Sex Type Research Articles

A comprehensive scoping review and meta-analysis of upper limb strength asymmetry

The “10% rule” of handedness asserts the dominant hand is 10% stronger than the non-dominant hand. Primarily derived from handgrip data, it is unclear if a generalized asymmetry exists across the upper limb. Understanding how strength asymmetry may be affected by handedness, sex, and exertion type has important implications for ergonomics design, sports performance, and clinical rehabilitation. The purpose of this study was to systematically synthesize currently available evidence examining upper limb strength asymmetry. 10,061 results were retrieved, and 174 studies remained after title/abstract screening. 87 studies were synthesized. Results are compiled by exertion type and manner of asymmetry comparison (i.e. right/left, dominant/non-dominant). Asymmetry ratios were calculated to examine the effects of handedness, exertion side, arm region, and sex. Strength differences were most frequently reported for grip exertions (n = 49). 25 studies reported other joint strength asymmetries. Overall, the right limb was 6.7% stronger than the left limb (n = 9342) and the dominant limb was 11.6% stronger than the non-dominant limb (n = 9327), though strength asymmetry varied across joints and movements (2.1% to 19.5%). This research demonstrates that the 10% rule is a good approximation for upper limb strength asymmetry. However, several factors, including joint, movement type, and sex, can affect this relationship.

Differences in athlete’s left ventricular morphology by sex and sports discipline categories in elite Japanese athletes

ABSTRACT Objectives The cardiac morphology of elite athletes is related to sports disciplines and race; however, no studies have examined the effects of sports discipline on East Asian athletes. Therefore, this study aimed to assess left ventricular (LV) remodeling using transthoracic echocardiography in elite Japanese athletes and establish standard values for the indicators of the cardiac morphology of elite athletes in East Asia, considering the influence of body size. Methods We retrospectively evaluated 1,363 elite Japanese athletes who underwent electrocardiography and transthoracic echocardiography between January 2011 and December 2021. The athletes were assigned to four sports discipline categories (skill, power, mixed, and endurance). We evaluated the differences in LV volume and mass between the groups for each sex. Results The LV end-diastolic volume (LVEDV) and LV mass indexed to the body surface area (BSA) in the endurance group (LVEDV/BSA: 72.3 ± 11.4 mL/m2 in males and 68.7 ± 11.0 mL/m2 in females, LV mass/BSA: 121.1 ± 19.1 g/m2 in males and 106.5 ± 18.0 g/m2 in females) were significantly larger than those of any other groups. Both values were affected by sex, BSA, and endurance sport type, whereas only LV mass was affected by age. Conclusion Cardiac remodeling is proportional to the sport type, with a significantly greater effect in athletes playing endurance sports. The remodeling is particularly evident in the left ventricle; however, the corresponding remodeling is also observed in other heart chambers. Cardiac remodeling in elite Japanese athletes is similar to that observed in elite athletes of other races, except for the changes in LV wall thickness.

Differential antibody response to EBV proteome following EBVST immunotherapy in EBV-associated lymphomas

Epstein-Barr virus (EBV) is associated with a diverse range of lymphomas. EBV-specific T-cell (EBVST) infusions have shown promise in safety and clinical effectiveness in treating EBV-associated lymphomas; however, not all patients respond to T-cell immunotherapies. To identify EBV-antigen specific antibody responses associated with clinical outcomes, we comprehensively characterized the antibody responses to the complete EBV proteome using a custom protein microarray in 56 EBV-associated lymphoma patients who received EBVST infusions enrolled in Phase I clinical trials. Responders (non-progressors) and non-responders (progressors) had distinct antibody profiles against EBV. Twenty-five IgG antibodies were significantly elevated in higher levels in non-responders compared to responders at 3 months post-EBVST infusion. Ten of these remained significant after adjustment for sex, age, and cancer type, including LMP2A (four variants), BGRF1/BDRF1 (two variants), LMP1, BKRF2, BKRF4, and BALF5. Random forest analysis identified these 10-IgG antibodies as key predictors of clinical response. Paired analyses using blood samples collected at both pre-infusion and 3 months post-EBVST infusion indicated an increase in the mean antibody level for six other anti-EBV antibodies (IgG: BGLF2, LF1, BGLF3; IgA: BGLF3, BALF2, BBLF2/3) in non-responders. Overall, our findings suggest that these EBV-directed antibodies as potential serological markers for predicting clinical responses to EBVST infusions and as therapeutic targets for immunotherapy in EBV-positive lymphomas. NCT01555892 - Cytotoxic T-Lymphocytes for EBV-positive Lymphoma, GRALE NCT02973113 - Nivolumab With Epstein Barr Virus Specific T Cells (EBVSTS), Relapsed/Refractory EBV Positive Lymphoma (PREVALE) NCT02287311 - Most Closely Matched 3rd Party Rapidly Generated LMP, BARF1 And EBNA1 Specific CTL, EBV-Positive Lymphoma (MABEL)

