Age In Women Research Articles

Age-specific prevalence, clinical and urodynamic findings of detrusor underactivity and bladder outlet obstruction in female voiding dysfunction.

Female voiding dysfunction with cystocele have been widely studied, but there are no data regarding women without cystoceles. The present study aimed to evaluate the prevalence of detrusor underactivity (DU) and bladder outlet obstruction (BOO) without cystoceles in a large sample size. This was a retrospective cohort study. Between April 1996 and September 2018, 602 neurologically intact women with voiding dysfunction without cystoceles were enrolled. Detrusor pressure (DU) at the maximum flow rate (PdetQmax) <20 cmH2O, maximum flow rate (Qmax) <15 mL/s, and a bladder voiding efficiency <90% and BOO (PdetQmax ≥40 cmH2O and Qmax <12 mL/s) were diagnosed by urodynamic study. Otherwise, a non-DU/BOO diagnosis was made. The prevalence of DU and BOO was the primary outcome. The secondary outcomes were the analyses of the differences between these three groups in objective UDS parameters and subjective questionnaires and bladder diary parameters. This study included 100 (17%) women with DU, 60 (10%) with BOO, and 442 (73%) with a non-DU/BOO diagnosis. DU increased with age, but BOO decreased as age increased. The women in the DU group were older, had higher parity and pad weights, and lower PdetQmax, maximum urethral closure pressure, and functional profile length than the BOO group. The urodynamic findings did not correlate well to subjective questionnaire parameters. None of the symptoms revealed a significant difference between the groups. The retrospective design was the limitation of the study. The prevalence of DU increased with age in women with voiding dysfunction without advanced cystoceles. Conversely, BOO decreased with age. Prevalence intersected in the fourth decade. Diagnosis requires urodynamic evaluation, as subjective symptoms are inconclusive.

Predictors of Pregnancy Outcome for Libyan Infertile Women Underwent Intracytoplasmic Sperm Injection Cycle at Tripoli Infertility Center

Intracytoplasmic Sperm Injection (ICSI) is a crucial treatment approach in assisted reproduction technology (ART) for infertility clinics. However, low pregnancy rates in ICSI cycles are a problem. Despite its potential, ICSI can be expensive, time-consuming, and cause concerns about gametes and newborn health. The study aims to identify factors predicting pregnancy rates among infertile couples undergoing Intracytoplasmic Sperm Injection cycle at Tripoli Infertility Center in Libya. This retrospective study reviewed all infertile couples' medical files at the Infertility Tripoli Centre from January to December 2023. A structured case sheet was used to collect data on female patients' age, causes of infertility, duration of infertility, previous pregnancy, antral follicles count, endometrial thickness, number of embryos transferred, and pregnancy outcomes. The study was divided into two groups based on pregnancy test results. Statistical analysis involved simple descriptive statistics, Chi square, and independent sample t-test. This study involved 90 women, with 35.6% having a positive pregnancy test. The pregnancy rate was 59.4% in women under 35, and decreased to 9.4% in those 40 or older. No significant differences were found in infertility duration or previous pregnancy (all P &gt; 0.05). Partner analysis revealed that 64.2% had asthenospermia, while endocrinopathies were reported by 41.8% of women. No significant differences were found in antral follicle count, endometrial thickness, oocyte number, or quality between pregnant and non-pregnant women (all P &gt; 0.05). Our findings suggest that Maternal age has a significant impact on the success of ICSI, with advanced age in women negatively affecting ICSI outcomes.

Single-cell proteomics reveals decreased abundance of proteostasis and meiosis proteins in advanced maternal age oocytes.

Advanced maternal age is associated with a decline in oocyte quality, which often leads to reproductive failure in humans. However, the mechanisms behind this age-related decline remain unclear. To gain insights into this phenomenon, we applied plexDIA, a multiplexed, single-cell mass spectrometry method, to analyze the proteome of oocytes from both young women and women of advanced maternal age. Our findings primarily revealed distinct proteomic profiles between immature fully grown germinal vesicle and mature metaphase II oocytes. Importantly, we further show that a woman's age is associated with changes in her oocyte proteome. Specifically, when compared to oocytes obtained from young women, advanced maternal age oocytes exhibited lower levels of the proteasome and TRiC complex, as well as other key regulators of proteostasis and meiosis. This suggests that aging adversely affects the proteostasis and meiosis networks in human oocytes. The proteins identified in this study hold potential as targets for improving oocyte quality and may guide future studies into the molecular processes underlying oocyte aging.

