Significant Sex-related Differences Research Articles

Sex-related differences in the load-velocity and load-power relationships of the decline bench press exercise.

The purpose of this study was to analyse the load-velocity and load-power relationships of the decline bench press exercise (DBPE) and to compare sex-related differences. Twelve young healthy men and women performed a progressive loading test for the determination of 1RM strength and individual load-velocity and load-power relationship in the DBPE. A very close relationship between mean propulsive velocity (MPV) and %1RM was observed (R2 = 0.94). This relationship improved when plotting data separately by sex (R2 = 0.96-97). Individual load-velocity profiles gave an R2 = 0.99 ± 0.01. The relationship between mean propulsive power (MPP) and %1RM was R2 = 0.23. When separating data by sex, R2 = 0.64-73 were obtained. Individual load-power profiles gave an R2 of 0.93 ± 0.07. Significant sex-related differences were found for MPV, with males having faster velocities than females from 30% to 40% 1RM (p = 0.01) and for MPP, with males having greater MPP (W) than females from 30% to 95% 1RM (p < 0.001). The results of this study show that a strong correlation exists between relative load and MPV/MPP in the DBPE, allowing the possibility of using one to predict the other with great precision, especially when a sex-specific equation is used.

Trends in Sex Differences of Functional Outcome after Intravenous Thrombolysis in Patients with Acute Ischemic Stroke.

Intravenous thrombolysis (IVT) is an approved treatment for patients with acute ischemic stroke irrespective of sex. However, the current literature on sex differences in functional outcomes following IVT is inconsistent. So far, a number of studies - including a previous analysis based on data from the Austrian Stroke Unit Registry (ASUR) - detected significant sex-related differences in functional outcome, while others did not report any differences between women and men. In addition, currently there is a lack of data on how sex-related differences evolve over time. To assess time trends of sex-related differences in functional outcome of ischemic stroke in a large nationwide cohort and to investigate associations of patient characteristics with functional outcome post thrombolysis in women and men. These data will offer crucial insights into whether sex differences in functional outcome persist despite the large advances in acute stroke treatment. We analyzed retrospective data of consecutive patients with acute ischemic stroke treated with IVT in 39 stroke centers contributing to the ASUR between 2006 and 2021. We included patients over 18 years of age diagnosed with an acute ischemic stroke who received IVT and with available data on functional outcome at 3 months after treatment. The primary outcome parameter was favorable functional outcome (modified Rankin Scale (mRS) of 0-2) at 3 months. Multivariable logistic regression analysis was performed in the overall population and stratified by sex to assess associations of baseline characteristics with functional outcome. Among 11840 patients receiving IVT, 2489/5503 (45.4%) women achieved favorable functional outcome compared to 3787/6337 (59.8%) men. Overall, female sex was a statistically significant predictor of functional outcome after thrombolysis, but additional predictors of outcome differed between women and men. Female sex was independently associated with decreased chances of achieving functional independency (adjOR 0.87, 95%CI 0.79-0.96, p=0.005) and we detected a statistically significant improvement in functional outcome over time only in men (year of treatment, adjOR (per year) 1.04, 95%CI 1.02-1.06, p<0.001) but not in women (adjOR (per year) 1.01, 95%CI 0.99-1.03, p=0.280). Hypertension, smoking, and longer or unknown onset-to-door times were statistically significant predictors of outcome only in male patients, whereas atrial fibrillation, prior myocardial infarction and longer door-to-needle times were significantly associated with outcome only in women. Sex differences in functional outcome after IVT for acute ischemic stroke are persisting over the past years. Results of our analysis can increase awareness and a resulting focus on sex differences in predictors of outcome could be helpful in mitigating these differences in the future by supporting a more individualized patient care in clinical routine. Follow-up analyses are needed to assess this potential impact and its effect in the future.Data access statement: Data from the Austrian Stroke Unit Registry can only be accessed by the employed statistician (DM), access inquiries have to be addressed to the registry's academic review board.

