Search Results (510)

Loneliness and social isolation are related but distinct experiences, and their relative contributions to mental health among men who have sex with men (MSM) remain insufficiently studied in Portugal. This cross-sectional online survey of 641 cisgender MSM (age 18–74 years; M = 38.51, SD = 12.83) examined associations among loneliness, objective connectivity, interpersonal belonging, LGBTQIA+ community belonging, social-network composition, negative affect, and psychological distress, using the UCLA Loneliness Scale, the Social Isolation Scale, the Depression Anxiety Stress Scales-21, and a short Portuguese Positive and Negative Affect Schedule. LGBTQIA+ community belonging and LGBTQIA+ network representation were assessed with single items. Correlations, multiple regressions, and two moderation models were estimated with heteroscedasticity-consistent standard errors and sensitivity analyses. Loneliness was the strongest independent correlate of psychological distress (β = 0.509, p < 0.001, R² = 0.353) and negative affect (β = 0.398, p < 0.001, R² = 0.193). Interpersonal belonging showed a small, borderline inverse association with distress (β = −0.10, p = 0.050) that did not survive covariate adjustment. Neither LGBTQIA+ community belonging nor LGBTQIA+ network representation moderated the loneliness–distress association. Subjective loneliness was more closely tied to distress than objective connectivity or broad community integration. These cross-sectional findings are consistent with the value of examining interventions that address the quality and reciprocity of close relationships alongside affirming community resources. Full article

Background: Sex-based differences in complications after venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock are not well defined. We compared 30-day coded acute kidney injury and other short-term outcomes between female and male patients receiving ECMO. Methods: We performed a retrospective multicenter cohort study using the TriNetX U.S. Collaborative Network from 2012 through 2025. Adults with cardiogenic shock supported with VA-ECMO were identified. Patients with a diagnosis-coded AKI (ICD-10-CM N17) recorded on or before the index ECMO procedure were excluded, and female and male cohorts were then matched 1:1 by propensity score on 23 characteristics. The primary endpoint was diagnosis-coded AKI between day 1 and day 30 after ECMO initiation. Secondary endpoints were all-cause mortality, newly diagnosis-coded sepsis, and newly diagnosis-coded ischemic stroke. Results: Among 11,229 adults meeting cohort criteria, 3773 were women, and 7456 were men. After exclusion of 8272 patients with previously coded AKI, 1152 women and 1805 men were eligible, and 1100 patients were matched in each group. Diagnosis-coded AKI occurred in 222 women (20.2%) and 276 men (25.1%) (risk ratio, 0.80; 95% confidence interval [CI], 0.69–0.94; hazard ratio [HR], 0.78; 95% CI, 0.65–0.93; p = 0.005). All-cause mortality was identical between groups (29.5% vs. 29.5%; risk ratio, 1.00; 95% CI, 0.88–1.14). Newly coded sepsis (5.1% vs. 6.3%) and newly coded ischemic stroke (4.0% vs. 3.2%) did not differ significantly. In an unadjusted Aalen–Johansen analysis performed in the unmatched eligible cohorts, the 30-day cumulative incidence of coded AKI was 21.6% among women and 27.8% among men. Conclusions: In this propensity-matched federated electronic health record cohort of adults with cardiogenic shock receiving VA-ECMO and without previously coded AKI, recorded female sex was associated with a lower 30-day risk of diagnosis-coded AKI. Mortality, newly coded sepsis, and newly coded ischemic stroke were similar. These findings are hypothesis-generating and support further investigation of sex-associated differences in datasets with granular renal and ECMO-specific variables. Full article