#1611 Diverging epidemiology of kidney replacement therapy (KRT) prevalence in Madrid and Catalonia between 2012 and 2021

Abstract Background and Aims Chronic kidney disease (CKD) is one of the fastest growing global causes of death and the number of persons on kidney replacement therapy (KRT) is increasing. A critical assessment of current clinical practice in different regions may identify best clinical practice and provide a benchmark to improve outcomes. Given the current long-life expectancy in Spain and its high proportion of elderly population, analysis of Spanish data may provide insight of interest for the future for other European countries. Catalonia (Cat) and Madrid (Mad) are among the three most populated Spanish Autonomous Communities and have similar life expectancy, gross domestic product (GDP) and GDP per capita, accounting for 30% of Spain's population and 38% of GDP. The aim was to set the basis for benchmarking in CKD care and KRT initiation and care by comparing the evolving prevalence of KRT in Cat and Mad. Method We compared KRT prevalence in Cat and Mad over the past years using data from European Renal Association (ERA) Registry annual reports and Spanish Instituto Nacional de Estadística's (INE) census. Results From 2012 to 2021, the adjusted prevalence of KRT per million population (pmp) increased by 275.8 (1221 to 1479, 22.6% increase) in Cat and by 134.8 (1046 to 1118, 12.9% increase) in Mad. The difference between Cat and Mad increased from 175 to 316 pmp (60% increase), resulting in a 26.8% higher KRT prevalence in Cat than in Mad in 2021 (up from 16.7% higher in 2012) (Fig. 1A). During the same period, the median age of prevalent KRT patients increased from 63.2 to 65.4 years (yrs) (2.2 yrs, 3.5%) in Cat and from 62.2 to 63.8 years (1.6 yrs, 2.6%) in Mad. In 2021, median age for prevalent patients on KRT was 1.6 yrs older in Cat (65.4 (53.9, 75.3)) than in Mad (63.8 (52.6, 74.1)), this difference being of 2.5 yrs in women (Cat 65.5 (53.6, 75.7), Mad (63 (51, 73.8), difference) and 1.1 yrs in men (Cat 65.3 (53.9, 75); Mad 64.2 (53.4, 74.3)). In subgroup analysis by age and sex, prevalence of KRT per million age-related population (pmarp) in 2021 was always higher in Cat than in Mad, except for women aged 20-44 yrs (363.7 in Cat, 370.5 in Mad, Cat/Mad ratio 0.98), and the largest gap was observed for women &amp;lt;19 yrs (Cat 77.4, Mad 41.5, Cat/Mad ratio 1.86). The Cat-Mad ratio increased with age in women &amp;gt;45 yrs, but not in men (Fig. 1B) The contribution of diabetes to KRT prevalence remained stable or increased slightly in both Cat (13.9-15.5%) and Mad (17.4-17.7%) between 2012 and 2021. In 2021 for most causes of KRT the prevalence adjusted for age and sex was higher in Cat, except for hypertension and miscellaneous. The largest differences were observed for unknown cause (most common cause in Cat: Cat 330.8, Mad 85.5, difference 245.3 pmp), miscellaneous (most common cause in Mad: Cat 165.9, Mad 271.5, difference −105.6 pmp), and missing (Cat 53.8, Mad 0, difference 53.8 pmp) (Fig. 1C). Prevalence of kidney transplantation in 2021 was higher in Cat than Mad (60.0% vs 54.9%), while prevalence of hemodialysis and peritoneal dialysis was higher in Mad (39.6% and 5.5%, respectively) than in Cat (36.2% and 3.9%) (Fig. 1D). Conclusion In conclusion, a stark difference in prevalence trends and in current KRT was observed for two Autonomous Communities within the same country which are broadly comparable in terms of population, life expectancy and GDP. An in-depth analysis of the drivers of these differences may bring insight into best practices for CKD prevention, treatment to slow CKD progression, timing and criteria for initiation of KRT and standard of care for KRT.

Age and BMI have different effects on subcutaneous, visceral, liver, bone marrow, and muscle adiposity, as measured by CT and MRI.

We analyzed quantitative computed tomography (CT) and chemical shift-encoded magnetic resonance imaging (MRI) data from a Chinese cohort to investigate the effects of BMI and aging on different adipose tissue (AT) depots. In 400 healthy, community-dwelling individuals aged 22 to 83 years, we used MRI to quantify proton density fat fraction (PDFF) of the lumbar spine (L2-L4) bone marrow AT (BMAT), the psoas major and erector spinae (ES) muscles, and the liver. Abdominal total AT, visceral AT (VAT), and subcutaneous AT (SAT) areas were measured at the L2-L3 level using quantitative CT. Partial correlation analysis was used to evaluate the relationship of each AT variable with age and BMI. Multiple linear regression analysis was performed in which each AT variable was evaluated in turn as a function of age and the other five independent AT measurements. Of the 168 men, 29% had normal BMI (<24.0 kg/m2), 47% had overweight (24.0-27.9 kg/m2), and 24% had obesity (≥ 28.0 kg/m2). In the 232 women, the percentages were 46%, 32%, and 22%, respectively. Strong or very strong correlations with BMI were found for total AT, VAT, and SAT in both sexes. BMAT and ES PDFF was strongly correlated with age in women and moderately correlated in men. In both sexes, BMAT PDFF correlated only with age and not with any of the other AT depots. Psoas PDFF correlated only with ES PDFF and not with age or the other AT depots. Liver PDFF correlated with BMI and VAT and weakly with SAT in men. VAT and SAT correlated with age and each other in both sexes. Age and BMI are both associated with adiposity, but their effects differ depending on the type of AT.

