Variables Sex Research Articles

Robot-assisted thoracic surgery for benign tumors at the cervicothoracic junction: a propensity-matched study

This study aimed to assess the feasibility and safety of robot-assisted thoracic surgery (RATS) for resecting benign tumors of the cervicothoracic junction. Between 2017 and 2021, a total of 54 patients with benign cervicothoracic junction tumors were included. Among them, 46 underwent RATS while 8 underwent open surgery. Using a propensity score based on four variables (age, sex, comorbidity, and tumor size). The outcomes compared included short-term outcomes such as blood loss, as well as long-term outcomes including respiratory function and patients' postoperative health-related quality of life. No operative deaths occurred in this study. RATS was associated with less intraoperative blood loss (102 < 380 ml, P = 0.001) and a shorter length of hospital stay (1.8 < 4.8, P < 0.001). After a median follow-up of 37 months, no recurrences were reported, and no statistically significant differences were found in the 3-year survival between the two groups. The postoperative respiratory function of patients with open surgery showed a significant decrease compared to preoperative levels and were lower than those of RATS patients. In terms of health-related quality of life, RATS was associated with a better mean EQ-5D-5L index than open surgery (0.808 > 0.650, P < 0.05). In RATS, tumor sizes > 5 cm (mean ± SD = 0.768 ± 0.111, P = 0.028) and neurogenic tumors (mean ± SD = 0.702 ± 0.082, P < 0.001) remained significantly and independently associated with a lower EQ-5D-5L index. This study demonstrated that robot-assisted thoracic surgery for benign tumors of the cervicothoracic junction is a safe and technically feasible procedure, particularly for tumors < 5 cm and non-neurogenic tumors.

An MRI Study of Morphology, Asymmetry, and Sex Differences of Inferior Precentral Sulcus

Numerous studies utilizing magnetic resonance imaging (MRI) have observed sex and interhemispheric disparities in sulcal morphology, which could potentially underpin certain functional disparities in the human brain. Most of the existing research examines the precentral sulcus comprehensively, with a rare focus on its subsections. To explore the morphology, asymmetry, and sex disparities within the inferior precentral sulcus (IPCS), we acquired 3.0T magnetic resonance images from 92 right-handed Chinese adolescents. Brainvisa was used to reconstruct the IPCS structure and calculate its mean depth (MD). Based on the morphological patterns of IPCS, it was categorized into five distinct types. Additionally, we analyzed four different types of spatial relationships between IPCS and inferior frontal sulcus (IFS). There was a statistically significant sex disparity in the MD of IPCS, primarily observed in the right hemisphere. Females exhibited significantly greater asymmetry in the MD of IPCS compared to males. No statistically significant sex or hemispheric variations were identified in sulcal patterns. Our findings expand the comprehension of inconsistencies in sulcal structure, while also delivering an anatomical foundation for the study of related regions’ function.

Sex and pubertal variation in reward-related behavior and neural activation in early adolescents

This study aimed to characterize the role of sex and pubertal markers in reward motivation behavior and neural processing in early adolescence. We used baseline and two-year follow-up data from the Adolescent Brain and Cognitive DevelopmentSM study (15844 observations; 52% from boys; age 9–13). Pubertal development was measured with parent-reported Pubertal Development Scale, and DHEA, testosterone, and estradiol levels. Reward motivation behavior and neural processing at anticipation and feedback stages were assessed with the Monetary Incentive Delay task. Boys had higher reward motivation than girls, demonstrating greater accuracy difference between reward and neutral trials and higher task earnings. Girls had lower neural activation during reward feedback than boys in the nucleus accumbens, caudate, rostral anterior cingulate, medial orbitofrontal cortex, superior frontal gyrus and posterior cingulate. Pubertal stage and testosterone levels were positively associated with reward motivation behavior, although these associations changed when controlling for age. There were no significant associations between pubertal development and neural activation during reward anticipation and feedback. Sex differences in reward-related processing exist in early adolescence, signaling the need to understand their impact on typical and atypical functioning as it unfolds into adulthood.