Cancer Mortality by Ethnicity in Colombia Between 2011 and 2022: A Population-Based Study

ObjectivesTo examine cancer mortality rates in Colombia by ethnic groups (Indigenous, Rom, Raizal, Afro-Colombian, and Mestizo) and assess trends from 2011 to 2022.MethodsNational vital statistics from death certificates and the Colombian census data were used. Crude and direct age-standardized mortality rates were determined by ethnicity for the study period, by year, sex, and cancer type and Joinpoint analysis was conducted to examine trends.ResultsAge-standardized cancer mortality of Mestizos (60.1 per 100,000 population) was lower than in Rom and Raizales (557.3 and 77.7 per 100,000), and higher than for Afro-Colombians and Indigenous (37.2 and 20.0 per 100,000). Indigenous people in Colombia had greater proportions of individuals under 45 dying of cancer than Mestizos (18.7% vs. 9.7%, p-value = <0.01). Compared to the Mestizo population, Raizales and Afro-Colombians experienced disproportionately higher age-standardized mortality rates due to prostate cancer (26.6/100,000 and 8.6/100,000 vs. 8.1/100,000), and for Raizales and Rom breast cancer (14.0/100,000 and 103.2/100,000 vs. 9.1/100,000).ConclusionThe disparities in cancer mortality in ethnic minorities in Colombia call for investigating cancer etiology and access to care among the Rom and the Raizal populations.

Acute Open Reduction and Internal Fixation versus Non-Operative Treatment of Scapular Spine Fractures after Reverse Shoulder Arthroplasty: A Propensity Score-Matched Study.

Scapular spine fractures occur in 1-11% of cases after reverse shoulder arthroplasty (RSA). While non-operative management has been recommended, poor clinical outcomes have been reported for Levy type II-III fractures. The literature on surgical management mostly includes open reduction and internal fixation (ORIF) for established non-unions with mixed results. Currently, little evidence exists on acute ORIF of displaced scapular spine fractures after RSA. Therefore, the purpose of this propensity score-matched study was to compare acute ORIF (<6 weeks) with non-operative management. This retrospective case-control study included 74 Levy type II-III fractures from 3 surgical centers. Sixteen patients underwent acute ORIF within 6 weeks of symptom onset, and 58 patients non-operative management. In the operative group, 11 patients (69%) were treated with 90:90° double plating, 4 with hook plating (25%), and 1 (6%) with a hybrid double construct. Clinical (Subjective Shoulder Value (SSV), ASES score, VAS, patient satisfaction, and active forward elevation) and radiological outcomes were compared. Propensity score matching was performed using 5 criteria (age, sex, BMI, diagnosis, and Levy type) to balance the covariates and to reduce selection bias. Of the total group (74 fractures: 16 ORIF and 58 non-operative), 14 patients in each group were matched using the propensity score. At a mean follow-up of 3.7 years, the mean SSV was significantly better (p = 0.005) for the ORIF group (90%, IQR 76-90) compared to the non-operative group (57%, IQR, 42-70). The mean ASES score (82, IQR 74-90 versus 59, IQR 40-70), and mean active forward elevation (123°, IQR 95-137° versus 75°, IQR 50-100°) were significantly better in the ORIF group (p = 0.007 and p = 0.021, respectively) compared to the non-operative group. The union rate for the ORIF group was 93% (13/14), compared to 30% (4/13, 1 undetermined) for non-operative group (risk ratio 0.13, p = 0.001). Acute ORIF for displaced Levy-type II and III scapular spine fractures after RSA is associated with significantly better clinical outcomes and union rates compared to non-operative treatment.