#1637 Diverging trends in kidney replacement therapy (KRT) incidence in Madrid and Catalonia in the past decade

Abstract Background and Aims Chronic kidney disease (CKD) is one of the fastest growing global causes of death and the number of persons on KRT is increasing. A critical assessment of current clinical practice across regions may identify best clinical practice, providing a benchmark to improve outcomes. Given the long life expectancy in Spain and its high proportion of the population over 65 y/o, analysis of Spanish data may provide insight for the future for other European countries. Catalonia (Cat) and Madrid (Mad) are two of the most populated Spanish Autonomous Communities, have similar life expectancy (above 83 years) and GDP per capita, and together account for 30% of Spanish population and 38% of GDP. The aim was to set the basis for benchmarking in CKD care and KRT initiation by comparing the evolving KRT incidence of two representative Spanish Autonomous Communities. Method We compared the KRT incidence in Cat and Mad from 2012 to 2021, using data from European Renal Association (ERA) Registry annual reports and the Spanish Instituto Nacional de Estadistica's (INE) census. Results From 2012 to 2021, the incidence of KRT (day 1) adjusted for age and sex increased by 69.7 pmp (59% increase) in Cat (from 118.7 to 188.4 pmp) and by 14.2 pmp (12% increase) in Mad (from 115.5 to 129.7 pmp). The differential incidence of KRT between Cat and Mad increased from 3.2 to 58.7 pmp, i.e., 1734% increase (Fig. 1A). As a result, the incidence of KRT was 45% higher in Cat than in Mad in 2021 (up from 3% higher in 2012). During the same period, the median age to start KRT increased from 67.0 to 69.6 years (2.6 years, 3.9%) in Cat and from 66.1 to 66.9 years (0.8 years, 1.2%) in Mad. Median age at KRT initiation in 2021 was 3 years older in Cat in both men (Cat 70.0 (58.4-77.8), Mad 67.3 (56.9-76.2)) and women (Cat 69.0 (58.4-77.2), Mad 66.1 (51.7-75.8)). In subgroup analysis by age and sex, the largest difference in KRT incidence in 2021 was observed for women and for those aged 75+ years: Cat/Mad KRT incidence (pmarp) ratio was 1.79 in women 75+, 1.62 in men 75+, 1.49 in women &amp;lt;75 y/o, 1.34 in men &amp;lt;75 y/o (Fig. 1B). The gap between Cat and Mad increased progressively with age in both men and women and the slope was steeper for women. The contribution of diabetes to the overall incidence of KRT ranged from 16.8% to 23.2% in Cat and from 24.3% to 29.0% in Mad between 2012 and 2021, remaining grossly stable or decreasing slightly over time. For most causes, the incidence adjusted for age and sex in Cat and Mad was similar, with largest differences observed for unknown cause (the most common cause in Cat: Cat 45.9 pmp, Mad 7.9 pmp) and missing (the 3rd most common cause in Cat after unknown and diabetes: Cat 25.4 pmp, Mad 0) (Fig. 1C). Together, unknown and missing causes of CKD accounted for 38.1% of incident KRT cases in Cat in 2021. Pre-emptive transplantation was 3-fold more common in Cat in 2021 (7.6% vs 2.7%), while incidence of haemodialysis and peritoneal dialysis were similar (Fig. 1D). Conclusion In conclusion, trends for KRT incidence differed for two Autonomous Communities from the same country, broadly comparable in terms of population, life expectancy and GDP. The incidence of KRT was higher in Catalonia, and the gap increasing over time, especially among the elderly and older women, with unknown cause of CKD being the leading cause of incident KRT. An in-depth analysis of the drivers of these differences may bring interesting insight into best practice for CKD prevention, treatment to slow CKD progression and prescription and initiation of KRT.

Reproductive Ageing: Metabolic contribution to age-related chromosome missegregation in mammalian oocytes.