Effect of sex on chronic stress induced alterations in hindbrain catecholaminergic system and autonomic dysfunction resulting in gastrointestinal dysmotility

It has been reported that the clinical symptoms of functional dyspepsia (FD) exacerbate upon stress while the gender-related factors have been incompletely understood. This study aims to investigate the role of sex in chronic heterotypic stress (CHS)-induced autonomic and gastric motor dysfunction. For CHS, the rats were exposed to the combination of different stressors for 7 consecutive days. Subsequently, electrocardiography was recorded in anesthetized rats to evaluate heart rate variability (HRV) for the determination of autonomic outflow and sympathovagal balance. Solid gastric emptying (GE) was measured in control and CHS-loaded male and female rats. The immunoreactivities of catecholaminergic cell marker tyrosine hydroxylase (TH), choline acetyltransferase (ChAT), corticotropin releasing factor (CRF), and estrogen receptor (ER-α/β) were evaluated in medullary and pontine brainstem sections by immunohistochemistry. Compared with the controls, CHS significantly delayed GE in males but not in females. There was no significant sex-related difference in parasympathetic indicator HF under either control or CHS conditions. Sympathetic indicator LF was significantly higher in control females compared to the males. The higher sympathetic output in females was found to be attenuated upon CHS; in contrast, the elevated sympathetic output was detected in CHS-loaded males. No sex- or stress-related effect was observed on ChAT immunoreactivity in the dorsal motor nucleus of N.vagus (DMV). In males, greater number of TH-ir cells was observed in the caudal locus coeruleus (LC), while they were more densely detected in the rostral LC of females. Regardless of sex, CHS elevated immunoreactivity of TH throughout the LC. Under basal conditions, greater number of TH-ir cells was detected in the rostral ventrolateral medulla (RVLM) of females. In contrast, CHS remarkably increased the number of TH-ir cells in the RVLM of males which was found to be decreased in females. There was no sex-related alteration in TH immunoreactivity in the nucleus tractus solitarius (NTS) of control rats, while CHS affected both sexes in a similar manner. Compared with females, CRF immunoreactivity was prominently observed in control males, while both of which were stimulated by CHS. ER-α/β was found to be co-expressed with TH in the NTS and LC which exhibit no alteration related to either sex or stress status. These results indicate a sexual dimorphism in the catecholaminergic and the CRF system in brainstem which might be involved in the CHS-induced autonomic and visceral dysfunction occurred in males.

Predictors of Mortality in Infective Endocarditis: A Retrospective Study

Introduction: Infective endocarditis (IE) remains a major health problem with significant morbidity and mortality rates. Despite its serious implications, data on prognostic factors remain scarce. Aim: We aim to determine predictive factors of mortality during infective endocarditis. Methods: We performed a retrospective study including patients admitted to university hospital Mohammed 6 of Marrakech between September 2019 and January 2024 for a confirmed IE based on Dukes modified criteria. Results: Of 43 patients included, 30 were males (69%) and 13 were females (30%). The mean age was 47.4 for men and 49.30 for women. 44.1% of our patients were admitted in heart failure, and 37% presented themselves late to our facility for management. Only 25.58% suffered from kidney failure and 55.8% presented an LV dysfunction. Complications were noted at a rate of 48%. Male’s group had less complication rate with 10% vs 38% in females’ group (p=0.042). And an overall mortality rate was at 34% and there were no significant sex related differences in terms of mortality between the two groups (33% in males vs 38% in females, p = 0.742). The analytical study concluded that heart failure at admission(p&lt;0.001), neurological complications(p=0.024), anemia (p=0.049), kidney failure (p=0.002), prolonged antibiotics (p=0.016), LV dysfunction (p=0.027) and an emergency surgery (p&lt;0.001) were independent risk factors for mortality. Conclusion: Our study underscores the urgent need to identify predictive factors of mortality in infective endocarditis (IE), and to adopt a multidisciplinary approach to enhance the care and management of patients, ultimately aiming to improve their survival rates.

Structural and functional alteration of the gut microbiota in elderly patients with hyperlipidemia.