Impact of quarantine on stress management, inter-personal, and spiritual growth of quarantined nurses

Due to the outbreak of coronavirus disease, 83% of households experienced a reduction in income, more than 25% of Filipinos reported anxieties, and 66,000 deaths from coronavirus disease 2019 (COVID-19) have been reported. With the pandemic, nurses are an essential part of the healthcare industry. With the notion that nurses now handle a variety of patients, sometimes nurses neglect their health. This study bridges the gap between the nurses’ health situation when afflicted with COVID-19, and how they can manage their health in terms of stress management, interpersonal, and spiritual aspects while in quarantine. Thus, using the quantitative design, this study determined the extent of impact of quarantine on the stress management, interpersonal, and spiritual growth of nurses who were infected with COVID-19 and experienced quarantine in Negros Occidental when they were taken as a whole and grouped according to age, sex, civil status, areas of the hospital, and types of quarantine facility. Also, it investigated on the relationship between the demographics and the impact of quarantine on stress management and interpersonal and spiritual growth of nurses. The study determined a very great extent of quarantine impact on the stress management, interpersonal, and spiritual growth of nurses who were infected with COVID-19 and experienced quarantine in Negros Occidental. There was a significant relationship for age and areas of the hospital on the impact of quarantine; while there was no significant relationship for the variables sex, civil status, and types of quarantine facilities on the impact of quarantine. It is essential to recognize that stress is a subjective experience that varies from person to person; it is crucial for policymakers and healthcare providers to recognize the importance of addressing the mental health needs of individuals in quarantine facilities. At the same time, the administrators should recognize and address different challenges encountered by nurses in quarantine to ensure their well-being.

The tympanic region of the skull in extant pinnipeds: A pilot study of auditory morphological disparity using linear morphometric principal component analysis.

Pinnipeds are unique semiaquatic taxa possessing adaptations to hear efficiently both in water and on land. Research over the past century is extremely limited on the auditory apparatus morphology of pinnipeds, which include the Families Phocidae (true seals), Otariidae (sea lions/fur seals), and Odobenidae (walruses). Our extensive literature review revealed inaccurate terminology of this region, with details corresponding only to terrestrial taxa, and a severe lack of information due to very few current studies. This demonstrates the need for evaluation and comparison of the auditory morphologies of modern terrestrial and semiaquatic carnivorans in relation to hearing. This initial study compares tympanic bullar morphologies of Phocidae to other pinnipeds and representatives of terrestrial carnivoran families. Morphological correlations of the basicranial auditory region were also compared within phocid subfamilies. Eleven skull measurements and about eleven calculated ratios were included in multiple principal component analyses to determine what areas of the auditory apparatus had the most significant morphological variation. This is the first study using this methodology, especially in reference to the hearing adaptations of pinnipeds, specifically in phocids. Results demonstrate distinct trends in phocid bullar morphology relative to other pinnipeds. Analyses reveal that: (1) phocids generally have different bullar morphology than otariids and odobenids; (2) Neomonachus schauinslandi (Hawaiian monk seal) and Neomonachus tropicalis (Caribbean monk seal) have unique morphology compared to phocids and other pinnipeds. Future work with increased number of specimens will further substantiate these findings and both ontogenetic and sexual variations will be examined.

Age-, sex- and proximal–distal-resolved multi-omics identifies regulators of intestinal aging in non-human primates

The incidence of intestinal diseases increases with age, yet the mechanisms governing gut aging and its link to diseases, such as colorectal cancer (CRC), remain elusive. In this study, while considering age, sex and proximal–distal variations, we used a multi-omics approach in non-human primates (Macaca fascicularis) to shed light on the heterogeneity of intestinal aging and identify potential regulators of gut aging. We explored the roles of several regulators, including those from tryptophan metabolism, in intestinal function and lifespan in Caenorhabditis elegans. Suggesting conservation of region specificity, tryptophan metabolism via the kynurenine and serotonin (5-HT) pathways varied between the proximal and distal colon, and, using a mouse colitis model, we observed that distal colitis was more sensitive to 5-HT treatment. Additionally, using proteomics analysis of human CRC samples, we identified links between gut aging and CRC, with high HPX levels predicting poor prognosis in older patients with CRC. Together, this work provides potential targets for preventing gut aging and associated diseases.

Load and recovery monitoring in Swiss top-level youth soccer players: Exploring the associations of a new web application-based score with recognised load measures

Load and recovery monitoring in Swiss top-level youth soccer players: Exploring the associations of a new web application-based score with recognised load measures

Genetic Correlates of Biological Aging and the Influence on Prediction of Mortality.