Chromosome missegregation and declining energy metabolism are considered to be unrelated features of oocyte ageing that contribute to poor reproductive outcomes. Given the bioenergetic cost of chromosome segregation, we propose here that altered energy metabolism during ageing may be an underlying cause of age-related chromosome missegregation and aneuploidy. Advanced reproductive age in women is a major cause of infertility, miscarriage and congenital abnormalities. This is principally caused by a decrease in oocyte quality and developmental competence with age. Oocyte ageing is characterised by an increase in chromosome missegregation and aneuploidy. However, the underlying mechanisms of age-related aneuploidy have not been fully elucidated and are still under active investigation. In addition to chromosome missegregation, oocyte ageing is also accompanied by metabolic dysfunction. In this review, we integrate old and new perspectives on oocyte ageing, chromosome segregation and metabolism in mammalian oocytes and make direct links between these processes. We consider age-related alterations to chromosome segregation machinery, including the loss of cohesion, microtubule stability and the integrity of the spindle assembly checkpoint. We focus on how metabolic dysfunction in the ageing oocyte disrupts chromosome segregation machinery to contribute to and exacerbate age-related aneuploidy. More specifically, we discuss how mitochondrial function, ATP production and the generation of free radicals are altered during ageing. We also explore recent developments in oocyte metabolic ageing, including altered redox reactions (NAD+ metabolism) and the interactions between oocytes and their somatic nurse cells. Throughout the review, we integrate the mechanisms by which changes in oocyte metabolism influence age-related chromosome missegregation.

Scientific applicability in day-to-day practice on Granthokta Garbhini Paricharya

Achievement of motherhood is the cherished desire of every woman, as fetus depends upon mother for its nourishment, so health of pregnant women is most important as motherhood represents the bearing capacity of fetus inside the womb and delivery in a healthy status. There are many physiological and psychological changes occur in different stages of pregnancy in which some of them may ends up in discomfort and trouble. Acharyas have described Masanumasika Garbhini Paricharya in classical texts of Ayurveda for pregnant women that help in the development of fetus, healthy growth of fetus and care to mother. Garbhini Paricharya is nothing but the care given to pregnant women mostly through Ahara and Vihara. It is the daily regimen one should have to follow in the most delicate days of their life. The nine monthly diets are singularly unique in Ayurveda. This Paricharya changes in accordance to the growth of fetus in the womb and at the same time ensures health of mother. One can find remnants of dietetics (Paricharya) with older women and midwives but detailed and comprehensive diet plan as Paricharya is being practiced only by Acharyas. The main intension of advising Garbhini Paricharya is Paripurnatya (providing growth to fetus and mother), Anupaghata (pregnancy without complications) and Sukhaprasava (for normal delivery and healthy progeny). In this paper we are giving a broad expanse of the month wise diet as Garbhini Paricharya which can be modified according to the season, age, place, and digestive fire of pregnant woman.

Abstract PO2-12-04: Suboptimal adherence to adjuvant endocrine therapy (ET) in Brazilian women with early-stage estrogen receptor-positive (ER+) breast cancer

Abstract Background: Adjuvant ET reduces breast cancer recurrence and increases overall survival among patients with early-stage ER+ breast cancer, however a suboptimal number of patients in fact takes oral medicine as prescribed. In Brazil, there is a paucity of data about adherence to adjuvant ET. This study aims to evaluate adherence to adjuvant ET in Brazilian women with early breast cancer and to evaluate clinical and sociodemographic characteristics associated with higher or lower adherence. Methods: Women with history of early-stage ER+ invasive carcinoma of the breast on adjuvant ET for at least 6 months were invited to participate of this study. Adherence was assessed with questionnaire Morisky Medication Adherence Scale (MMAS-8) and high adherence was defined by a MMAS-8 score=8. Demographic and medical information, site of treatment (private versus public), degree of education (completed high school vs not) were reviewed from medical records. Quality of life was assessed using EORTC QLQ C30 and BR-23 forms, sexuality was evaluated with the Female Sex Function Index questionnaire. Additionally, patients were interviewed about return to work. Data collection was done with RedCap software. Qualitative variables were compared between groups using the Chi-square or exact Chi-square test and for quantitative variables the non-parametric Mann-Whitney test was used. Multivariable analysis was performed using Poisson regression. P &amp;lt; 0.05 was considered significant. Analyzes were performed in SAS 9.4. Results: From June 2021 to May 2023, a total of 461 women with ER+ early-stage breast cancer from 12 Brazilian institutions were included in this analysis. The mean age was 56.0 years (range 22-93), 47.7% were non-white and 38.7% were premenopausal. A total of 233 women (50.6%) had private insurance and the remaining were treated in public institutions. Median duration of ET use was 2.78 years (range 6 months- 9.61 years). High adherence to adjuvant endocrine therapy was present in 55.7% of patients. Median age of high adherent woman was higher than low adherent (p=0.005). Factors significantly associated with high adherence were no use of ovarian suppression (p=0.0095), use of anti-Her2 therapy (p=0.0462). Furthermore, higher scores for EORTC QLQ-C30 global health status (p=0.017) and in specific domains, including role functioning (p=0.007), emotional functioning (p&amp;lt; 0.0001), cognitive functioning (p&amp;lt; 0.001), social functioning (p = 0,0005), higher scores for EORTC BR23 body image (p&amp;lt; 0.001) and future perspective (p = 0.0198) were also associated with high adherence. Higher EORTC QLQ-C30 cognitive function score was the only variable associated with high adherence (p &amp;lt; 0.0001) to ET in multivariate model. Conclusion: Using the MMAS-8, only 55.7% of Brazilian women with stage I-III ER+ breast cancer reported high adherence to endocrine therapy. This suboptimal adherence rate leads to important questions such as the impact on the prognosis of this population Charactheristic with adjusted prevalence ratio for the occurrence of High adherence PR: Prevalence ratio; EORTC: European Organisation for Research and Treatment of Cancer Citation Format: Daniele Assad-Suzuki, Heloísa Resende, Danielle Santos, Fernanda Moura, Sulene Oliveira, Andrea Shimada, Anna Luiza Galvão, Bruno Souza, Amanda Castro, Monalisa Andrade, Yuri Beckedorff, Maria Cristina Magalhães, Cristiano Souza, Carlos Paiva, Daniela Pereira, Angelica Rodrigues, Daniela Rosa, Romualdo Barroso-Sousa. Suboptimal adherence to adjuvant endocrine therapy (ET) in Brazilian women with early-stage estrogen receptor-positive (ER+) breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-12-04.

