adult tribal population. Methods and Material: A cross-sectional study was conducted using multi-stage random sampling techniques. Using a pretested validated modified Stepwise questionnaire, a detailed interview with the participants aged above 30 years were performed. Random blood sugar and anthropometric parameters were estimated for all the participants. Chi-square test and multivariate regression analysis were used to study association. Results: Prevalence of abdominal obesity was 49.6% [211] among the study participants. Prevalence of diabetes was 7.8% [33] among the study population and 92.2% [392] of them were nondiabetic. Normal WHR was seen among 27.3% [9] of the diabetic individuals. High WHR was seen among 72.7% [24] of diabetic individuals. Gender, Illiterate, BMI, and waist-hip ratio shows significant association with diabetes. Conclusions: The prevalence of abdominal obesity was higher in the study population. As this burden among tribal people is on the increasing trend when compared with other general populations, effective strategies to prevent this have to be devised among the tribal population.

Gender- and personality-specific differences in academic qualifications, research motivation, and attractiveness of leadership positions: a survey among radiologists from Germany.

This study investigated gender- and personality-specific differences in academic qualifications, research motivation, and options to increase the attractiveness of leadership positions in radiology.A validated questionnaire with 66 questions was distributed via the German Roentgen Society and individually sent to 4,500 radiologists in Germany. Participants were asked about their gender. Personality dimensions were assessed using the OCEAN (Big Five) model. Multivariable regression analyses were employed.Of 510 included participants (women 237 (46.5%)), men were four times more likely to have acquired an associated professorship (AP, Habilitation Privatdozent) ((odds ratio (OR) 4.39 (2.22-8.67)). Also, they planned to achieve an AP more frequently (OR 2.87 (1.47-5.61)). The only gender-specific motivator for an AP was the option to become eligible for the position of chief physician (men OR 2.56 (1.07-6.15)). Mentors increased the probability of acquiring an AP (OR 2.07 (1.13-3.80)) or striving for an AP (4.82 (2.39-9.73)). Female mentees were likelier to have female mentors (OR 4.62 (1.68-12.73)). To increase the attractiveness of leadership positions, female radiologists perceived gender balance at the management level (OR 3.32 (2.28-4.82)), top sharing (OR 2.22 (1.48-3.32)), and better work-life balance (OR 2.02 (1.19-3.43)) as more relevant than male radiologists. More pronounced openness (OR 1.62 (1.10-2.38)) and extroversion (OR 1.45 (1.07-1.97)) were positively associated with planning an AP. More pronounced agreeableness (OR 0.67 (0.50-0.91)) was negatively associated.Research motivation is mainly independent of gender. Academic qualification varies with gender and personality dimensions. Mentoring, female role models, top sharing, and better work-family compatibility could motivate women to pursue academic leadership. · Male radiologists are more frequently motivated to pursue an associated professorship by the option of becoming a chief physician.. · Openness and extroversion make pursuing an associated professorship more likely.. · Role models at the management level, top sharing, and flexible work time are more important for female radiologists.. · Molwitz I, Kemper C, Stahlmann K et al. Gender- and personality-specific differences in academic qualifications, research motivation, and attractiveness of leadership positions: a survey among radiologists from Germany. Fortschr Röntgenstr 2024; DOI 10.1055/a-2415-7337.

Decreased Neutrophil-to-lymphocyte Ratio in Patients with Vitiligo: National Data Analysis.