Longevity and disease-free survival are influenced by a combination of genetics and lifestyle. Biological age (BioAge), a measure of aging based on composite biomarkers, may outperform chronological age in predicting health and longevity. This study investigated the relationship between genetic risks, lifestyle factors, and delta age (Δage), estimated as the difference between biological and chronological age. BioAge and Δage were calculated for 52418 participants from the population-based Lifelines cohort. We computed 2 independent polygenic risk scores (PRS) for health span and DNA methylation-based aging clock to characterize genetic risks. The capacity of BioAge to predict all-cause mortality when adjusted for chronological age and genetic risks for aging, was assessed. Obesity, lifestyle, socioeconomic status, sex, and genetic variations in a population contributed to the differences in the rates of accelerated aging. The overall risk of death for a 1-year increase in BioAge for a given chronological age and sex among the genotyped participants was 11% (HR = 1.11; 95% CI: 1.09, 1.13). After adjusting for genetic factors, BioAge maintained its sensitivity for predicting mortality. Findings from this study ascertain that BioAge can be a useful tool for risk stratification in research and aging interventions.

Reference intervals for cardiometabolic risk factors in China: a national multicenter cross-sectional study on an adult population sample.

The reference intervals (RIs) of adult blood lipid parameters currently used in China are not derived from the results of research in local populations and have not been adjusted for age and sex. In this study, we aimed to determine accurate RIs for blood lipid parameters and blood glucose (GluG) for Chinese adults using a national multicenter study. A total of 11,333 adults between 18 and 90 years of age were recruited in seven representative regions in China between June 2020 and December 2020. Hospitals participating in the study were regrouped into two geographical regions, southern China (Changsha, Chengdu, Hangzhou, and Nanning) and northern China (Beijing, Shenyang, and Ningxia), according to their geographical and administrative location. All samples were freshly collected and measured collectively in one laboratory on the Mindray full Automatic biochemical analyzer chemistry BS2000 analytical systems. Outliers were removed using the Tukey test. Three-level nested analysis of variance and scatter plot were used to explore the variations in sex, age, and region. Percentile curves of each indicator were plotted using the least mean square (LMS) method. The lower limit (2.5th percentile) and the upper limit (97.5th percentile) of the RI were determined by using nonparametric statistical methods. We also calculated the 90% confidence interval (CI) for the lower and upper limits. A total of 8,283 participants were enrolled in the final analysis, with 3,593 (43.4%) men and 4,690 (56.6%) women. Regionality was observed in three analytes [small dense low density lipoprotein cholesterol (sd-LDLC), GluG, and apolipoprotein A1 (ApoA1)]. In northern China, the sd-LDLC and GluG levels in Shenyang were significantly higher than those in Ningxia and Beijing (P<0.05). In southern China, the sd-LDLC and GluG levels in Nanning were significantly higher than those in the three other cities (P<0.05), whereas the sd-LDLC and GluG levels in Chengdu were significantly lower than those in the three other cities (P<0.05). The level of ApoA1 in Chengdu was significantly higher than that in the three other cities. The homocysteine (HCY) level in male participants was clearly higher than that in female participants [ratio of standard deviation (SDR)sex =0.56], whereas the levels of high density lipoprotein cholesterol (HDLC) (SDRsex =0.40) and ApoA1 (SDRsex =0.27) in males were lower. The GluG and HCY level increased gradually with age. In females aged 45-55 years, there was an interesting change in scatter charts, where triglyceride (TG) and total cholesterol (TC) increased rapidly. We also found that for the age group of >55 years, the levels of TG and TC in females gradually surpassed those in males. The findings of this study may help establish age- and sex-specific reference values for the blood lipids of Chinese adults and serve as a valuable guide for the screening, diagnosis, treatment, prevention, and monitoring of cardiovascular disease (CVD).