The dynamics of Long-Acting Reversible Contraception (LARC) choices in rural Jambi: Socio-economic perspectives

High population growth without concurrent improvements in human quality poses significant challenges in promoting equitable welfare across various life aspects. Thus, population control is crucial for achieving sustainable development goals. This study emphasizes the role of Long-Acting Reversible Contraception (LARC) in managing fertility rates and investigates three main components of population growth: fertility, mortality, and migration. The objectives are threefold: 1) Analyze the profile of fertile-age couples using LARC in rural Jambi; 2) Investigate the socio-economic factors influencing the choice between LARC and non-LARC methods among these couples; 3) Explore the relationship between the couples' characteristics and their choice of LARC. Data were collected from a survey of 200 fertile-age couples participating in a family planning program across four villages in Jambi. The analysis utilized descriptive statistics, binary logistic regression, and multinomial logistic regression. Findings indicate that LARC usage among fertile-age couples in rural Jambi is low, at approximately 28% of total contraceptive users, with implants being the most common LARC type. In contrast, non-LARC methods are more prevalent, accounting for 72% of usage, dominated by three-month injectables, followed by pills and male condoms. Significant factors influencing the choice between LARC and non-LARC include the husband's education, the woman's employment status, the number of living children, the disparity between actual and ideal family size, desire for more children, knowledge about contraceptive options, and family income. Furthermore, characteristics significantly related to the choice of LARC methods such as tubal ligation, implants, and IUDs include the woman's age, number of living children, the gap between the ideal and actual number of children, desire for more children, woman's employment status, knowledge about contraceptive devices, and family income.

Seroprevalence of Hepatitis B virus in pregnancy women at the time of delivery

To determine the seroprevalence of HBV in pregnant women at the time of delivery. Observational, descriptive, cross-sectional study with cross-association between 2018 and 2019 at the Hospital Carlos Van Buren (HCVB), in Valparaiso, Chile. All pregnant women admitted for delivery care or with an immediate newborn who had HBV surface antigen study were included. Data were collected from the pregnant woman (age, nationality, education level, parity, type of delivery, and peripartum HIV-syphilis serology) and the newborn (gestational age, weight, and APGAR score). Inferential and multivariate analysis was performed using the Stata software. 1,355 pregnant women were analyzed. 87.7% were Chilean, 5.5% Haitian, 4.2% Venezuelan, and 2.6% were of other nationalities. 0.3% were positive for HBV. The prevalence of HBV in Chileans was 0.08% and in Haitians 4%. Haitian nationality was at higher risk of HBV (OR = 83) vs. Chilean nationality (p = 0.0001). None presented coinfection with HIV and/or syphilis. HBV seroprevalence in HCVB pregnant women was 0.3%, similar to that described in the general population in Chile. There was no coinfection with other sexually transmitted diseases. The only predictor of HBV infection was Haitian nationality.

Serosusceptibility and hesitancy for booster HBV vaccination among health care workers in Italy: A cross-sectional study