Vitiligo is characterized by depigmented skin lesions involving melanocyte defects and immune dysregulation. Haematological markers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been explored in various skin disorders. Given vitiligo's proposed pathogenesis, we hypothesized differences in NLR and PLR in vitiligo patients compared to controls. In a national retrospective cohort study (2005-2020) in Israel, blood count data from patients diagnosed with vitiligo (ICD-10 codes) were analysed, excluding patients with recent infections, surgeries, or malignancies. Controls matched for age and sex were selected. Sub-analyses examined age groups, treatment type, and matched controls. Children (n = 3,796) and adults (n = 38,608) with vitiligo showed significant differences in gender distribution, cell counts, and ratios. Vitiligo patients (n = 38,358) exhibited lower NLR, decreased neutrophils and platelets, and increased lymphocytes compared with controls. Non-systemically treated vitiligo patients (n = 33,871) displayed lower NLR and neutrophils compared with matched controls. Systemically treated vitiligo patients (n = 4,487) showed lower NLR, higher PLR, and reduced lymphocytes. Logistic regression identified associations between increased lymphocyte and platelet counts and being systemically treated. This study highlights significant haematological differences in vitiligo patients, emphasizing the potential utility of NLR as an accessible tool for vitiligo assessment. Further investigations are warranted to elucidate the roles of neutrophils and lymphocytes in vitiligo pathogenesis.

The impact of physician communication skills on glycemic control in patients with diabetes mellitus

ObjectivesThe purpose of the study was to evaluate the impact of physicians’ communication skills on glycemic control in type I and II diabetes patients.MethodThis cross-sectional study was conducted at the diabetic center at King Saud University Medical City, Riyadh, Saudi Arabia. The Arabic version of the communication assessment tool was used to evaluate the patient’s perception of the physicians’ communication skills.ResultsA total of 348 patients were invited to participate in the study in which 332 filled the questionnaire completely and hence participation rate was 95.4%. The average age of the patients was 44.2 (±19.7) years with an almost equal gender ratio. The percentage of excellent ratings for most of the questions was varying between 70 and 80%. The overall percentage of excellent ratings was 75.3%. Glycated hemoglobin and other metabolic features except for diastolic blood pressure did not have any significant association with the overall mean communication assessment tool score and the percentage of excellent rating.ConclusionStudy findings provided high patient satisfaction with their physicians’ communication skills. However, diabetes and metabolic control were not affected by this satisfaction. Hence, improvement in the communication skills of the physicians is recommended.

Combination of oral anticoagulant and antiplatelet therapy does not change the 1-year prognosis compared to oral anticoagulant alone in stroke patients with atherosclerosis and atrial fibrillation

This study aims to evaluate the effectiveness of combined antiplatelet and oral anticoagulant (OAC) therapy versus OAC therapy alone on one-year post-stroke outcomes in patients with non-valvular atrial fibrillation (NVAF) and systemic atherosclerosis. A retrospective study was conducted using the recorded data of patients diagnosed with ischemic cerebrovascular disease between January 1, 2022, and January 1, 2023, at the Neurology Clinic, Afyonkarahisar Health Sciences University. Patients with non-valvular atrial fibrillation (NVAF) and systemic atherosclerosis were included in the study. Collected data included demographic information, medical history. Patients were divided into two groups based on the treatment regimen used at discharge: those receiving OAC alone and those receiving a combination of OAC and antiplatelet therapy. Clinical outcomes were evaluated within one year following the stroke. A total of 671 stroke patients were screened, and 565 (84.2%) had ischemic stroke. Among these, 113 (20%) had NVAF, and 53 had both NVAF and systemic atherosclerosis. Data from these 53 patients were analyzed. The mean age was 71.81±11.90 years, with a female gender ratio of 52.8%. Logistic regression analysis showed no statistically significant differences between the two treatment groups in terms of all-cause mortality, bleeding, recurrent stroke, and hemorrhagic stroke (p>0.05 for all comparisons). The combination of antiplatelet and OAC therapy did not demonstrate superiority over OAC therapy alone in reducing the risks of recurrent ischemic stroke, hemorrhagic stroke, myocardial infarction, and mortality in patients with NVAF and systemic atherosclerosis. These findings suggest that OAC therapy alone may provide sufficient protection in this patient population. Prospective studies with larger samples are needed to confirm these results.

A Five-Year Malaria Prevalence/Frequency in Makenene in a Forest-Savannah Transition Ecozone of Central Cameroon: The Results of a Retrospective Study.