Background/Objectives: Choline is an essential nutrient, and deficiency is associated with metabolic dysfunction-associated steatotic liver disease. Research shows that Western populations have inadequate choline intake; however, the intake in Asian populations is less studied. This study developed a choline database for Thai food and evaluated intake in the Thai population. Methods: Following guidelines of the Food and Agriculture Organization/the International Network of Food Data Systems, 1806 Thai food items were matched to the U.S. choline database, and the missForest imputation method was used to impute missing data. Choline intake was assessed in Thai adults aged 18 years and older using a nationally representative sample of the Thai Food Consumption Survey (n = 3593). Results: Animal-based foods such as eggs, meat, and fish contained more choline than plant-based foods. Median choline intake was 134.7 mg/day (IQR: 70.6, 229.3), with 3.6% of Thai individuals meeting adequate intake levels. Men consumed more choline than women (median 153 vs. 120 mg/day; p < 0.001). Choline intake declined with age but did not differ by body mass index. Conclusions: This study created a choline database for Thai food and shows that most Thais have intake below the recommended intake levels. Full article

Historically, mpox was thought to be a geographically constrained ‘disease of poverty,’ leading to decades of neglect by global health actors. Waning population immunity from the cessation of smallpox vaccination and prolonged scientific neglect created conditions that enabled the monkeypox virus (MPXV) to adapt cryptically. This ultimately contributed to the emergence of unprecedented global public health crises. This review aims to systematically trace the history, epidemiology, genomic evolution, and reservoir ecology of mpox in West Africa from 1970 to 2025. Following PRISMA guidelines, 110 articles met the inclusion criteria and were synthesized to map the virus’s trajectory. For nearly four decades, an “Era of Silence” (1970–2016) masked the silent enzootic circulation of MPXV within West African wildlife, primarily rodents and small mammals. This epidemiological quiescence ended with the 2017 re-emergence in Nigeria, which signaled a fundamental paradigm shift. The disease profile transitioned from sporadic, rural paediatric infections to sustained, urban and secondary transmission among young adult males. This shift was often associated with sexual networks, especially among men who have sex with men, and was characterized by novel clinical presentations, including genital and perianal lesions. Genomic analyses revealed that clade II diverged from clade I approximately 3500 years ago and is uniquely defined by the deletion of virulence factors, such as the complement-binding protein. Importantly, the clade IIb lineage, which triggered the 2022 global outbreak, exhibits accelerated microevolution consistent with APOBEC3-mediated hypermutation. This host-driven mutational signature provides genomic evidence supporting the hypothesis that clade IIb circulated cryptically within human-to-human transmission chains in West Africa as early as 2014. Ecologically, while no definitive reservoir has yet been identified, evidence suggests diverse rodents and an expanding host range. The transformation of mpox from a rare zoonosis to a global threat underscores the severe consequences of delayed intervention, demanding robust, integrated “One Health” surveillance. Full article

Background: Familial hypercholesterolemia (FH) is associated with accelerated atherosclerosis and an increased risk of cardiovascular disease. Aims: To evaluate circulating biomarkers of inflammation and atherosclerosis in patients with clinically suspected FH stratified according to the Dutch Lipid Clinic Network (DLCN) criteria. Methods: This cross-sectional study included 80 patients (mean age, 53.4 [13.2] years; 58% women) receiving maximally tolerated lipid-lowering therapy (statins ± ezetimibe). Serum concentrations of lipoprotein-associated phospholipase A₂ (Lp-PLA₂), tumor necrosis factor-α (TNF-α), apolipoprotein B (ApoB), oxidized low-density lipoprotein (oxLDL), and monocyte chemoattractant protein-1 (MCP-1) were measured. Participants were classified as definite FH (DLCN score > 8; n = 45) or non-definite FH (DLCN score ≤ 8; n = 35). Biomarker concentrations were analyzed according to the above subgroups and sex. Results: Patients with definite FH had significantly higher serum Lp-PLA₂ concentrations (62.2 [33.8] vs. 46.5 [19.9] ng/mL; p = 0.03) and TNF-α concentrations (6.94 [4.53] vs. 4.51 [2.93] pg/mL; p = 0.02) compared to non-definite FH, whereas ApoB, oxLDL, and MCP-1 concentrations did not differ significantly between the subgroups. Women had significantly higher TNF-α concentrations compared to men (6.57 [4.74] vs. 4.60 [2.20] pg/mL; p = 0.04) with no differences among other cytokines. Conclusions: Patients with definite FH exhibited persistently higher circulating Lp-PLA₂ and TNF-α concentrations despite maximally tolerated lipid-lowering therapy, suggesting ongoing activation of specific inflammatory pathways. These findings support further investigation of Lp-PLA₂ and TNF-α as candidate biomarkers for cardiovascular risk assessment in FH. Full article