BackgroundHealth care workers (HCWs) are at increased risk of exposure to hepatitis B virus (HBV). The most effective prevention measure is vaccination, with a serum hepatitis B surface antibody (HBsAb) titre > 10 mIU/ml considered protective. To date, the sociodemographic and occupational characteristics related to HBV serosusceptibility and factors associated with booster hesitancy remain unclear. Therefore, this study aimed to identify factors associated with maintaining a protective HBsAb titre in a large sample of HCWs and to evaluate factors potentially associated with hesitancy towards vaccine boosters. MethodsA cross-sectional study was conducted among HCWs who underwent a health surveillance visit between 2017 and 2022. If the serum HBsAb titre was < 10 MIU/ml, a vaccine booster dose was offered. Based on their willingness to be vaccinated, employees were classified into three groups: acceptance, hesitation, and refusal. Uni- and multivariable analyses were performed to assess the association of demographic and occupational characteristics with serosusceptibility and attitudes towards vaccination. ResultsA total of 1632 (27%) employees were shown to be nonimmune. A lower median age and being a physician were significantly associated with a protective HBsAb titre. A total of 706 nonimmune employees (43.3%) accepted the vaccination, 865 (53%) hesitated, and 61 (3.7%) refused. The median age of those who refused vaccination was significantly higher than that of those who hesitated and those who were vaccinated. Acceptance of vaccination was significantly higher among nurses, while nurse aides hesitated more; among nonmedical graduate staff both hesitation and refusal were higher than expected. In the multivariable analysis, higher age, female sex, and employment as an allied health care professional were shown to be significantly associated with hesitation/refusal, while being born abroad turned out to be protective. ConclusionsOur study showed that approximately a quarter of HCWs were not immune to HBV infection, and of these, more than half were hesitant towards or refused the booster dose. The risk of hesitation/refusal was higher with age in women and among allied health care staff. Based on these findings, further studies are needed to prospectively evaluate HBV seroprevalence, vaccination adherence, factors associated with hesitancy, and the effectiveness of health surveillance strategies in a high-risk population susceptible to infection.

The relationship between resting metabolic rate and quality of life is moderated by age and body composition in women: a cross-sectional study

BackgroundHealth-related quality of life (HRQOL) is related to body composition, which is also related to resting metabolic rate (RMR). RMR can be increased by exercise and diet interventions that are not dependent on changes in body composition, so a link between RMR and HRQOL may provide interventions that directly improve HRQOL in women.MethodsOne hundred twenty women (median age 63.5 [IQR: 53.0–71.0] years) completed one-time measurement of body composition (multi-frequency bioelectrical impedance), RMR (handheld calorimetry), and HRQOL (RAND-36). Physical (PCS) and mental (MCS) composite scores were calculated for the RAND-36. Pearson correlations were used to identify relationships between RMR, body composition, and HRQOL. Variables at the p < .01 level were entered into multiple regression models.ResultsMedian body mass index was 26.1 [IQR: 23.2–30.9] kg/m2 and median lean mass index was 16.1 [IQR: 14.6–17.3] kg/m2. Body composition consisted of fat mass (median 27.2 [IQR: 20.3–34.7] kg) and lean mass (median 42.7 [IQR: 38.2–46.9] kg). Median RMR was 1165.0 [IQR: 1022.5–1380.0] kcal/day. Median HRQOL scores were PCS (84.0 [IQR: 74.0–93.0]) and MCS (85.0 [IQR: 74.3–90.0]). RMR was not directly related to PCS, but was directly and negatively related to MCS (p = .002). RMR was significantly and positively related to body composition (lean mass: p < .001; fat mass: p < .001), body mass index (p = .005), and lean mass index (p < .001); but only fat mass (PCS: p < .001; MCS: p < .001) and body mass index (PCS: p < .001; MCS: p < .001) were related to HRQOL, although the relationship was negative. In addition, age was found to be significantly negatively related to RMR (p < .001) and PCS (p = .003). Regression models confirmed the moderating influence of age and body composition on the relationship between RMR and HRQOL. RMR, age, fat mass, and body mass index explained 24% (p < .001) of variance in PCS; and RMR, fat mass, and body mass index explained 15% (p < .001) of variance in MCS.ConclusionIn women, the relationship between RMR and HRQOL is moderated by age and body composition. Understanding these pathways will allow clinicians and researchers to direct interventions more effectively.

Evaluation of women's aging influence on sperm passage inside the fallopian tube using 3D dynamic mechanical modeling.

The fallopian tubes play an important role in human fertility by facilitating the spermatozoa passage to the oocyte as well as later actively facilitating the fertilized oocyte transportation to the uterus cavity. The fallopian tubes undergo changes involving biological, physical, and morphological processes due to women aging, which may impair fertility. Here, we have modelled fallopian tubes of women at different ages and evaluated the chances of normal and pathological sperm cells reaching the fertilization site, the ampulla. By utilizing a unique combination of simulative tools, we implemented dynamic three-dimensional (3D) detailed geometrical models of many normal and pathological sperm cells swimming together in 3D geometrical models of three fallopian tubes associated with different women's age groups. By tracking the sperm cell swim, we found that for all age groups, the number of normal sperm cells in the ampulla is the largest, compared with the pathological sperm cells. On the other hand, the number of normal sperm cells in the fertilization site decreases due to the morphological and mechanical changes that occur in the fallopian tube with age. Moreover, in older ages, the normal sperm cells swim with lower velocities and for shorter distances inside the ampulla toward the ovary. Thus, the changes that the human fallopian tube undergoes due to women's aging have a significant influence on the human sperm cell motility. Our model of sperm cell motility through the fallopian tube in relation to the woman's age morphological changes provides a new scope for the investigation and treatment of diseases and infertility cases associated with aging, as well as a potential personalized medicine tool for evaluating the chances of a natural fertilization per specific features of a man's sperm and a woman's reproductive system.