Impact of insurance status on mortality following surgical treatment of colorectal cancers.

40 Background: Healthcare disparities in colorectal cancer, driven by insurance status and socioeconomic factors, lead to delayed diagnoses and poorer surgical outcomes. We sought to examine the impact of insurance status on presentation, treatment, and in-hospital mortality in CRC patients undergoing colectomy using the Nationwide Inpatient Sample (NIS) database. Methods: We included patients aged 18-65 years diagnosed with colon cancer and undergoing colectomy, as identified by ICD-9-CM codes, who had private insurance, Medicaid, or no insurance from January 1, 2005, through December 31, 2014. The primary variable was insurance status; patient characteristics such as age, sex, race, income, and tumor type were analyzed. We used the Elixhauser comorbidity index to control for confounding and performed a subset analysis on patients without major comorbidities. The primary outcome was in-hospital postoperative death. Associations between this outcome and insurance status were analyzed using the Cox proportional hazard model, both in the full cohort and in a subset of patients without comorbidities, with models stratified by hospitals to account for clustering effects from variations in access to care. Results: The study cohort included 301,304 patients, of whom 238,158 (79.0%) were privately insured, 40,417 (13.4%) on Medicaid, and 22,729 (7.6%) were uninsured. Most patients were White (71.6%), followed by African American (12.6%), Hispanic (8.4%), Asian/Pacific Islander (3.8%), and Native American (0.5%). A total of 55.4% of cases took place in teaching hospitals. In the unadjusted analysis, the mortality rate for privately insured patients was 0.7% (95% CI, 0.6%-0.7%) compared with 2.1% for uninsured patients (95% CI, 1.7%-2.5%) and 1.5% for Medicaid recipients (95% CI, 1.2%-1.8%; p=0.001). After adjusting for patient characteristics and stratifying by hospital in patients with no comorbidity, uninsured patients still had a higher risk of experiencing in-hospital death (HR, 1.60; 95% CI, 1.24-2.07) compared with privately insured patients, while no significant disparity was found in Medicaid recipients (HR, 0.95; 95% CI, 0.75-1.22) (Table). Conclusions: Uninsured patients undergoing colectomy for colon cancer experienced the highest in-hospital mortality, a disparity not fully explained by overall health differences. These findings underscore the critical role of insurance coverage in improving surgical outcomes and highlight the need for policy interventions to reduce mortality disparities. In-hospital mortality after surgery for colorectal cancer. Covariate Full sample Patients With No Comorbidity Patients With No Comorbidity in Urban Teaching Hospitals Hazard Ratio (95% Cl) Insurance Private Reference Reference Reference Medicaid 0.95 (0.75-1.22) 1.38 (0.91-2.11) 1.66 (0.91-3.02) Uninsured 1.60 (1.24-2.07) 2.12 (1.42-3.15) 2.28 (1.25-4.16)

Comparing structural and vascular parameters between advanced pseudoexfoliation glaucoma and primary open angle glaucoma using optical coherence tomography angiography

BackgroundTo compare structural and vascular parameters between advanced pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG).MethodsOne hundred and six eyes of 81 patients were enrolled in this cross-sectional study. All patients underwent complete ophthalmic examination and measurement of the thickness of the peripapillary retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC). The vessel densities (VD) in the peripapillary and macular area were also determined using optical coherence tomography angiography (OCTA). A linear mixed model was used for the comparison of the structural and vascular parameters between groups with adjustment for type of glaucoma, age, sex, intraocular pressure (IOP), and mean deviation (MD) of the visual field C24-2.ResultsThe patients in the PXG group were significantly older (68.06 ± 10.6 vs. 61.24 ± 15.23, p = 0.01) and had worse MD in the visual field C24-2 (-24.83 ± 6.18 vs. -22.37 ± 5.94, p = 0.04). Sex and IOP were comparable between groups (p > 0.05). Perippaillry RNFL and GCC thickness were not different between groups (p > 0.05). The PXG eyes showed lower VD in the average peripapillary area (32.67 ± 7.78 vs. 37.75 ± 8.87, p = 0.027) and nasal (37.45 ± 9.74 vs. 42.15 ± 7.36, p = 0.026) and inferior (38.09 ± 8.27 vs. 42.71 ± 9.13, p = 0.041) quadrants of parafovea.ConclusionThe advanced PXG and POAG eyes have comparable structural defects in the peripapillary and inner macula while the PXG eyes may have more vascular deterioration, especially in the macula.