Background/Objectives: Empirical research exploring the linkages between community leisure facility diversity, distinct facility categories, and mental health outcomes among older populations remains scarce, especially regarding gender-specific variations. Methods: Grounded in social capital theory, this study establishes an analytical framework to unpack the underlying mechanisms of these relationships. Based on a sample of 10,270 adults aged 60 and older drawn from the 2023 CLASS, structural equation modeling is applied to investigate the correlational patterns, indirect transmission pathways, and gender heterogeneity embedded in these associations. Results: The results indicate that community leisure facility diversity is positively correlated with better mental health status among older adults, with a total association coefficient of 0.052. Social networks partially mediate this correlational pattern, with an indirect association value of 0.010. Five facility categories exhibit significant positive total associations with mental health, namely senior activity rooms (0.038), fitness centers (0.053), chess and card rooms (0.031), libraries (0.028), and community canteens (0.043), while their indirect association pathways present divergent features. Notably, the linkages between community leisure facilities and mental health are more pronounced for older men. Five facility types show significant positive associations with male mental health, whereas for older women, only senior activity rooms and fitness centers yield significant correlational patterns. Conclusions: These findings suggest that community leisure facility planning can be optimized by shifting from simple quantity expansion to refined, targeted provision with gender-sensitive design. Adopting gender-informed strategies, particularly prioritizing socially supportive facilities and reducing usage barriers for older women, offers a valuable direction for building age-friendly communities and promoting healthy aging. Full article

Bedouin society in the Negev/Naqab has experienced rapid social, spatial, and economic transformation, including expanded access to higher education and paid employment alongside enduring kinship obligations and gendered expectations. Guided by an ecological perspective on family life, this qualitative descriptive study examined how married, educated, and employed Bedouin women and men described their experiences at the intersection of social change, family relationships, parenting, gendered work, and place. Twenty-four participants (12 women and 12 men), aged 28–60, participated in semi-structured interviews. Data underwent reflexive thematic analysis. Four interconnected patterns were identified: (1) negotiating household-level autonomy within extended-family belonging; (2) pursuing marital partnership while unequal care and public authority persisted; (3) treating children’s education as both an intergenerational resource and a present-day strain; and (4) experiencing locality and planning status as conditions that shaped family security and everyday coordination. Rather than presenting a linear movement from “tradition” to “modernity”, participants’ accounts suggest that family change is an ecological process: everyday marital and parental arrangements are negotiated within kin networks, work demands, community expectations, and their location’s material conditions. The study contributes to family science by showing how dual-earner family processes in a collectivist, Indigenous-minority context are shaped not only by household-level role negotiation, but also by spatial governance and collective belonging. Full article