Low-dose aspirin for the prevention of preterm birth in nulliparous women: systematic review and meta-analysis

ObjectiveThe objective was to assess the efficacy and safety of low-dose aspirin for the prevention of preterm birth in nulliparous women.Data sourcesWe searched PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to June 2022.Study eligibility criteriaRandomized controlled trials that compared aspirin to placebo in nulliparous women were eligible.MethodsThis study was reported in accordance with the PRISMA 2020 checklist. The primary outcomes of this study were the rates of preterm birth at less than 37 weeks and less than 34 weeks of gestation. The secondary outcomes included postpartum hemorrhage, placental abruption, cesarean section, any hypertensive disorder of pregnancy and small for gestational age. Relative risks with their 95% confidence intervals were calculated for analysis. Heterogeneity was assessed by Cochran’s Q test and Higgins’s I2. A random-effects model was used when I2 was > 50% to generate the RR and 95% CI; otherwise, a fixed-effects model was used. The risk of publication bias was assessed by funnel plots. We performed sensitivity analysis by sequentially omitting each included study to confirm the robustness of the analysis.ResultsSeven studies with a total of 29,029 participants were included in this review. Six studies were assessed as having a low risk of bias or an unclear risk of bias, and one study was judged as having a high risk of bias. In nulliparous women, low-dose aspirin was associated with a significant reduction in the rate of preterm birth at less than 34 weeks of gestational age (RR 0.84,95% CI: 0.71–0.99; I2 = 0%; P = 0.04), but we did not observe a significant difference in the rate of preterm birth at less than 37 weeks of gestation (RR 0.96,95% CI: 0.90–1.02; I2 = 31%; P = 0.18). Low-dose aspirin was associated with a significant increase in the rates of postpartum hemorrhage (RR 1.32,95% CI: 1.14–1.54; I2 = 0%; P = 0.0003), placental abruption (RR 2.18,95% CI: 1.10–4.32; I2 = 16%; P = 0.02) and cesarean section (RR 1.053, 95% CI: 1.001–1.108; I2 = 0%; P = 0.05) in nulliparous women. We also did not observe a significant effect of low-dose aspirin on the rates of any hypertensive disorder of pregnancy (RR 1.05, 95% CI: 0.96–1.14; I2 = 9%; P = 0.28) or small for gestational age (RR 0.96, 95% CI: 0.91–1.02; I2 = 0%; P = 0.16) in nulliparous women. Funnel plots indicated that no significant publication bias existed in this meta-analysis. Except for preterm birth at less than 34 weeks of gestation, placental abruption and cesarean section, the sensitivity analysis showed similar results, which confirmed the robustness of this meta-analysis.ConclusionsLow-dose aspirin might reduce the risk of preterm birth at less than 34 weeks of gestation in nulliparous women. The use of low-dose aspirin in nulliparous women increased the risk of postpartum hemorrhage and might increase the risk of placental abruption and cesarean section.

Walking net O2 rises with advancing age in older women: where to go from here?

Walking net O2 tends to increase with advancing age; however, factors contributing to this relationship have not been widely described. The implications of such findings could inform targeted strategies to promote independent mobility in older adults. Herein, we evaluated the relationship between net O2 and age at two submaximal workloads while exploring potential moderators of this relationship. Secondary analyses were performed on 35 older (65 ± 3years) women who completed a battery of physical assessments including fixed-speed, non-graded and graded (+ 2.5%) treadmill walking with indirect calorimetry to determine net O2. Maximal oxygen uptake ( O2max), knee extensor maximal isometric voluntary contraction (MVC), peak rate of torque development (RTD), and plantar flexor range-of-motion (PFROM) were also measured. Bivariate correlations showed non-graded (r = 0.403, p = 0.017) and graded (r = 0.413, p = 0.014) net O2 were positively related to age. Notably, these relationships strengthened after adjusting for O2max. Regression modeling showed age, RTD:MVC ratio (composite of muscle performance), and PFROM together explained 49% and 34% of the variance in non-graded and graded net O2, respectively. Further analyses suggested knee extensor MVC moderates the relationship between non-graded net O2 and age, accounting for 9% of the variance [ΔR2 = 0.090, F (1,31) = 4.13, p = 0.05]. These data support the premise that, in older women, walking net O2 rises with advancing age, and additionally, the RTD:MVC ratio and PFROM are independent correlates of non-graded net O2. Exercise interventions with a high degree of training specificity including explosive, velocity-based elements may promote independent mobility in older women.

Sex differences in Alzheimer's disease blood biomarkers in a Caribbean population of African ancestry: The Tobago Health Study.