P0300 Ultra-processed food consumption affects body composition in a cohort of italian patients with inflammatory bowel disease

Abstract Background Diet is a key factor in the development of IBD, which are showing rising incidence in industrialized countries, where the “Western” diet, rich in ultra-processed foods (UPF), is prevalent. Consumption of UPFs has been linked to an increased risk of both IBD developing and relapse. However, there is limited data on the relationship between UPF intake and body composition in IBD patients. We aimed to evaluate the impact of UPF consumption on body composition in individuals with IBD. Methods In this single-center observational study, we enrolled adult IBD patients. Exclusion criteria were active disease, defined as Harvey-Bradshaw Index &amp;gt; 5 for Crohn’s disease (CD) and Partial Mayo Score &amp;gt; 2 for Ulcerative Colitis (UC), pregnant or breastfeeding women, use of corticosteroids, high physical activity as assessed by the International Physical Activity Questionnaire (IPAQ), and previous bowel surgery. UPF consumption was assessed using country-specific validated food frequency questionnaires (FFQ), whose evaluated foods were categorized based on the NOVA classification into 4 classes according to their degree of processing. The percentage of UPF consumption was divided into 3 tertiles (T1=low; T3=high). Body composition was assessed through bioimpedance analysis. Continuous variables were expressed as mean±standard deviation (SD) or as median and interquartile range (IQR) according to their distribution assessed by the Kolmogorov-Smirnov test. Frequencies were calculated for the categorical variables. The Mann-Whitney rank-sum test, t-test, or ANOVA test was used to compare continuous variables; the Chi-square and Fisher’s exact test were used to compare categorical variables. Multiple linear regression analysis was used for fatty-free mass (FFM) predicted by UPF consumption. Results We enrolled 40 IBD patients (12 UC and 28 CD). The mean age and BMI were 42.5±16.2 years and 25±4.4 kg/m², respectively. UPF consumption was higher in CD than UC patients, both in terms of g/day (823±312 vs 609±248, p=0.04) and % weight (20.3±6.9 vs 15.1±6.1, p=0.028). Patients with T3 UPF consumption compared to T1 had a lower age (37.69±10.7 vs 55.9±17, p=0.001) and lower FFM (0.69±0.06 vs 0.75±0.09, p=0.012). When adjusting for age, sex and disease type the percentage of FFM was lower in T3 compared with T1 (β= -0.56; p=0.002). Higher UPF consumption was associated with FFM reduction in younger IBD patients. Conclusion Our findings emphasize the need for nutrition counseling in IBD patients, focusing on reducing the intake of UPFs, which can exacerbate the disease either by directly inflaming the bowel or by negatively impacting body composition. Further large-scale prospective studies are needed to validate our results.

Pollution, stress response, and obesity: A systematic review.

Limited literature addresses the association between pollution, stress, and obesity, and knowledge synthesis on the associations between these three topics has yet to be made. Two reviewers independently conducted a systematic review of MEDLINE, Embase, and Web of Science Core Collection databases to identify studies dealing with the effects of semi-volatile organic compounds, pesticides, conservatives, and heavy metals on the psychosocial stress response and adiposity in humans, animals, and cells. The quality of papers and risk assessment were evaluated with ToxRTool, BEES-C instrument score, SYRCLE's risk of bias tool, and CAMARADES checklist. A protocol for the systematic review was registered on PROSPERO. Of 1869 identified references, 63 were eligible after title and abstract screening, 42 after full-text reading, and risk of bias and quality assessment. An important body of evidence shows a positive association between pollution, stress response, and obesity. Pollution stimulates the hypothalamic-pituitary-adrenal axis by activating the glucocorticoid receptor signaling and transcriptional factors responsible for adipocyte differentiation, hyperphagia, and obesity. Endocrine-disrupting chemicals also alter the Peroxisome Proliferator-activated Receptor gamma pathway to promote adipocyte hyperplasia and hypertrophy. However, these associations depend on sex, age, and pollutant type. Our findings evidence that pollution promotes stress, leading to obesity.