Body mass index and sex and their effect on patient-reported outcomes following cartilage repair: an insight from the International Cartilage Regeneration and Joint Preservation Society Patient Registry

IntroductionChondral injuries in the knee, whether isolated or accompanying other injuries are found in as many as 60% of arthroscopic examinations. Although current research has identified negative outcomes for patients with a body mass index (BMI) >30kg/m2 undergoing chondral repair, our understanding of the relationship between presurgery BMI and postoperative patient-reported outcomes across all BMI categories remains lacking. ObjectivesThrough the International Cartilage Regeneration and Joint Preservation Society (ICRS) Patient Registry, this study aimed to explore this relationship, taking into account sex variations. MethodsThe ICRS Patient Registry was used to extract the data for this study. The outcomes in focus were the Knee Osteoarthritis Outcome Score (KOOS) and EQ-5D scores. Pearson and Spearman correlation methods were applied and the level of significance was set as α= 0.05. ResultsOf 3194 Registry patients at the time of data extraction, 1757 had undergone a surgical procedure, and 336 of these had complete KOOS or EQ-5D scores available for 6-week, 6-month, and 1-year postoperation. Analyses revealed that neither male (average BMI – 28.2 kg/m2) nor female (average BMI – 25.3 kg/m2) data sets indicated a correlation between BMI and the patient-reported outcomes. ConclusionsBMI, irrespective of sex, is not correlated with patient-reported outcomes in patients enrolled in the ICRS Registry with a BMI <30 kg/m2. Although BMIs in the overweight classification were not associated with poorer outcomes than BMIs in the normal classification, the current literature continues to support the notion that a BMI >30 kg/m2 is linked to poor cartilage repair and failure.

Effects of sex on meat quality traits, amino acid and fatty acid compositions, and plasma metabolome profiles in White King squabs

The objective of this study was to investigate the effects of sex on meat quality and the composition of amino and fatty acids in the breast muscles of White King pigeon squabs. Untargeted metabolomics was also conducted to distinguish the metabolic composition of plasma in different sexes. Compared with male squabs, female squabs had greater intramuscular fat (IMF) deposition and lower myofiber diameter and hydroxyproline content, leading to a lower shear force. Female squabs also had higher monounsaturated fatty acid and lower n-6 and n-3 polyunsaturated fatty acid proportions in the breast muscle, and had greater lipogenesis capacity via upregulation of PPARγ, FAS and LPL gene expression. Moreover, female squabs had lower inosine 5'-monophosphate, essential, free and sweet-tasting amino acid contents. Furthermore, Spearman's correlations between the differential plasma metabolites and key meat parameters were assessed, and putrescine, N-acetylglutamic acid, phophatidylcholine (18:0/P-16:0) and trimethylamine N-oxide were found to contribute to meat quality. In summary, the breast meat of male squabs may have better nutritional value than that of females, but it may inferior in terms of sensory properties, which can be attributed to the lower IMF content and higher shear force value. Our findings enhance our understanding of sex variation in squab meat quality, providing a basis for future research on pigeon breeding.

Role of Church Affiliation and the Sexual Behaviour Choices of Students in Selected Universities in Nairobi County, Kenya

Purpose: The current study sheds light on the role of church affiliation in shaping sexual attitudes and behaviour. Not enough was known about how Christianity can influence the construction of values and beliefs that discourage risky sexual behaviour among adolescents at universities in Kenya. Little was understood on the role of church affiliation explaining variation in adolescent sexuality among Christian communities at universities. Spirituality is an understudied subtype of religiosity yet it may explain patterns of sexual behaviour. Most studies that have examined the relationship between sexual behaviours and religiosity have focused on sexual intercourse. These studies have not examined other sexual behaviour choices, like internet sex.&#x0D; Methodology: Using a mixed-methods design, the relationship between church affiliation and sexual behaviour was examined. In quantitative analysis, a stratified probability sample of (n=176 students) who attend regular prayer sessions in three universities: the Kenyatta University (KU) Main Campus, the Jomo Kenyatta University of Agriculture and Technology (JKUAT) Karen Campus, and the Daystar University was used. Qualitative interviews were conducted with university administrators, chaplains, and other church workers. Undergirding the study was the social identity theory, which articulates the idea of people seeking to gain membership and acceptance in any social group.&#x0D; Findings: The findings suggest church affiliation has a significant effect on sexual attitudes, values, and behaviour. There seems to be an interaction between extrinsic and intrinsic religiosity, with frequent church attendance appearing to induce more conservative sexual beliefs, attitudes and behaviour. Church affiliation had a significant effect on sexual behaviour choices, which includes internet sex and cohabitation and extreme sexual activities.