Understanding the epidemiological features of malaria is a key step to monitoring and quantifying the impact of the current control efforts to inform future ones. This study establishes the prevalence and frequency of malaria in a forest-savannah ecozone for 5 consecutive years in Cameroon. A retrospective study was conducted in 3 health centers of Makenene from 2016 to 2020, a period covering the second long-lasting insecticide net mass distribution campaign. Malaria infectious records were reviewed from laboratory registers. The difference in exposure to malaria was estimated using a regression logistic model. A total of 13525 patients underwent malaria diagnostic tests, with a general malaria prevalence of 65.3%. A greater prevalence of malaria was observed in males (68.39%) compared to females (63.14%). The frequency of consultations in health centers was dominated by females, with a gender ratio (M/F) of 0.66. Annual trends in malaria prevalence slightly varied from 2016 to 2020, exceeding 60%: 65.2% in 2016; 66.7% in 2017, 68.1% in 2018, 63.2% in 2019, and 65.3% in 2020, with a significant seasonal variation (p < 0.0001). The highest malaria prevalence was observed during the short rainy season, no matter the year. Among positive cases, the most represented age groups were 6-15 (p < 0.0001), followed by those under 5, while the age group >25 years was the least represented. Close monitoring and additional intervention measures for malaria control are needed, as are more studies on vector bionomics and transmission patterns.

Association of specific PM2.5 chemical constituents and ozone exposure with pregnancy outcomes in women undergoing assisted reproductive technology treatment in central China

The associations of air pollutants exposure with assisted reproductive technology (ART) pregnancy outcomes are mixed, and the effects of specific components of fine particulate matter (PM2.5) and ozone (O3) are not well understood. We conducted a retrospective longitudinal study to explore the association of PM2.5 constituents and O3 exposure with three ART outcomes among women undergoing ART treatment. The exposure window was segmented into five periods corresponding to the cycle of ovarian stimulation and oocyte retrieval procedure. Generalized linear mixed model (GLMM) was applied to explore the relationships between PM2.5 constituents, O3, Normalized Vegetation Index (NDVI) exposure and three ART outcomes. The combined effect of PM2.5 constituents was evaluated by the quantile g (qg)-computation. We also explored the modifying effect of different covariate. Elevated exposure level of PM2.5 (OR = 0.915, 95% CI: 0.859, 0.974) and its constituents (BC: 0.905, 95% CI: 0.840, 0.975; OM: 0.910, 95% CI: 0.848, 0.976; NO3−: 0.909, 95% CI: 0.850, 0.972, SO42−: 0.905, 95% CI: 0.846, 0.968, and NH4+: 0.902, 95% CI: 0.842, 0.966) exposure throughout the year before oocyte retrieval (period 1) was correlated with a reduced odds ratio (OR) of live birth with statistical significance. Similarly, for each interquartile range (IQR) increase in O3 exposure during periods 2 (85 days prior to oocyte retrieval), 3 (30 days prior to oocyte retrieval), 4 (oocyte retrieval to embryo transfer) and 5 (embryo transfer to hCG test) was significantly related to a decreased OR of live birth. Especially, participants who underwent fresh embryo transfer cycles and received two cleavage-stage embryo transfer, and were younger than 30 years old, showed a higher susceptibility to particulate matter. Findings from this study suggest that PM2.5 constituents and O3 exposure may have adverse effects on the ART outcomes, highlighting the importance of identifying critical exposure periods for various air pollutants and the need for meticulous management of particulate matter.