Leptomeningeal dissemination in H3 K27M- mutant diffuse midline gliomas: clinical characteristics, risk factors, and prognostic insights.

This study aimed to describe the incidence, clinical and pathological features, and outcomes of H3 K27M- mutant Diffuse Midline Glioma (DMG) patients with leptomeningeal dissemination (LMD) and systematically investigate the predictive and prognostic factors to clarify the response to treatment after the onset of LMD. A total of 304 patients diagnosed with DMG from October 17, 2017, to October 17, 2023, were enrolled in this study, of which 32 patients were diagnosed with LMD. Logistic regression analyses were conducted to identify the predictors of LMD, including clinical, molecular, and imaging data. Univariable and multivariable cox regression analyses were used for overall survival (OS) and post-LMD survival (PLS) analysis. The median OS and PLS were 12.5 and 8.0 months respectively. Tumor with contrast-enhanced lesions reaching ependyma (Ventricular contact type I) was the only independent risk factor for LMD. Male sex and ventricular contact type I were independent risk factors for primary LMD. In all LMD patients, Karnofsky Performance Status (KPS) of ≥ 90 and radiotherapy were statistically significantly associated with longer OS, and primary LMD was significantly associated with shorter OS. Supratentorial location and chemotherapy after LMD diagnosis were independent favorable prognostic factors on PLS. In primary LMD subgroup analysis, radiotherapy was the only independent favorable prognostic factor on OS. The association between contrast-enhanced lesions and ventricular involvement is an independent predictive factor for LMD in DMG patients. Radiotherapy and preoperative KPS may contribute to improved overall survival in these patients. Chemotherapy is a potential treatment option following an LMD diagnosis.

Increasing Incidence of Facial Nerve Disorders in the United States from 2007 to 2022.

Incidence data on Facial Nerve Disorders (FND) and Bell's palsy are currently limited. Prior epidemiological studies have estimated the incidence rate of Bell's palsy to be between 11 and 53/100,000 individuals, although the most cited incidence data are from single regions or municipalities, many of which are outdated from several decades ago. This was a retrospective cohort study of US adults from 2007 to 2022 using the Merative™ Marketscan® Research Databases. Trends in the incidence of FND were described overall and by specific sociodemographic groups, including age, sex, region, and insurance plan type. Chi-squared and simple logistic regression analyses were performed. From 2007 to 2022, the total adult incidence of all FND was 30.5/100,000, and the total incidence of Bell's palsy alone was 24.5/100,000. Over the study period, there was a significant annual increase of 2.1 cases of FND/100,000 adults (95% Confidence Interval [CI] 1.8, 2.3; p < 0.001), and a significant total increase of 1.5 cases of Bell's palsy/100,000 adults (95% CI 1.2, 1.7; p < 0.001). The total incidence of FND was higher in males (33.1/100,000) than in females (28.4/100,000, p < 0.001), and greater in older age groups (p < 0.001). Additionally, the incidence of FND varied significantly by region (p < 0.001) and insurance plan type (p < 0.001). This study provides up-to-date incidence rates for Bell's palsy and facial nerve disorders, based on national administrative claims data. Incidence rates of FND and Bell's palsy alone have been increasing in the United States from 2007 to 2022. III Laryngoscope, 2025.

Prevalence of depression three years before and three years after obesity surgery: Sex-stratified case-control study using German health insurance claims data between 2009 and 2015