Alzheimer's disease (AD) is increasing in the Caribbean, especially for persons of African ancestry (PAA) and women. However, studies have mostly utilized surveys without AD biomarkers. In the Tobago Health Study (n = 309; 109 women, mean age 70.3±6.6), we assessed sex differences and risk factors for serum levels of phosphorylated tau-181 (p-tau181), amyloid-beta (Aβ)42/40 ratio, glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). Blood samples were from 2010 to 2013 for men and from 2019 to 2023 for women. Women were more obese, hypertensive, and sedentary but reported less smoking and alcohol use than men (age-adjusted p<0.04). Compared to men, women had worse levels of AD biomarkers, with higher p-tau181 and lower Aβ42/40, independent of covariates (p<0.001). In sex-stratified analyses, higher p-tau181 was associated with older age in women and with hypertension in men. GFAP and NfL did not differ by sex. Women had worse AD biomarkers than men, unexplained by age, cardiometabolic diseases, or lifestyle. Studying risk factors for AD in PAA is warranted, especially for women earlier in life.

Whole-brain dynamics across the menstrual cycle: the role of hormonal fluctuations and age in healthy women

Recent neuroimaging research suggests that female sex hormone fluctuations modulate brain activity. Nevertheless, how brain network dynamics change across the female menstrual cycle remains largely unknown. Here, we investigated the dynamical complexity underlying three menstrual cycle phases (i.e., early follicular, pre-ovulatory, and mid-luteal) in 60 healthy naturally-cycling women scanned using resting-state fMRI. Our results revealed that the pre-ovulatory phase exhibited the highest dynamical complexity (variability over time) across the whole-brain functional network compared to the early follicular and mid-luteal phases, while the early follicular showed the lowest. Furthermore, we found that large-scale resting-state networks reconfigure along menstrual cycle phases. Multilevel mixed-effects models revealed age-related changes in the whole-brain, control, and dorsal attention networks, while estradiol and progesterone influenced the whole-brain, DMN, limbic, dorsal attention, somatomotor, and subcortical networks. Overall, these findings evidence that age and ovarian hormones modulate brain network dynamics along the menstrual cycle.

INVESTIGATING RADIOLOGICAL INSIGHTS OF BREAST CANCER WITH AGE AT JINNAH POSTGRADUATE MEDICAL CENTRE, KARACHI

There is a conflicting opinion regarding the association between age and breast cancer in women. This study was conducted to investigate the histopathological findings of findings and features of diagnosed patients of breast cancer about their age and radiological findings of lesions and to determine the relation of aggressive findings in different age groups. Methods: A cross-sectional study was conducted in the Radiological Department, JPMC, Karachi, from September 2022- September 2023. To ascertain if the histological characteristics of the tumors were connected to the age of the patient, the histology reports of 100 women with breast cancer diagnoses underwent examination. Grading of their cancer based on BIRAD Classification was done on the radiological findings of ultrasound and mammography. Patients between 15 and 65 years were split into five different age groups. Patients who were naive and had never had any surgical or medicinal treatment for cancer before were included. After obtaining consent, a detailed questionnaire with the required data and physical and chemical parameters was completed. Tissue samples in studies mainly included trust biopsies, large mass removal, and tissues from mastectomies. Results: People under the age of 40 were shown to have a higher incidence of grade III infiltrating ductal carcinoma (P 0.0001). Lobular carcinomas were observed more frequently in the elderly group. With advancing age, there was a discernible decline in lymphoplasmacytic stromal response, axillary lymph node metastases, and vascular invasion, all unaffected by tumor grade. Conclusion: These findings imply that the histology of breast cancer may alter with age and that older patients may exhibit less aggressive characteristics in some circumstances.

Attributes of Menstruation among Young Physical Therapy Female Students of Karachi

The average age of menarche is between 9 to 14 years of age. Menarche is considered a normal milestone of every female's life. This period is supposed like a special period of every girl's life because in this stage girl is converted to the woman's age. Menarche is the indicator sign of a female that is ready to take part in reproduction activity. Objective:To determine the attributes of menstruation among young physical therapy female students of Karachi. Methods: This cross-sectional study was done among 385 young physical therapy female students in Karachi-Pakistan to reveal the age, duration, symptoms, and length of the menstruation cycle. The duration of the study was between June to November 2023. A non-probability purposive sampling technique was used. The validated questionnaire was used from a previous study done in 2016. Data were analyzed through SPSS version 23.0 software. Results: A total number of 385 young females was included in this study. The mean age of menarche revealed 187 (48.57%) found between 11 to 13 years. The regularity of menses was found in 299 (77.66%)participants. The average days of menstruation flow were about 6 to 8 days in 218 (56.62%) of research participants. The average length of the menstrual cycle was 21 to 35 days in 221 (57.40%) while the most common symptom found in research participants was lower abdominal pain in 187 (48.57%). Conclusions:There were significant differences between the characteristics of every young female related to the pattern, duration, age, regularity, and cycle length of the menstrual cycle.