Entrepreneurship in South Africa is widely recognised as a critical driver of economic inclusion and job creation. While existing research highlights the role of formal education in enhancing entrepreneurial capability, less attention has been given to how entrenched gender norms, historical inequalities, and informal learning processes shape entrepreneurial visions. This study aims to investigate how gender dynamics shape entrepreneurial visions beyond formal educational attainment, particularly in contexts of persistent structural inequalities and high unemployment. The study adopts a qualitative research design. Using purposive sampling, 60 participants were selected and organised into three focus groups. Guided by Social Feminist Theory, the analysis foregrounds gendered social structures as central to the formation of entrepreneurial visions. Data were analysed thematically to explore recurring patterns related to structural uncertainty, informal learning, gendered perceptions of risk and confidence, and the reframing of entrepreneurial aspirations. The findings reveal that entrepreneurship often emerges in response to structural uncertainty rather than purely from opportunity-driven motives. Informal learning through community networks, lived experiences, and adaptive strategies constitutes a central source of entrepreneurial knowledge, particularly for women. Women participants frequently reported constrained growth aspirations shaped by structural barriers and questioned their own legitimacy, while men tended to benefit from broader institutional networks and greater perceived entrepreneurial confidence. The study highlights the need for policy interventions that extend beyond formal education. It recommends recognising informal competencies, addressing structural constraints, and developing gender-responsive support systems that validate diverse entrepreneurial pathways. Such interventions are essential for fostering inclusive entrepreneurship and reducing inequality in South Africa. This study contributes to the entrepreneurship literature by foregrounding the role of gendered social realities in shaping entrepreneurial visions. It further demonstrates how informal learning processes inform these visions beyond formal educational attainment. Full article

Hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV), together with HIV and bacterial sexually transmitted infections (STIs), account for a rising toll of more than one million deaths annually and overlap within shared behavioral and social networks, yet are still diagnosed through separate, pathogen-specific pathways. This narrative review synthesizes contemporary evidence on the convergence between viral hepatitis, HIV, and high-risk STI groups—men who have sex with men, pre-exposure prophylaxis (PrEP) users, people practicing chemsex, people who inject drugs, incarcerated populations, and migrants from endemic regions—and characterizes the diagnostic technologies and linkage-to-care models available to address it. Despite effective antivirals, the diagnostic cascade remains the principal bottleneck: most people with chronic HCV are undiagnosed, and HDV—with a pooled anti-HDV seroprevalence of approximately 4.5% among HBsAg-positive individuals—is its clearest expression, as most carriers are never tested. Reflex algorithms, multiplex panels, point-of-care assays, dried blood spots, and electronic health record alerts are validated but unevenly implemented. We argue that, alongside persistent resource, political, and equity-related constraints, a substantial share of the remaining barriers is operational rather than purely technological, and propose a practical, STI-clinic-centered framework integrating reflex testing, population-specific periodicity, and explicit linkage pathways toward the WHO 2030 elimination targets. Full article

Background/Objectives: Previous research has linked religious involvement to increased rates of breastfeeding initiation and duration, as well as improved lactation-related health outcomes. However, affiliation with certain faith traditions may also constrain breastfeeding practices due to misconceptions, modesty norms, religiously informed cultural beliefs, or other contextual factors. Given Mississippi’s status as one of the most religious states in the United States, this study examines unique facets of the association between religion and breastfeeding, with special attention to the direct and indirect role of congregational support. Methods: This study uses data from men and women, primarily White and African American respondents, in Wave II of the Mississippi REACH Social Climate Survey. This survey features both established and novel measures of breastfeeding outcomes, enabling new insights into the linkages among religion, community perceptions, and breastfeeding prevalence in primary social networks. The REACH Social Climate Survey combines a general population sample with an oversample of African American residents from the Mississippi Gulf Coast, collected in 2023. The analysis focuses on the direct and indirect associations between congregational support for breastfeeding and the prevalence of breastfeeding within social networks. Results: The main findings reveal (1) a direct and positive association between congregational support and breastfeeding social network prevalence and (2) an indirect association between congregational support and breastfeeding social network prevalence through community support for breastfeeding. Conclusions: These results underscore the importance of examining the intersectional associations among religion, community context, and infant health outcomes. Full article