8080 Factors Affecting Survival of Lymph Node Positive Medullary Thyroid Cancer: A Population-Based Study From Surveillance, Epidemiology, and End Results (SEER) Program

Abstract Disclosure: M. Mortagy: None. A. Abdelhameed: None. M. Hegazy: None. Introduction: 50-70% of patients with MTC have positive lymph nodes. The Aim is to identify factors affecting survival of the lymph node positive MTC sub-population. Understanding these factors is important in treating these patients. Methods 1359 patients with lymph node positive MTC who were diagnosed with positive histology or cytology from 1975 to 2020 were extracted from SEER after removing duplicates. Survival analysis was performed, and Kaplan-Meier graph was produced. Univariate and multivariable Cox regression were performed, and respective hazard ratios (HR) were generated. Results: The cohort were 54% males with a median age of 55 years. Median survival: for the cohort was 163 months with survival of 91%, 80% and 74% at 1, 3, and 5 years respectively. Univariate Cox regression was statistically significant for age (HR 1.04), female sex (HR 0.64), T4 stage (HR 2.48), M1 stage (HR 5.43), bone metastasis (HR 4.74), brain metastasis (HR 17.1), liver metastasis (HR 5.41), lung metastasis (HR 5.97), distant lymph node metastasis (HR 6.00), number of positive lymph nodes (HR 1.008), lymph node ratio (HR 4.50), tumor size (HR 1.02), multifocal tumor (HR 0.69), total number of malignant tumors (HR 1.21), not performing total thyroidectomy (HR 6.35), chemotherapy (HR 3.85), radiotherapy after surgery (HR 1.67), beam radiotherapy (HR 2.20), systemic therapy after surgery (HR 0.67). Univariate Cox regression was not statistically significant for grade, treatment delay, total number of benign tumors, race/ethnicity, income, and living in rural areas. Multivariable cox regression was done after inclusion of all significant variables from univariate Cox regression. It was only significant for number of positive lymph nodes (HR 1.03), bone metastasis (HR 0.18), liver metastasis (HR 14.57), multifocal tumor (HR 3.49), total number of malignant tumors (HR 2.66), T4 stage (HR 3.57), M1 stage (HR 3.65), not performing total thyroidectomy (HR 352.43), tumor size (HR 1.03). Conclusion: Number of positive lymph nodes, T4 stage, M1 stage, presence of liver metastasis, presence of multifocal tumor, not performing total thyroidectomy and large tumor size lead to worse prognosis. Age, gender, chemotherapy, and lymph node ratio don’t affect survival. Future research is required to study this group of patients. Presentation: 6/2/2024

7642 A Mixed Model of Clinical Characteristics and Ultrasound ACR-TIRADS Predicts Malignancy in Thyroid Micro Lesions

Abstract Disclosure: N. Angelopoulos: None. I. Iakovou: None. D. Goulis: None. R. Paparodis: None. S. Livadas: None. A. Boniakos: None. J.C. Jaume: None. Background: The frequency of papillary thyroid carcinoma (PTC) has increased, mainly due to the detection of small tumors incidentally found during unrelated imaging. While most of these small cancers have a non-aggressive course, some can be more biologically hostile, with potential for metastasis. Current guidelines discourage routine biopsy for nodules ≤10 mm, but the challenge is identifying higher-risk microcarcinomas. This study aims to identify ultrasound and clinical characteristics indicating malignancy in small thyroid lesions. Patients and methods: 151 patients with accidentally discovered solid nodules in thyroid ultrasound were enrolled in the study. All patients were stratified according to both ACR and EU-TIRADS systems. Two qualified endocrinologists performed ACR-TIRADS scoring and accordingly, all patients were stratified to the five ACR categories TR1-5 Strain elastography was also performed in all nodules and the elastography ratio (E2/E1) was calculated (E2 elastography of the nodule, E1 elastography of healthy thyroid gland). FNA was performed in nodules classified as EU-TIRADS 5 Results: 41 patients were classified as EU-TIRADS 5. The rest of the patients were classified as 69 EU-TIRADS 4, 40 EU-TIRADS 3, and one EU-TIRADS 2. According to FNA results, 11 patients had Bethesda II cytology (Group A), 2 Bethesda III, one Bethesda IV, 10 Bethesda V, and 17 Bethesda VI (V and VI comprised Group B). FNAs indicative of malignancy (Group B) were more frequent in patients with autoimmune thyroiditis (Chi-squared 5,833, df(1), p=0.015). In Group B, both ACR-scoring points and ACR-TIRADS categories were significantly higher than those detected in patients in Group A. Logistic regression analysis revealed a significant prognostic role of ACR-scoring points in discriminating suspicious FNA results for thyroid cancer. ROC analysis (AUC:0.993 with Youden Index:0.926, associated criterion &amp;gt;6, Sensitivity 92.59 % and Specificity 100 %). To analyze the predictive power of the clinical parameters in the presence of thyroid malignancy, age, BMI, gender, autoimmune disease, therapy, nodule diameter, and elastography ratio were examined in a “clinical model”. The overall prognostic value of the model was significant (p=0.0029, AUC:0.744) with a sensitivity of 77.78% and specificity of 72.73%, (Youden Index: 0.505, associated criterion &amp;gt;0.6). Finally, a “mixed model”, combining the clinical characteristics and the ACR scoring points, was generated for methodological reasons. The model was overall significant (p&amp;lt;0.001) with AUC:1 (95% Confidence interval: 0.907 to 1), Youden Index:1, sensitivity, and specificity 100%. Conclusion: ACR- TIRADS points &amp;gt; 6 may be a strong indicator of thyroid malignancy and the “mixed model” is an excellent predictor of thyroid malignancy, but its usefulness in everyday clinical practice may be cumbersome. Presentation: 6/1/2024