To investigate the structure, composition, and functions of the gut microbiota in elderly patients with hyperlipidemia. Sixteen older patients diagnosed with hyperlipidemia (M group) and 10 healthy, age-matched normal volunteers (N group) were included. These groups were further subdivided by sex into the male normal (NM, n = 5), female normal (NF, n = 5), male hyperlipidemia (MM, n = 8), and female hyperlipidemia (MF, n = 8) subgroups. Stool samples were collected for high-throughput sequencing of 16S rRNA genes. Blood samples were collected for clinical biochemical index testing. Alpha- and beta-diversity analyses revealed that the structure and composition of the gut microbiota were significantly different between the M and N groups. The relative abundances of Bacteroides, Parabacteroides, Blautia, Peptococcus, and Bifidobacterium were significantly decreased, while those of Lactobacillus, Helicobacter, and Desulfovibrio were significantly higher in the M group. There were also significant sex-related differences in microbial structure between the NM and NF groups, and between the MM and MF groups. Through functional prediction with PICRUSt 2, we observed distinct between-group variations in metabolic pathways associated with the gut microbiota and their impact on the functionality of the nervous system. Pearson's correlation coefficient was used as a distance metric to build co-abundance networks. A hypergeometric test was used to detect taxonomies with significant enrichment in specific clusters. We speculated that modules with Muribaculaceae and Lachnospiraceae as the core microbes play an important ecological role in the intestinal microbiota of the M group. The relative intestinal abundances of Agathobacter and Faecalibacterium in the M group were positively correlated with serum triglyceride and low-density lipoprotein levels, while the relative abundance of Bifidobacterium was negatively correlated with the serum lipoprotein a level.

Mercury and rare earth elements (REEs) show different spatial trends in feathers of Kentish plover (Charadrius alexandrinus) breeding along the Adriatic Sea coast, Italy.

Feather analysis is an ethical and effective method for assessing the exposure of wild birds to environmental contamination due to trace elements and organic pollutants. We used feather to monitor the exposure to three toxic and non-essential metals (Hg, Cd, and Pb) and rare earth elements (REEs) of Kentish plover (Charadrius alexandrinus) breeding in different coastal areas (Veneto, Emilia-Romagna, Marche, Abruzzo, and Apulia) along the Italian coast of the Adriatic Sea. Feathers (n = 113) were collected from April to June. Feather concentrations evidenced a significant exposure to Hg (13.05 ± 1.71 mg kg−1 dw) and REEs (447.3 ± 52.8 ng g−1 dw) in the Kentish plover breeding in Veneto (n = 21) compared to the other coastal areas, with several individuals showing Hg concentrations above the adverse effect (5 mg kg−1 dw) and high-risk (9.14 mg kg−1 dw) thresholds reported for birds. Higher REE concentrations compared to Marche (n = 29), Abruzzo (n = 11) and Apulia (n = 13) were also reported for birds breeding in Emilia-Romagna (474.9 ± 41.9 ng g−1 dw; n = 29). The exposure to Cd and Pb was low in all the coastal areas, and only a few samples (n = 6 and n = 4 for Cd and Pb, respectively) exceeded the adverse effect thresholds (0.1 and 4 mg kg−1 for Cd and Pb, respectively). A significant sex-related difference was observed for REE-concentrations, with females showing higher concentration than males. These data highlight the need to monitor the exposure of the Kentish plover to Hg and REEs, especially in the northern basin of the Adriatic Sea, since these elements might negatively affect species' reproductive success and threaten its conservation.

Customized Landing Task for ACL Injury Risk Assessment: Kinematic Sex-Related Differences.