Network orientation reflects beliefs about whether seeking help from others is desirable, safe, and useful. Cross-national studies have often focused on differences in the mean levels of negative network orientation; however, similar help-seeking scores may conceal distinct underlying psychosocial structures. Methods: A cross-sectional study was conducted among 676 university students from Mexico (n = 422) and Russia (n = 254). Participants completed the Network Orientation Scale (NOS), Rosenberg Self-Esteem Scale, Generalized Trust Scale, and Interpersonal Sympathy Scale. Mean comparisons, Pearson correlations with Fisher’s r-to-z tests, and multivariable linear interaction models were performed. Results: Mean NOS levels were similar across countries, but the psychosocial correlates differed substantially. Russian students reported higher generalized trust and higher self-esteem, whereas interpersonal sympathy was comparable between the countries. Greater interpersonal sympathy was associated with higher network avoidance in both populations, while generalized trust was associated with lower network avoidance, with a stronger effect in Russia. Self-esteem was not significantly associated with network orientation in Mexico but was significantly associated with lower network orientation in Russia. Continuous multivariable interaction models demonstrated a significant self-esteem × country interaction. Men showed higher network orientation than women in both countries. Conclusions: Although Mexican and Russian university students showed similar average levels of negative network orientation, the psychosocial structure underlying help-seeking differed across contexts. These findings suggest that help-seeking tendencies should not be interpreted solely through mean comparisons, but also through the psychosocial configurations shaping support-seeking within each cultural setting. Full article

Background/Objectives: Due to advances in paleogenetic research, a substantial amount of data has been accumulated on the Y-chromosome of the ancient Scytho-Siberian population that inhabited South Siberia and the adjacent territories of modern Mongolia and North-West China. It became possible to compare the Y-chromosomes of ancient men and modern Tuvans of various clans. Methods: We analyzed Y-SNPs and Y-STRs of ancient and modern samples. Results: During Tuvan ethnogenesis, the total frequency of the haplogroups Q and R1a dropped from 85% in Scytho-Siberian populations to 35% in modern Tuvans. Today, the gene pool of Tuvans is dominated by haplogroups N-P43, N-M178 and O-M175, which remain undetected in the samples from the Scytho-Siberian period. An analysis of the Y-STR phylogenetic networks that integrated data on Y-STR haplotypes and Y-SNPs of the Q and R1a haplogroup branches of both ancient and modern specimens provides findings that should be interpreted as broad phylogenetic affinities consistent with the paternal lineage continuity of haplogroups Q-YP1102 and R1a-Y39884. At the same time, the TMRCA estimate for the Y-STR cluster of the dominant branch of haplogroup Q in modern Tuvans, Q-YP1102-YP1691, is only 670 ± 130 YBP. Clusters of Y-STR haplotypes of the R1a-Y39884, R1a-YP1506, and R1a-YP1543 branches in modern Tuvans are also young and date back to between 1200 and 400 YBP. The Scytho-Siberian haplogroups R1a-YP1272, Q-BZ180, and N-Y147969 were not found in our sample set of modern Tuvans (n = 633). Conclusions: Haplogroups Q-YP1102 and R1a-Y39884 originated in Siberia and their branches are typical for the modern indigenous populations of South and West Siberia. Q-YP1102 marks the Yeniseian substrate and R1a-Y39884 was common in the ancient Siberian Andronovo culture. Overall, the gene pool of the Tuvan population was shaped (at least since the Scytho-Siberian period) by close interactions with the gene pools of Siberia and West Mongolia. However, the resolution of Y-SNP and Y-STR genotyping, as well as the limited sample size of ancient samples and their location in a limited area of the Eerbek River valley, do not allow us to conclude about the direct inheritance of modern Tuvan lineages from the ancient Scytho-Siberian population. Full article

Social activity is considered a primary factor in prolonging health and independence in later life, alongside physical activity. While population ageing reflects increasing life expectancy, the risk of living longer in poor health remains. In response to this risk, the United Kingdom developed extra-care schemes, introducing a housing and care model that combines social activities with flexible support to promote healthy and independent living in later life. Despite these potential benefits, observations that male tenants engage less with social opportunities than female tenants highlight a gap in understanding the social needs of men in care environments. This study explores how male social engagement is understood and influenced in extra-care schemes through a dual-perspective approach, combining service–user and service–provider viewpoints. Semi-structured interviews were conducted with six male tenants (mean age = 84 years) and five scheme managers across four extra-care schemes. Reflexive Thematic Analysis revealed barriers to male social engagement related to gender imbalanced environments, poor health, social identity disruption, and widowhood. Conversely, group membership and reliable family involvement function as protective resources that sustain identity roles and support networks for men living in a care environment. Developing male-oriented community links and peer support initiatives within extra-care, alongside appropriate training and psychoeducation for staff and tenants, may be effective when supporting men in care settings. Future research would benefit from broader multi-stakeholder samples to address the limitations of this study. Full article