Self-determined motivation and physical activity in patients with rheumatoid arthritis: a cross-sectional study

Objective To identify factors associated with two self-reported measures of physical activity (PA) in patients with rheumatoid arthritis (RA). Method Hospital outpatients with RA from central Norway filled in questionnaires about symptoms, psychological factors, and PA. Outcomes were two alternative self-reported measures of PA: (i) fulfilling the aerobic PA recommendations of ≥ 150 min/week at moderate intensity or ≥ 75 min/week at vigorous intensity; or (ii) being in the PA maintenance stage of the Stages of Exercise Behaviour Change framework. Logistic regression was applied to identify factors associated with PA. Step 1 included the independent variables sex, age, and smoking habits. Step 2a added self-reported function, joint pain during the past 6 months, and fatigue to Step 1. Step 2b added Exercise Self-Efficacy and the Relative Autonomy Index (RAI), calculated from the Behavioural Regulation in Exercise Questionnaire-2, to Step 1. Step 3 included all the mentioned independent variables. Steps 1–3 were analysed for each PA measure. Results In total, 227 patients participated. The RAI had a statistically significant positive association with being physically active according to both PA definitions. Joint pain had a significant negative association with meeting the aerobic PA recommendations but was not associated with being in the PA maintenance stage. Conclusion The degree of self-determined motivation was the most consistent variable associated with self-reported PA behaviour. Joint pain was associated with one of the two PA measures. Motivation and joint pain may be useful targets for intervention in clinical practice to improve PA engagement among patients with RA.

Genomic analyses provide insights into sex differentiation of tetraploid strawberry (Fragaria moupinensis).

The strawberry genus, Fragaria, exhibits a wide range of sexual systems and natural ploidy variation. Nearly, all polyploid strawberry species exhibit separate sexes (dioecy). Research has identified the sex-determining sequences as roughly conserved but with repeatedly changed genomic locations across octoploid strawberries. However, it remains unclear whether tetraploid wild strawberries evolved dioecy independently or shared a common origin with octoploid strawberries. In this study, we investigated the sex determinants of F. moupinensis, a dioecious plant with heterogametic females (ZW). Utilizing a combination of haplotype-resolved genome sequencing of the female F. moupinensis, k-mer-based and coverage-based genome-wide association studies (GWAS), and transcriptomic analysis, we discovered a non-recombining, approximately 33.6 kb W-specific region on chromosome 2a. Within this region, only one candidate sex-determining gene (FmoAFT) was identified. Furthermore, an extensive resequencing of the entire Fragaria genus indicated that the W-specific region displays conservative female specificity across all tetraploid species. This observation suggests that dioecy evolved independently in tetraploid and octoploid strawberries. Moreover, employing virus-induced gene silencing (VIGS), we knocked down the expression of the FmoAFT homologue transcript in cultivated strawberries, revealing its potential role in promoting female functions during early carpel development. We also applied DNA affinity purification sequencing (DAP-seq) and yeast one-hybrid assays to identify potential direct targets of FmoAFT. These insights shed new light on the genetic basis and evolutionary history of sex determination in strawberries, thereby facilitating the formulation of strategies to manipulate sex determination in breeding programs.

Morphological variation of the European Pond Turtle, Emys orbicularis (Linnaeus 1758), on the island of Menorca

The European Pond Turtle (Emys orbicularis) is a widely distributed species in Menorca (Balearic Islands,western Mediterranean) and it likely was introduced in historical times. In this study, we evaluated sexual dimorphismand morphological variation of E. orbicularis on the island from a sample of 455 individuals captured at ten surveysites. In these individuals, we measured seven linear traits related to body size. In addition, we measured two shapedescriptors (carapace and plastron shape) and iris and plastral coloration. The results showed very pronounced sexualdimorphism, with females being larger than males and also having longer and broader plastra with higher carapaces.The site of capture had significant effects on carapace, plastral shape, and coloration. Both males and females had darkorlight-colored plastra, but some males had almost completely dark plastra (to 99% dark), whereas in females, themaximum extent of black plastra was lower (79%). The sexes also differed in iridal chromatic attributes, with femalesmore frequently having yellow and males having red or orange irises. However, this was not diagnostic of sexual identity,as 13% of females had red irises and 15% of males had yellow irises.