Women present a higher anterior cruciate ligament (ACL) injury rate than men, suggesting sex-related biomechanical differences. Task characteristics are often fixed for both sexes, possibly affecting the perceived difficulty. We investigated kinematic sex differences across landing tasks for ACL injury risk assessment, adjusted to participants' anthropometrics/performance, and whether different tasks affect kinematic sex comparisons. Female subjects would exhibit motion patterns more associated with ACL injury risk, and sex-related differences may depend on task type. Descriptive laboratory study. Level 3. A total of 27 female and 29 male amateur players (18-30 years) executed horizontal hop, drop jump (DJ), and DJ followed by vertical or forward jump (length, proportional to maximal forward jump; box, 20% participant's height). An optoelectronic system provided lower limb kinematics at initial contact and peaks until maximum knee flexion (KF), analyzed separately by multivariate analysis of variance (MANOVA) (α = 0.05). At initial contact, the interaction term had significant effects on hip adduction (P < 0.01) and knee abduction (KAb) (P = 0.04); female participants demonstrated higher KAb (P < 0.01) and knee internal rotation (P = 0.05). For peaks analysis, the interaction term had no significant effects on any individual variable, although significant in MANOVA; female participants had higher KAb (P = 0.01) and lower KF (P = 0.04). Task type affected hip flexion and knee angles in both analyses. All variables in which significant sex-related differences were found are potential ACL injury risk factors, and all findings indicate that the analyzed female sample exhibited higher injury-related patterns. Although customized, male and female participants showed different landing strategies depending on the task. The findings underline how female participants adopted potentially harmful kinematics while executing customized landing tasks (adjusted by subject's anthropometrics/performance), which may enhance risk of ACL injury.

Differences between male and female patients with pilonidal disease

BackgroundPilonidal disease begins in puberty when males and females have different sex hormone expression. We hypothesize that sex differences can lead to clinical differences in pilonidal disease. MethodsPatient demographics, Fitzpatrick skin type, hair characteristic, presentation, pain score, recurrence were recorded 2019–2022. All patients underwent regular epilation+/-pit excision. Excised pits were stained for estrogen receptor, progesterone receptor, and androgen receptor. Results237 patients (110F, 127 M) were followed 351±327days. Females present younger than males (17.5 ± 3.9 vs.18.4 ± 3.6years). While no sex-related differences noted in recurrence rate (4.5% vs.7.9 %) or skin type, there were significant sex-related differences in hair amount, thickness, density, and color. More males had granuloma than females (34% vs.12 %): 63 % granuloma were located left of midline, 30 % right, 7 % center. More males than females presented with drainage (67% vs.35 %). Significant differences were noted in patient-reported pain: Females’ mean initial pain score was higher than that of males’ (5.6 ± 2.5 vs.4.7 ± 2.2). 35 % females had menstruation-related gluteal cleft pain (MRGCP), not associated with recurrence or pads/tampons use. Females on contraceptives (15.5 %females) had lower pain score than those who were not (3.9 ± 2.7 vs.5.8 ± 2.4) and none of these females reported MRGCP. Patients with drainage had lower pain score than those without (4.5 ± 2.4 vs.5.8 ± 2.2). Excised pits from females with MRGCP had higher proportion of fibroblasts stain positive for estrogen receptor and androgen receptor compared to those without MRGCP (28.4 %±9.0 %vs.14.4 %±6.5 %, 18.0 %±11.7 %vs.6.9 %±9.0 %, respectively). ConclusionsMale and female pilonidal patients differ in pain intensity, drainage, and granuloma formation. More fibroblasts with estrogen receptor and androgen receptor expression is a potential mechanism for MRGCP that is ameliorated by contraceptive use.

Gut Biogeography Accentuates Sex-Related Differences in the Murine Microbiome.

Recent studies have highlighted the influence of factors such as sex and sex-linked hormones on microbiome composition, raising concerns about the generalizability of findings. Here, we explore whether gut geography, specifically the upper and lower gastrointestinal tract (GI), contributes to sex-linked microbiome differences in mice. We collected microbial samples throughout the length of the GI from male and female C57B6/J mice at 6- and 8-weeks old, and conducted 16S rRNA sequencing. Our findings revealed significant sex-related differences, with Clostridium_sensu_stricto_1 more abundant in the male colon, while females exhibited higher levels of Dubosiella newyorkensis across all organs at 6 weeks. We also observed decreased Shannon alpha diversity in the small intestine compared to the lower GI, and this diversity decreased further at 8 weeks. Interestingly, our results suggest that age mitigates sex-related, but not gut geography-related differences in beta diversity, with implications for experimental outcomes and treatment strategies. This study underscores the dynamic nature of microbial diversity, influenced by sex, age, and GI localization, emphasizing the need for a more comprehensive understanding of microbiome dynamics in experimental research and clinical interventions.