Background/Objectives: Prostate cancer (PCa) remains a leading cause of cancer-related mortality in men. While localized PCa carries a favorable prognosis, progression to locally advanced disease substantially worsens outcomes. There is an unmet need for molecular markers that reliably distinguish indolent from aggressive tumors. MicroRNAs (miRNAs), small non-coding RNAs that post-transcriptionally regulate gene expression, are implicated in cancer development and progression, and their expression profiles may serve as putative biomarkers of disease stage. Methods: We performed small RNA sequencing on formalin-fixed paraffin-embedded (FFPE) prostate tumor tissues from nine patients (five localized, four locally advanced-stage). Differentially expressed miRNAs were identified using a bioinformatics pipeline (fold-change ≥ 2, p < 0.05). Target gene prediction, KEGG pathway enrichment, and miRNA–mRNA interaction network analyses were conducted, followed by in silico validation using two independent public mRNA datasets (GSE46602 and GSE21034, a subseries of GSE21032). Results: Seven unique mature miRNAs were differentially expressed between localized and locally advanced PCa. Five miRNAs (miR-145-5p, miR-205-5p, miR-206, miR-24-1-5p, and hsa-miR-3648) were downregulated in locally advanced tumors, while hsa-miR-625-3p and miR-324-5p were upregulated. Network analysis identified CLTC and CDK6 as putative downstream targets co-targeted by multiple downregulated miRNAs. Independent validation using GSE46602 and GSE21034 consistently demonstrated significantly higher expression of CLTC and CDK6 in locally advanced prostate cancer following Benjamini–Hochberg correction. Conclusions: This exploratory pilot analysis identified several miRNAs that differ between localized (pT2) and locally advanced (pT3–T4/N+) prostate cancer. Independent validation across two publicly available mRNA cohorts supports CLTC and CDK6 as candidate stage-associated genes. However, these findings remain hypothesis-generating and require validation in larger prospective cohorts together with functional confirmation before biomarker or therapeutic claims can be made. Full article

Many politicians heavily leverage social media platforms to further their interests and professional goals. TikTok, the widely popular social network established in 2016, has amassed a vast user following, especially among the younger demographic known as Generation Z. This study conceptualizes it as part of a platformized political communication environment that enables direct-to-audience communication beyond traditional journalistic gatekeeping. The current study aims to analyze high-visibility TikTok content produced by active Israeli politicians by scrutinizing the best-performing videos created by politicians representing diverse political ideologies. High-visibility content refers to videos that generated relatively high engagement, exposure, and platform presence, and therefore had greater potential to influence or impact audiences compared with less visible posts. The goal is to characterize and understand the content patterns and visibility dynamics of these successful TikTok videos posted by politicians. The findings suggest that the popularity of TikTok videos posted by politicians is associated with gender, age, and political affiliation. Men, older individuals, and those with right-wing affiliations tend to create content that garners the highest levels of popularity. Moreover, a considerable proportion of the sampled high-visibility videos do not engage directly with political subject matters. This suggests that, among best-performing political TikTok posts, visibility and engagement may sometimes outweigh explicit political or ideological discourse. This implies that politicians feel compelled to participate on the platform, even when their most visible content does not specifically revolve around promoting political messages. Consequently, the findings lend cautious support to the view that platform logic shapes political visibility and communication practices, even in politicians’ use of TikTok. In doing so, this study contributes to understanding how commercial social media platforms such as TikTok shape political visibility, engagement, and direct-to-audience communication. Full article