Search Results (3,685)

Background/Objectives: This study analyzed demographic, clinical, laboratory, and outcome data from patients hospitalized with Coronavirus disease 2019 in eastern Poland between March 2020 and December 2024. This study aimed to assess sex-related differences in clinical features, treatments, and outcomes, and to identify predictors of mortality and mechanical ventilation in hospitalized patients. Methods: A retrospective cohort of 2811 adults hospitalized across four infectious disease centers was examined. Data included demographics, comorbidities, symptoms, laboratory findings, treatments, and clinical outcomes. Multivariable logistic regression was performed to identify predictors of mortality and mechanical ventilation. Results: The cohort comprised 1398 females and 1413 males. Women were older (median 67.5 vs. 63 years, p < 0.0001) and had a higher burden of comorbidities, while men presented with more severe baseline respiratory status and higher inflammatory markers. Oxygen therapy was required more frequently in men (60% vs. 49.9%, p < 0.0001). Overall mortality was 8.9% and did not differ significantly by sex, although men aged 60–79 years had higher mortality than women (11.2% vs. 7.7%, p = 0.0422). Independent predictors of mortality (OR, 95%CI) included age ≥ 80 years (3.78, 2.66–5.39), procalcitonin > 1 ng/mL (OR 4.07, 2.54–6.52), interleukin-6 (IL-6) > 100 pg/mL (OR 2.24, 1.53–3.27), and oxygen therapy at admission (OR 9.41, 5.22–16.97). Predictors of mechanical ventilation were age ≥ 80 years (7.14, 1.75–33.33), procalcitonin > 1 ng/mL (OR 2.09, 1.2–3.63), IL-6 > 100 pg/mL (OR 2.3, 1.4–3.78), and CRP at admission (OR 1.82, 1.15–2.88). Conclusions: Sex-related disparities in clinical presentation, laboratory profiles, and treatment strategies were evident, but mortality differences were driven primarily by age and inflammatory burden rather than sex alone. Elevated procalcitonin, high IL-6, and early oxygen requirement emerged as robust predictors of poor outcomes. Full article

Background/Objectives: Neuromuscular functions (NMFs) encompass biomechanical and viscoelastic properties that are essential for coordinated movement and muscular control. While NMFs have been extensively investigated in the lower limb, normative data for the upper extremity remain limited, particularly regarding the interaction between neuromuscular properties, superficial fascia, and body composition. As body composition and fascial characteristics may influence neuromuscular behavior and the interpretation of mechanical measurements, this study aimed to establish reference values for upper limb NMF, analyze dominance-related differences, and investigate the relationship between superficial fascia thickness and body mass composition. Methods: A descriptive, non-experimental study was conducted involving 61 healthy adults (122 upper limbs). Assessments included body composition (bioimpedance), superficial fascia thickness (skinfolds), viscoelastic properties (MyotonPro), and isometric strength (handheld dynamometry). Standardized protocols were applied for all measurements. Comparisons were performed between sexes and between dominant and non-dominant limbs. Correlation analyses explored associations between NMF, adiposity, and fascia parameters. Results: Dominant limbs showed slightly greater strength; however, these differences were not statistically significant. Viscoelastic properties were largely symmetrical between limbs, with minimal dominance-related differences. Clear sex differences were observed: men demonstrated greater strength, lean mass, and increased stiffness, whereas women presented higher skinfold thickness and lower muscle tone. Weak correlations were identified between stiffness, relaxation, and strength, as well as between adiposity and superficial fascia thickness. Greater adipose thickness was associated with lower stiffness values in the triceps (rho= −0304; iC95% 0.041/0.528; p = 0.017). Conclusions: Upper limb neuromuscular properties exhibit high bilateral symmetry, with limb dominance influencing strength. Sex and body composition significantly modulate both viscoelastic and functional parameters. These findings provide normative reference values and highlight the relevance of considering body composition and fascial characteristics when assessing neuromuscular function in clinical and sports contexts. Full article