Background: Obesity shows significant association with depression elevating morbidity burden. Obesity surgery (OS) has been proven as an effective therapy reducing weight as well as depression prevalence rates, though the latter decrease appears to be unstable over time. For a better interpretation of the time trend, data on depression prevalence in OS-patients for the period before the surgery are needed. Furthermore, sex-stratified analyses can reveal potentials for improvements in mental health care in OS-patients. Methods: Claims data from a German statutory health insurance provider were used for the estimation of depression prevalence in patients who underwent obesity surgery in 2012 (n=340) and controls with (CGO) and without a diagnosis of obesity (CG; n=1700 each). The controls were matched to OS-patients regarding sex, age and insurance type. Sex-stratified depression prevalence was calculated between 2009 and 2015. Results: Overall, depression rates were higher in women than in men and increased from 2009 to 2015. Depression prevalence rates differed significantly between female OS-patients and controls in every year analyzed, e.g. in 2012: 39.4% in OS (95% CI: 33.4%-45.5%) vs. 19.8% in CGO (17.6%-22.0%) and 15.4% in CG (13.4%-17.4%). In men, no significant differences between OS-patients and controls could be observed at any time. After OS, depression prevalence rates dropped in women, then gradually increased until 2015. Also in male OS-patients, depression prevalence decreased in the year after OS and increased in the following years. In both sexes, the prevalence rates in 2015 did not significantly differ from the rates in 2012 (year of OS). Conclusions: We found a decrease of depression prevalence rates in the first year after OS in both sexes followed by an increase in the subsequent 2 years. OS appears to have a short-term effect on the prevalence rates of depression followed by a subsequent increase paralleling the increase over time found in the non-OS control groups. Due to the sex-stratified approach, differential results in the comparison of depression prevalence between OS-patients and controls became apparent. Depression prevalence was significantly increased three years before and after OS compared to controls in women, but not in men. Measures to perpetuate the decrease in depression prevalence rates after OS should be implemented during post-operative treatment.

The effects of sex and load on quantifying the bilateral force deficit during an upper body Wingate test.

The bilateral deficit (BLD) is a reduction in the amount of force during a bilateral task vs. the total force from the unilateral limbs performing the same task. We quantified the BLD during an upper body Wingate Anaerobic Test (WAnT) and evaluated the influence of sex and load on the BLD in force. Eighteen participants performed maximum handgrip strength, voluntary isometric contractions (MVIC), and three 30s WAnTs. In each session they completed the tasks with the dominant-arm, non-dominant arm and with both arms, randomly. WAnT intensities were 3, 4, and 5% body weight (BW). Instantaneous force data was used to calculate the BLD. Males showed greater (p < .001) BLD of force at 3, 4, and 5% BW than females by -17, -27.6 and -36%, respectively and had a greater (p < .001) BLD of force than females throughout time points 1-10 s, 11-20 s, and 21-30 s by -16, -29 and -35%, respectively. Females showed a difference (p < .001) in BLD of force between loads (-19% at 3%, -10% at 4% and +7% at 5%). Males had an increase (p < .001) in BLD of force from the beginning to the end of the WAnT starting with -18% (1-10 s), -38% (11-20 s) and -40% (21-30 s). WAnT had the highest BLD, followed by MVIC and grip strength. BLD in force is present during WAnTs and the sex-load interaction is important for determining this BLD during this maximal cycling test. Thus, when developing training or rehabilitation programs related to BLD in force, sex, load and exercise type should be taken into consideration.

Prevalence of cell phone use while driving in different urban settings. A roadside observational study in maputo city, Mozambique.

All forms of cell phone use while driving poses a threat to traffic safety. Few studies have reported the prevalence from low- and middle-income countries where the risk of severe road traffic crashes is highest. This study aimed to ascertain the prevalence of cell phone use among motor vehicle drivers in Maputo city, Mozambique, considering different types of vehicles and cell phone use. A roadside observational study was conducted to assess cell phone use while driving in three typical urban environments (on straight roads, at intersections, and by roadside markets) during three daytime periods. The prevalence of use, expressed in percentages with 95% confidence intervals, was estimated by type of vehicle and sex. An overall 9.3% prevalence of cell phone use was observed among the 11680 completed observations of motor vehicle drivers. Prevalence was lower at intersections and by roadside markets (7.1% respective 7.5%) and higher on straight roads (12.9%) and, for men, three times as high among car drivers (10.3%) than among drivers of motorized three-wheelers (3.3%). Speaking/listening was more prevalent than texting/reading for both women (52.6% vs 36.1%) and men (46.4% vs 40.5%). At all three types of sites, men in trucks spoke/listened more than men in other type of vehicles while men in cars texted/read to a greater extent. The overall prevalence of cell phone use observed among motor vehicle drivers in Maputo city is in the upper range of those observed in high-income settings. Notwithstanding sex-related differences and variations by type of site and vehicle and coupled with the poor road safety conditions of the city - and of the country as a whole - and the imminent rise in cell phone ownership and internet connectivity, cell phone use at the wheel is a significant cause for concern and concerted actions are called for.