Factors Associated with Acute Kidney Injury Occurrence and Prognosis in Rhabdomyolysis at the Emergency Department.

Background and Objectives: This study aimed to analyze patients with rhabdomyolysis who presented to emergency departments and identify their distribution of related disease and prognostic factors. Materials and Methods: A retrospective cohort study was conducted on patients with rhabdomyolysis who presented to emergency departments over a 10-year period. Patient data, including patients' demographic variables (sex and age), mode of arrival, final diagnosis, statin use, rhabdomyolysis trigger factors, and levels of serum creatine phosphokinase (CPK), myoglobin, creatinine, sodium, potassium, phosphate, calcium, and lactate, were analyzed. Univariate and multivariate logistic regression analyses were conducted to identify the predictive factors of acute kidney injury (AKI). Results: Among the patients, 268 (65.6%) were found to have trigger factors without underlying diseases. Furthermore, 115 (28.2%) patients developed AKI. This comprehensive study sheds light on the diverse factors influencing the occurrence of AKI in rhabdomyolysis and provides insights into AKI predictive markers. Furthermore, we analyzed the cases by dividing them into six groups: occurrence of AKI, occurrence of infection, and simple or complex rhabdomyolysis. CPK time course was found to be important in clinical prognosis, such as AKI occurrence, dialysis or not, and mortality. Conclusions: Age, statin use, elevated creatinine and lactate levels, and initial serum CPK level emerged as significant predictors of AKI. CPK time course was also found to be an important factor in predicting the clinical outcomes of patients with rhabdomyolysis.

Assessment of the prevalence and risk factors for dry eye symptoms among Romanian medical students using the ocular surface disease index – a cross-sectional study

BackgroundThis study aims to assess how Romanian medical students suffer from dry eye disease symptoms, establish the prevalence and severity of dry eye (DE) symptoms and identify potential risk factors.MethodsAn analytical, cross-sectional study was conducted on students from “Carol Davila” University of Medicine, Romania, after the final examination period of July 2022. The OSDI score (Ocular Surface Disease Index©) was applied in an online survey. The study adopted the standards used by other authors, who defined symptomatic DED as an OSDI score greater than 12. The chi-square test was used to establish statistical significance at a cutoff value of p < 0.05. The predictive model was created using linear logistic regression analysis. The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test. When the severity outcome had a nominal categorical form, multinomial regression analysis with normal subjects as a reference was performed. The distribution of the severe type of symptomatology across sex categories and years of study was analyzed using a nonparametric test (Independent-Samples Kruskal-Wallis Test).ResultsA total of 274 answers were received from 81.4% females and 18.6% males with a response rate of 35.58%. The mean age was 22.7 years ± 1.66 with an age range between 20 and 25 years old. Using the OSDI score, we established that the overall prevalence of DE symptoms was 83.6% (95%CI: 79.6%, 88%), with an 85.2% (95%CI: 80.5%, 89.8%) prevalence in females and 76.5% (95%CI: 65%,88%) in males. The severe form of DE was the most prevalent, regardless of the study year or sex. Increased screen time (p-value < 0.05) and non-smokers (p-value < 0.05) were proven risk factors. The predictive model which includes the explanatory variables (sex, contact lens wearers, smoking, oral contraceptives, screen time) proved an 84.7% predictability for symptomatic DE and was able to better predict the dependent variable than the intercept model only (p-value < 0.05). Smoking (p = 0.002) and screen time (p = 0.009) preserved their significance in the multinominal regression as well.ConclusionsThis is the first study to report the epidemiology of DE symptoms among Romanian medical students. OSDI revealed a high prevalence of symptomatic DE in medical students. Screen time, although not the only factor, likely plays a role in exacerbating the disease. This information can be used to inform healthcare policies, establish occupational health guidelines, and implement preventive measures for individuals in similar high-stress academic or professional environments.