Radiologic Examination of High Riding Vertebral Artery and Analysis of Secure Areas

ObjectiveTo radiologically examine the pedicle, lamina, and vertebral artery foraminal anatomies at the C2 vertebra for pedicular and laminar screw instrumentation at the axis in a Turkish population. Materials and MethodsFrom 2018 to 2019, we evaluated 100 patients who underwent cervical computed tomography (CT) for various reasons (excluding cervical pathologies) at Marmara University Hospital. The C2 pedicles were measured on CT images using measurement tools. In addition, axial computed tomography was performed at 0.1-mm intervals. Bilateral measurements were performed for each case. ResultsThe median right and left pedicle axial diameters were respectively 5.01 and 5.09 mm for the male patients and 4.31 and 4.38 mm for the female patients, showing a statistically significant difference between the sexes (p < 0.01). Of the patients, 15% had narrow pedicles. The pedicle sagittal diameters were smaller than 5 mm in 30% of the computed tomographic series. The internal height was <2 mm in 4% of the cases. ConclusionOur findings suggest significant individual and sex-related differences. Vertebral artery groove anomalies are commonly observed. Before performing a posterior craniocervical instrumentation surgery, a CT examination is beneficial because high-riding vertebral arteries must be kept in mind in determining the appropriate screw diameter and screw trajectory.

Electromyographic Activity of Lower Limb Muscles during Ankle Destabilizing Tests.

Ankle destabilizing devices were developed to improve the recruitment of the evertor muscles. Nevertheless, the activity of lower-leg muscles has never been compared to each other during functional tests performed with destabilization. The objectives were i) to compare the electromyographic activity between the lower-leg muscles during four functional tests performed with ankle destabilization, and ii) to determine sex-related differences in neuromuscular activation. Twenty-six healthy volunteers (13 males, 13 females) performed the modified Star Excursion Balance Test (mSEBT), unipedal balance and weight-bearing inversion and eversion tests with a destabilizing device, while recording electromyographic activity of the peroneus longus and brevis, tibialis anterior, gastrocnemius lateralis and gluteus medius. The activity of peroneal muscles was significantly greater than other muscles during all functional tests. Furthermore, the anterior direction of the mSEBT was the one implying the greatest activity of the peroneus longus muscle compared to the posteromedial (p=0.003) or posterolateral (p<0.001) directions. Finally, no significant sex-related differences in neuromuscular activity were reported. This study highlights the effectiveness of the destabilizing device to involve specifically the peroneal muscles when performing various functional tests. This device should be used by clinicians to be more specific to the stabilizers of the ankle joint during functional exercises.

Sex-related disparities in cardiac masses: clinical features and outcomes

Abstract Background Cardiac masses (CM) represent a heterogeneous clinical scenario. Sex-related differences of these patients remain to be established. Purpose: To evaluate sex-related disparities in CMs regarding clinical presentation and outcomes. Material and Methods Thestudy cohort included 321 consecutive patients with cardiac mass enrolled in our Centre between 2004 and 2022. A definitive diagnosis was achieved by histological examination or, in case of cardiac thrombi, with radiological evidence of thrombus resolution after anticoagulant treatment. All-cause death at follow-up was evaluated. Multivariable regression analysis was performed to assess potential prognostic disparities between men and women. Results Out of 321 patients with CM, 172 (54%) were female. Women were more frequently younger (p=0.02) than men. Regarding CM histotypes, females were more frequently affected by benign masses (with cardiac myxoma above all), while metastases were more common in men (p&amp;lt;0.001). At presentation, peripheral embolism occurred predominantly in women (p=0.03). Echocardiographic features such as greater dimension, irregular margin, infiltration, sessile mass and immobility were far more common in men. Despite a better overall survival in women, no sex-related differences were observed in the prognosis of benign or malignant masses. In fact, at multivariate analyses, sex was not independently associated with all-cause death. Conversely, age, smoking habit, malignancy and peripheral embolism resulted independent predictors of mortality. Conclusion In a large cohort of heart masses, a significant sex-related difference in histotype prevalence was found: benign CMs affected female patients more frequently, while malignant tumours affected predominantly men. Despite better overall survival in women, sex does not influence prognosis in benign and malignant masses.