Commentator Discussion: Multiarterial grafting in redo coronary artery bypass grafting: Type of arterial conduit and patient sex determine benefit.

Commentator Discussion: Multiarterial grafting in redo coronary artery bypass grafting: Type of arterial conduit and patient sex determine benefit.

Life expectancy of cats in Britain: moggies and mollies live longer.

The domestic cat (Felis catus) has been a popular companion animal for about 12,000 years, initially valued for rodent control before evolving into pets that provide affection and companionship. Unlike dogs, cats were not selectively bred for specific roles until the late 1800s, resulting in breeds defined primarily by appearance, which sometimes leads to genetic disorders. Modern animal welfare concerns emphasize longevity and health, prompting research into factors affecting cat lifespans, including sex, reproductive status, and breed. This study aims to expand on previous UK research by analyzing these interactions and highlighting the potential negative impacts of pure breeding on cat health. Data from 7,708 cats receiving veterinary care in the UK during 2019 were analyzed, focusing on reproductive status, breeding status, age at death, and sex. Data were analyzed using ANOVA and Cox proportional hazards models to assess survival differences. The overall mean lifespan of cats in the UK is 11.83 years. Analysis indicates that male cats live shorter lives than females, attributed to higher trauma rates and health issues among males. Neutered/spayed cats generally exhibit longer lifespans compared to entire cats. Tom cats have the shortest lifespan, while spayed females (mollies) live the longest. Moggies tend to outlive both pure and cross-bred cats, suggesting that genetic diversity may contribute to greater longevity. The results of this study emphasize the influence of sex, reproductive status, and cat type on feline lifespan, highlighting the need for targeted health interventions, particularly for male cats. The findings underscore the complex interplay of genetic and environmental factors in determining the health and longevity of domestic cats. This research not only contributes to existing knowledge but also advocates for the consideration of these variables in future studies and veterinary practices.

Appetite-Control and Eating-Behavior Traits Might Not Be Impacted by a Single Weight-Cycling Episode in Weight-Cycling Athletes: Results of the Wave Study.

The impact of weight cycling (WC)-successive weight loss (WL) and weight regain (WG)-on athlete performance is well documented, but effects on appetite are not. This study assessed the impact of a WC episode on dietary and appetitive profiles in athletes, considering sex and sport type. Athletes (28 male, 20 female) from combat (n = 23), strength (n = 12), and endurance (n = 13) sports participated in 3 conditions during a WC episode (baseline, WL, WG). Measurements included body composition (dual-energy X-ray absorptiometry), energy intake (48-h food record), appetite (visual analog scale), dietary profile (questionnaires), and food reward (computer task). Overall, athletes lost 4.4% (2.3%) of their body weight and regained 4.5% (2.9%) (P < .001). Energy intake decreased during WL (P < .001) with a higher protein intake (% of energy intake) before returning to baseline in WG (P > .05). WL increased hunger, prospective food consumption, and desire to eat compared with the baseline condition, but these changes were not seen in WG. Liking and wanting for fat and sweet foods were higher during WL and remained elevated in WG (P < .05). No eating disorders were found during the WC episode, but combat-sport athletes and females had a higher binge-eating risk than others, independent of the condition. Moderate WC episodes do not seem to impair appetite responses in athletes experienced with WC, likely due to their maintaining high physical activity levels. However, their long-term eating-behavior traits, especially in combat and female athletes, seem negatively affected. Practitioners should consider the long-term impacts of these WC practices on nutritional health.

Long-term Double-J stenting is superior to short-term Single-J stenting in kidney transplantation.