A New Tool for Estimating the Number of Pregnant People in the United States.

Knowing the approximate number of women of reproductive age (ie, 15-49 years) who are pregnant at a point in time in the United States can aid in emergency preparedness resource allocation. The Centers for Disease Control and Prevention (CDC) released a pregnancy estimator toolkit in 2012, which could be used to estimate the number of pregnant people in a geographic area at a point in time. This original toolkit did not account for pregnancy losses before 20 weeks of gestation; however, an updated toolkit released by the CDC in May 2024 uses a ratio of live births to estimate the number of pregnancy losses before 20 weeks at a point in time for improved estimation of total pregnant people at a point in time. We used the CDC's updated reproductive health tool, "Estimating the Number of Pregnant Women in a Geographic Area." Using publicly available data for 2020, we gathered the necessary input values, including total births, fetal deaths, and induced abortions, and applied the equation available in the CDC toolkit to estimate the number of pregnant people in the United States at any point in time in 2020. In 2020, there were 75,582,028 women of reproductive age in the United States, and we estimate that approximately 2,962,052 or 3.9% of women of reproductive age were pregnant at any point in time in the United States.

Analysis of clinical features and outcomes in patients with ocular myasthenia gravis according to anti-acetylcholine receptor antibody-seropositivity.

To comparatively analyze the clinical characteristics of patients with ocular myasthenia gravis (OMG) referred to an ophthalmology clinic, according to anti-acetylcholine receptor antibody (AchR Ab)-seropositivity. Retrospective Cohort Study. Medical records of patients with OMG who presented to a tertiary eye care center between 2003 and 2020 were retrospectively reviewed. Demographics, ophthalmologic characteristics, response to medical treatment, presence of autoimmune thyroid disease and thyroid autoantibody were compared between the AchR Ab seropositive and seronegative groups. A total of 130 patients with OMG were identified; among them, 46 patients (35.4%) had autoantibody against acetylcholine receptors. The mean age at symptom onset was 42.4 ± 18.9 years. There were no differences in mean age at symptom onset, gender ratio, and mean follow-up period between patients with seropositive and seronegative OMG. Graves ophthalmopathy was significantly more frequent in seronegative patients (p = 0.04), while thymic disease (p < 0.01) was more frequent in seropositive patients (p < 0.01). Among patients with seropositive OMG, 52.3% showed a good response to medical treatment, while only 31.4% of the seronegative patients were classified as good responders (p = 0.01). Thyroid dysfunction was found in 27.4% patients with OMG and the proportion of thyroid dysfunction was not different according to anti-acetylcholine receptor antibody-seropositivity. Seropositivity to acetylcholine receptor antibody is associated with a better response to medical treatment and lower risk of concomitant autoimmune thyroid disease in patients with OMG.