Abstract 14894: The Impact of Coronary Artery Disease on Cardiovascular Events Differs Between Men and Women in the PARTNER Trials

Introduction: Among individuals with severe aortic stenosis (AS), there is significant heterogeneity in the burden of coronary artery disease (CAD). Hypothesis: We hypothesize that a greater CAD burden will be associated with increased adverse events after AS treatment. Methods: Patients with severe AS in the PARTNER (Placement of Aortic Transcatheter Valves) 1, 2 and 3 trials and registries were categorized by CAD burden. Clinical characteristics, imaging, treatment, and outcomes were compared between those with obstructive CAD [defined invasively as coronary stenosis ≥50%, prior myocardial infarction (MI) or revascularization] and patients with no or non-obstructive CAD (all stenoses &lt;50% and no prior MI or revascularization). The primary endpoint was cardiovascular (CV) death or heart failure (HF) hospitalization at 2 years. Results: Among 8058 patients with severe AS, 2200 (27.3%) had non-obstructive or no CAD and were more likely to be female (61.2%) with fewer CAD risk factors. Left ventricular (LV) mass index and LV dimensions were smaller and LV ejection fraction was higher among those with non-obstructive or no CAD. TAVR was performed in 72.0% of non-obstructive or no CAD patients and in 81.3% of patients with obstructive CAD (p&lt;0.0001); the remaining patients received SAVR. After adjustment for clinical, imaging, and AS treatment differences, the rate of CV death or HF hospitalization was higher among those with obstructive CAD (HR 1.16, 95% CI: 1.03-1.30, p=0.01). However, there was a significant sex-related difference in the primary outcome particularly between males and females with non-obstructive or no CAD, p interaction =0.003 (Figure). Conclusions: Patients with a greater burden of CAD had worse clinical outcomes after treatment for severe AS. However, there was a significant interaction by sex. Further study is needed to understand the increased CV risk among females compared to males with non-obstructive or no CAD.

Age-related differences in the severity of sexual dysfunction symptoms and psychological distress in individuals with multiple sclerosis.