Psychosocial Identity, Intimacy and Suicidality in Young Adults

Objective Suicidality in young adults is a serious and growing clinical and social problem. The theory of psychosocial ego development assumes that identity and intimacy are two key factors for adaptation and vulnerability in early adulthood. The aim of the present study was to test whether psychosocial identity and intimacy are related to suicidality in young adults, even when controlling for confounding variables (depressive symptoms, sex, age, health and economic assessment, religious commitment, and pandemic-related distress). Method Respondents aged 18–25 (n = 607) completed the Identity-Confusion and Intimacy-Isolation subscales from the Modified Erikson Psychosocial Stage Inventory, as well as the Patient Health Questionnaire-9, the Suicidal Behaviors Questionnaire-Revised and answered questions about the pandemic-related distress and various sociodemographic factors. Results At the level of bivariate analyses, both identity and intimacy were negatively associated with suicidal risk in the overall sample and with the frequency of suicidal ideation in the suicide risk subsample (n = 242). Weaker identity, but not intimacy, was associated with belonging to a suicide risk group in multivariable logistic regression. Moreover, ordinal regression showed that, in the subgroup with suicide risk, identity was negatively associated with the frequency of suicidal thoughts. Conclusions Identity is a negative correlate of suicidality in young adults. Identity-focused therapy may be a promising target for intervention in suicidal young adults.

Healthcare payment mechanism: Execution results of bundled payment program for bariatric surgery diagnosis in its first year of implementation in Chile.

More than 600 thousand people in Chile live with morbid obesity. Effective, safe, cost-effective therapeutic interventions are critical for healthcare systems and insurance schemes. In 2022, two bundled payment codes for bariatric surgery (gastric bypass and gastric sleeve) were incorporated into the National Health Fund's free-choice modality fee scheme. The objective was to characterize the execution of this payment mechanism program associated with bariatric surgery diagnosis in its first year of implementation.More than six hundred thousand people in Chile are estimated to live with morbid obesity. Effective, safe, cost-effective therapeutic interventions are critical for health systems and insurance schemes. In 2022, FONASA incorporated two Bariatric Surgery codes into the Free Choice Modality: Gastric Bypass and Sleeve Gastrectomy. Our objective was to characterize the execution of the Bariatric Surgery Bundled Payment Program in its first year of implementation. Descriptive and observational study of the pragmatic approach of the national execution of the payment associated with diagnosis in bariatric surgery. We examined sociodemographic variables (sex, age brackets, and National Health Fund tranches) and characterization of surgeries by code broken down by public or private provider, period of issue, unit cost, co-payment, and medical loans between March and December 2022. We recorded n = 13 118 surgeries (45.81% bypass versus 54.19% sleeve), of which n = 2424 (18.48%) used medical loans. A total of 85.01% (p = 0.01) of the procedures were in women, in people between 35 and 39 years of age (20.15%), and 45.12% in beneficiaries of tranche B. Private providers performed a total of 99.21% of the surgeries. Ten accounted for 50% of the activity (range n = 1200 to 426 surgeries per year; n = 4.8 to 1.7 surgeries per working day). Total program expenditure was $71 626 948 350 CLP, accounting for 5.04% of the total activity of the national Diagnosis Associated Payment Program. The implementation of this bariatric surgery voucher benefited more than 13 thousand people living with obesity, mostly women of productive ages and with purchasing capacity. As an equity strategy, regardless of the access route through the voucher, it will be important to safeguard the activity in the public network.

Exploring sex variations in the incidence of cardiovascular events: a counterfactual decomposition analysis.

Some cardiovascular risk factors (CVRFs) that occur differently in men and women can be addressed to reduce the risk of suffering a major adverse cardiovascular event (MACE). Furthermore, the development of MACE is highly influenced by social determinants of health. Counterfactual decomposition analysis is a new methodology that has the potential to be used to disentangle the role of different factors in health inequalities. This study aimed to assess sex differences in the incidence of MACE and to estimate how much of the difference could be attributed to the prevalence of diabetes, hypertension, hypercholesterolaemia and socioeconomic status (SES). Descriptive and counterfactual analyses were conducted in a population of 278515 people with CVRFs. The contribution of the causal factors was estimated by comparing the observed risk ratio with the causal factor distribution that would have been observed if men had been set to have the same factor distribution as women. The study period was between 2018 and 2021. The most prevalent CVRF was hypercholesterolaemia, which was similar in both sexes, while diabetes was more prevalent in men. The incidence of MACE was higher in men than in women. The main causal mediating factors that contributed to the sex differences were diabetes and SES, the latter with an offsetting effect. This result suggests that to reduce the MACE gap between sexes, diabetes prevention programmes targeting men and more gender-equal salary policies should be implemented.