Urological complications after kidney transplantation, due to the ureteroneocystostomy, are associated with significant morbidity, prolonged hospital stay and even mortality. Ureteral stents can minimize the number of complications but are not consistently used, as previous studies were retrospective in nature. We aim to prospectively determine the most effective stenting approach. We performed a non-blinded single-centre randomised controlled trial in an academic hospital. Kidney transplant recipients were randomised to either a Single-J stent or a Double-J stent, removed according to respective protocols. Primary outcome was PCN placement within six months. Secondary outcomes encompassed urinary tract infections, cost-effectiveness, and hospital admission time. The study was conducted from November 2018 to August 2023, during which 300 recipients were included with complete follow-up. PCN was performed in 14.5% in the Single-J group (21/145) and 4.5% in the Double-J group (7/155), p = 0.003. Multivariable logistic regression, corrected for recipient age, BMI, sex, and donor type, showed an OR of 0.26 [0.10, 0.61] (OR [95%CI]). To prevent PCN in one recipient, 10 would have to receive the Double-J. All secondary outcomes were comparable, whereas hospital admission time and cost-effectiveness analysis heavily favoured Double-J stenting. An important limitation was that Single-J participants were unable to leave, even if their recovery allowed earlier discharge. This trial showed that Double-J stenting consistently reduced urological complications from 14.5% to 4.5%, while being highly cost-effective. Transplant surgeons should favour Double-J stenting to minimise the risk of complications.

Efficacy of Voice Therapy for Vocal Fold Masses: Avoidance of Surgery.

Voice abuse and misuse are the most common causes of benign vocal fold lesions (BVFL). Treatment may include a combination of voice therapy, singing sessions, or surgical resection. Otolaryngologists and speech language pathologists advocate for preoperative, as well as postoperative, voice therapy. To determine the efficacy of voice therapy in avoiding the need for surgery. This study was a retrospective chart review of patients who were seen in the office at Philadelphia Ear, Nose and Throat Associates and were diagnosed with BVFL from January 1, 2010to December 31, 2022. Information gathered from patient charts included past laryngeal medical/surgical history, BVFL pathology or subtype and description, voice intervention (type and dates of intervention), voice therapy outcomes, singing sessions,andvoice surgery and characteristics of preoperative voice therapy, among other information. Data were then analyzed using statistics for relationships and significance. One hundred twenty-seven patients met inclusion criteria for this analysis. Seventy-nine patients were included in the nonsurgical intervention group, while 48 underwent voice therapy (defined as voice therapy or singing sessions) and progressed to surgery. Professional voice users between the two groups were similar, but a higher percentage of singers were present in the surgical group. Sex and lesion type agreed with previous literature for most lesions, with a higher number of polyps in females differing from literature. Patients in the non-surgical group had longer duration and number of voice therapy sessions. Patients undergoing nonsurgical intervention (voice therapy or singing sessions) are less likely to have complete improvement as compared with their surgical counterparts, but the number of patients undergoing voice therapy over surgical options suggests voice therapy is still a valuable option for patients.

Risk Factors for Symptoms in Patients With Heterotopic Gastric Mucosa in the Upper Esophagus.

Goal: This study is aimed at comparing the clinical characteristics and histological types of symptomatic and asymptomatic patients with heterotopic gastric mucosa in the upper esophagus (HGMUE) and exploring the factors influencing the occurrence and severity of laryngopharyngeal reflux (LPR) symptoms in these patients. Background: HGMUE is a potential cause of LPR symptoms. Study: This retrospective analysis evaluated 70 patients with HGMUE using a detailed questionnaire. Clinical, histological, high-resolution manometry, and 24-h pH impedance monitoring data were compared between symptomatic (n = 49) and asymptomatic (n = 21) patients. Results: The diameter of HGMUE was significantly larger in the symptomatic group (p < 0.05), and the incidence of LPR symptoms increased with larger diameter grades; male patients were more likely to have LPR symptoms. The incidence of LPR symptoms varied significantly across histological classifications, being highest in patients with the fundic type (χ 2 = 6.64, p < 0.05). Binary logistic regression analysis identified sex and histological type as risk factors for LPR symptoms, with odds ratios of 8.996 (95% confidence interval (CI): 1.350-59.962) and 8.493 (95% CI: 1.486-48.522), respectively. The mean nocturnal baseline impedance (MNBI) in the upper esophagus was significantly lower in the symptomatic group (1676.82 ± 739.09 Ω vs. 2441.01 ± 604.11 Ω; p < 0.05). Clinical and demographic characteristics did not significantly affect the severity of LPR symptoms. Conclusion: The diameter, histological type, and sex of patients are risk factors for the occurrence of LPR symptoms in patients with HGMUE. More attention should be paid to patients with these factors. The MNBI is an effective indicator of the symptoms and treatment.