Sexual dysfunction (SD) is a common symptom for many with multiple sclerosis (MS). However, SD research in general appears to often overlook young adults within their samples, which can be a major issue for better understanding and treatment for the MS population. Few studies have compared age-related differences in distress in response to physical disability. Research has also found that many people diagnosed with MS do not discuss any SD struggles with their providers. The present study hopes to see whether age-related differences exist in the reporting of the levels of primary, secondary, and tertiary SD, as defined by subscale scores of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and amount of distress, as defined by the 12-Item Short Form Health Survey (SF-12)'s Mental Component Summary (MCS-12). Additionally, we hope to determine if there are any age-related or sex-related differences in help-seeking behaviors for SD. Study participants were recruited from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Participants completed the MSISQ-19, SF-12, and Patient Determined Disease Steps (PDDS), provided demographic information, and responded if they received medical or psychological treatment for SD. Study participants were 5815 respondents (Mage=51 years, SD=9.63, 75% female, 30% having attained a high school diploma, 35% scoring "advanced disability" on the PDDS). Young adult (19-39 years), middle adult (40-64 years), and mature adult (65-older) were compared on SD. Linear mixed effects modeling revealed that the MSISQ-19 subscale scores were significantly predicted by secondary SD (t=2.48, p<.13). Young adult participants had the lowest primary SD (M=13.87, 95% CI [13.13, 14.61]) when compared to mature adult (M=14.12, 95% CI [13.27, 14.97]) and middle adult participants (M=14.44, 95% CI [14.21, 14.66]), though none were statistically significant. Mature adults had the lowest secondary SD (M=16.50, 95% CI [15.65, 17.35]), a statistically significant difference from the middle adults (M=18.20, 95% CI [17.97, 18.42]) and young adults (M=18.91, 95% CI [18.17, 19.65]). Mature adults had the lowest tertiary symptoms (M=10.12, 95% CI [9.27, 10.96]), followed by young adults (M=12.23, 95% CI [11.48, 12.97]), and middle adults (M=11.65, 95% CI [11.43, 11.88]), though none were statistically significant. Hierarchical multiple regressions found that age had the most significant impact on SD. When SF-12 MCS-12 was added, linear mixed effects did not reveal any statistically significant results between the age groups and SD levels. In contrast, hierarchical multiple regressions found that SF-12 MCS-12 scores had the most significant impact on SD. There were significant age-related and sex-related differences in help-seeking behaviors in those who sought psychological counseling as opposed to medical treatment for SD. Our study has highlighted the importance of clinicians assessing for SD and psychological distress within their patients and to consider potential differences in symptom presentations of age groups to better address their unique needs.

Macrotraumatic Fractures of the Multisegmented Ankle-Foot Complex in Military Tactical Athletes: A Cohort Study.

Ankle-foot injuries are common in military personnel and substantially degrade function and force readiness. The purpose of this retrospective cohort study was to assess the incidence and contributing factors of traumatic ankle-foot fractures in the US military. A population-based study of all service members in the US military was performed assessing the factors of sex, occupation, service branch, rank, and year on segmental tibia-fibula, rearfoot, and forefoot fracture incidence between 2006 and 2015. The Defense Medical Epidemiology Database was queried for the number of individuals with fractures of the tibia-fibula, rearfoot, and forefoot using International Classification of Diseases, Ninth Revision, Clinical Modification on the initial medical encounter. Unadjusted relative risk (RR) calculations were performed assessing sex and occupation. A negative binomial regression assessed the adjusted factors of sex, branch, rank, and year. During this study, 95,540 enlisted service members (8.4 per 1,000 person-years) and 13,318 military officers (5.8 per 1,000 person-years) were diagnosed with ankle-foot fractures. In the adjusted analysis, sex was found to only be a significant factor in forefoot fractures (RR, 1.54), with female service members having a significantly higher risk. There were no significant sex-related differences observed in tibia-fibula or rearfoot fractures. US Navy and Air Force personnel had significantly lower risk of tibia-fibula fractures (RR range, 0.76-0.84) compared with the US Army. Forefoot fracture risk was significantly higher in the US Marine Corps (RR, 1.47) compared with the US Army. Officers had consistently lower risk for fractures in each segment (RR range, 0.68-0.77) compared with enlisted personnel. Enlisted engineers, aviation, and artillery/gunnery compared to infantry, and ground/naval gunfire officers had the greatest relative risk compared all other officer fields (RR range, 1.11-3.67). Sex, occupation, branch, and rank were salient factors for macrotraumatic ankle-foot fractures. These findings can be used to inform and increase precision in medical planning and in the targeted development of preventive interventions.

Team USA injury and illness incidence at the 2022 Beijing Winter Olympic and Paralympic Games

ObjectiveThe purpose of this study was to determine the injury and illness incidence from Team USA athletes from the 2022 Beijing Winter Olympic and Paralympic Games and assess any sex-based...

Long latency reflexes of the median nerves in healthy adults.

Long latency reflexes (LLRs) are late responses in nerve conduction studies seen after peripheral nerve stimulation during submaximal muscle contraction. They follow a short latency reflex, also known as the H reflex, and are thought to involve transcortical pathways, providing a measure of proximal nerve and central conduction. For this reason, they have been evaluated in several central nervous system diseases, but reference values are not widely published and are mostly based on old studies with very small numbers of participants. Therefore, in this work we aim to provide comprehensive reference values for LLR testing. LLRs were tested in a cohort of 100 healthy participants, testing the median nerve bilaterally. Mean latencies for short latency reflex (SLR), LLR1, LLR2, and LLR3 were 27.00, 38.50, 47.60, and 67.34 milliseconds, respectively. The allowable side-to-side difference was approximately 3 to 4 milliseconds. No significant sex-related differences were seen. Height correlated moderately with the SLR latency, but only weakly with LLR1, LLR2, and LLR3. This work provides normal LLR values for comparison with future studies in disease. The technique used may allow for improved evaluation of central nervous system or proximal peripheral nerve disorders.

Multi-slice CT Analysis and Identification of Anatomical Types of Segmental Bronchi in Right Superior Lobe.

The aims were to assess different branching patterns of segmental bronchi in the right superior lobe (RSL), as well as to investigate the anatomical diversity and sex-related variations of these branches in a large sample of the research population. 10,000 participants (5428 males, and 4,572 females, mean age 50+/-13.5 years [SD] years; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. Following that, the reconstructed images were interpreted to identify and categorize various bronchial patterns in the RSL. Cross-tabulation analysis and the Pearson chi-square test (χ2) were used to calculate the component ratios of bronchial branch types and determine their relevance between male and female groups. Our results revealed mainly six types for the RSL bronchial tree, i.e., (B1, B2, B3, 60.70%); (B1+2, B3, 18.72%); (B2+3, B1, 6.68%); (B1+3, B2, 7.57%); (B1, B2, B3, B*, 3.19%); (B1a+B3, B1b+B2, 3.14%). There were significant sex-related differences in the proportion of bronchial branches in the RSL (P< 0.05). The current study has validated the presence of segmental bronchial variations in the RSL. These findings may have significant implications for diagnosing symptomatic patients and performing particular procedures, including bronchoscopy, endotracheal intubation, and lung resection.

Identification of anatomical types of segmental bronchi in left superior and lingular lobes using multi-slice CT.

The objectives of this study were to evaluate various branching patterns of segmental bronchi in the left superior and lingular lobes and to survey the anatomical diversity and sex-related differences of these branches in a large sample of the study population. Overall, 10,000 participants (5428 males, and 4572 females, mean age 50 ± 13.5years [SD] years; age range: 3-91years) who underwent multi-slice CT (MSCT) scans between September 2019 and December 2021 were retrospectively included. Using the syngo.via post-processing workstation, the data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree. The reconstructed images were then interpreted to identify and categorize distinct bronchial patterns in the left superior and lingular lobes. Cross-tabulation analysis and the Pearson Chi-square (χ2) test were used to calculate the constituent ratios of bronchial branch types and determine their significance between male and female groups. Our results revealed mainly four distinct types for the left superior lobe (LSL) bronchial tree, i.e., (B1 + 2, B3, 76.13%); (B1 + 2 + 3, 17.32%); (B1 + 3, B2, 5.74%); (B1a + B3, B1b + B2, 0.81%) and two types for the left lingular lobe (LLL) bronchial tree, i.e., (B4, B5, 91.05%); (B4, B5, B*, 8.95%). There were no significant sex-related differences in the proportion of bronchial branches in LLL (P > 0.05). However, sex-related differences were significant in the proportion of bronchial branches in LSL (P < 0.05). The current study has validated the presence of segmental bronchial variations in the left superior and lingular lobes. These findings may have a crucial effect on the diagnosis of symptomatic patients, as well as in carrying out procedures such as lung resections, endotracheal intubation, and bronchoscopies.

Assessment of the distribution and volume of air chambers around the inner auditory canal on high-resolution computed tomography scans of the temporal bone.

Assessment of the distribution and volume of air chambers around the inner auditory canal on high-resolution computed tomography scans of the temporal bone.