Background: The Slovenian Nutrition Guidelines 2025 (SNG2025) provide a quantified, plant-forward framework aligned with the EAT–Lancet diet, whereas previous Slovenian FBDGs were qualitative. Objectives: (i) To compare SNG2025 with the EAT–Lancet diet and previous Slovenian FBDGs and (ii) to assess the alignment of food intake among Slovenian adults with the SNG2025. Methods: The SNG2025 food group targets were mapped to the EAT–Lancet diet and previous Slovenian FBDGs and evaluated against a nationally representative intake (Si. Menu 2017/18; 18–64 years; sex-specific). Sodium intake was corroborated by 24-h urinary sodium levels (2022). Results: The SNG2025 introduces numeric targets across more than 16 food groups, with national adaptations (e.g., potatoes, oils and fats from foods, and dairy being optional via milk-calcium equivalents and beverage specifications). The alignment reveals very low consumption of legumes; limited consumption of vegetables, whole grains, and nuts/seeds (and fruit in men); and excess consumption of total and red/processed meat, ultra-processed foods (UPFs), free sugars/sugar-sweetened beverages, sodium, and alcohol. Biomarkers indicate a mean salt intake approximately two times the <5 g/day limit. Trans fatty acid (TFA) levels ≥ 0.5% persist in a substantial percentage of adults, predominantly from ruminant-derived TFAs. Sex-specific patterns are more adverse for men (e.g., meat, SSBs, alcohol, and sodium), whereas women have a higher intake of sweet UPFs. Conclusions: Slovenian diets are misaligned with the SNG2025. Priorities include increasing the intake of legumes, whole grains, vegetables, and nuts/seeds, while shifting protein sources away from red and processed meat. Additional priorities include reducing the intake of alcohol, sodium, free sugars, and UPFs through reformulation, procurement, and pricing/marketing measures, alongside routine biomarker and UPF surveillance. The SNG2025 enable monitoring and targeted implementation. Considering the limitations of the Si. Menu 2017/18 dataset, which includes food-group aggregation and limited information on food preparation, the results should be interpreted with caution with respect to the magnitude of deviations from SNG2025 targets, while the overall direction of misalignment remains robust. Full article

Background: The monocarboxylate transporter 1 (MCT1) plays a central role in myocardial lactate handling and metabolic adaptation. The functional rs1049434 polymorphism (T1470A; Asp490Glu) affects MCT1-mediated lactate transport and substrate utilization, but its clinical relevance in sarcomere-related hypertrophic cardiomyopathy (HCM) remains poorly defined. Methods: We studied 56 carriers of pathogenic or likely pathogenic sarcomeric variants examined in a familial HCM program. All participants underwent standardized clinical phenotyping, including electrocardiography, transthoracic echocardiography, and cardiac magnetic resonance imaging. Genotyping of MCT1 rs1049434 was performed on genomic DNA. Analyses focused on sex-stratified genotype distribution, phenotypic expression among the 26 individuals who fulfilled diagnostic criteria for HCM, and the influence of habitual vigorous exercise. Septal wall thickness was the primary structural endpoint. Results: Among the 26 patients with established HCM (10 women, 16 men), a marked sex-specific effect emerged. Female carriers of the T-allele (TT/TA) exhibited significantly greater interventricular septal thickness compared with AA homozygotes (23.2 vs. 14.2 mm; p = 0.037). In men, septal thickness did not differ by genotype. However, male patients engaged in vigorous physical activity showed a consistently milder structural phenotype, including lower septal thickness (18.3 vs. 19.9 mm; p = 0.585) and directionally favorable markers of mechanical severity. Phenotypic distribution was predominantly asymmetric septal hypertrophy in both sexes, without genotype-dependent differences. Conclusions: The phenotypic impact of MCT1 rs1049434 in sarcomere-positive HCM is context-dependent. In women, impaired monocarboxylate handling is associated with greater hypertrophic remodeling, whereas in men, exercise-related metabolic conditioning appears to attenuate disease severity. These findings support a genotype–sex–environment interaction relevant to precision medicine approaches in HCM. Full article

Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are often used in hypertensive patients. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, binds the ACE2 receptor on the cell surface. This study aimed to identify the risk factors influencing COVID-19 infection in hypertensive patients. Methods: This is a part of a single-center, retrospective, observational study investigating patients ≥ 20 years old at Kenwakai Hospital (Nagano, Japan). COVID-19 was diagnosed by polymerase chain reaction. All patients received antihypertensive drugs. Results: Among 316 patients (mean age, 75.0 ± 13.4 years; men, 55.1%), COVID-19 was diagnosed in 39 (12.3%). Multiple logistic regression analysis after adjustment for age, sex, and smoking status identified increased serum creatinine (Scr) as a significant risk factor for COVID-19 (odds ratio [OR] 1.10; 95% confidence interval [CI] 1.00–1.20; p = 0.046). Conversely, lower serum chloride was associated with COVID-19 (OR 0.92; 95% CI 0.85–0.99; p = 0.047). There was no significant association between COVID-19 and the use of ACEIs and ARBs. Conclusions: Scr was independently associated with COVID-19 risk, whereas ACEI/ARB use was not associated with COVID-19 risk in Japanese hypertensive patients, suggesting that these users need not discontinue or change their treatment. The study population included a very high proportion of patients with advanced chronic kidney disease, which makes the cohort substantially different from the general hypertensive population. However, our results can help guide targeted treatment strategies, improving patient outcomes in healthcare settings. Full article

Background/Objectives: Chemsex is defined as the intentional use of psychoactive substances to enhance or prolong sexual activity, predominantly observed among men who have sex with men. It has emerged as a notable behavioral and public health concern due to its association with high-risk sexual practices, psychiatric morbidity, and somatic complications. Despite increasing recognition, global prevalence estimates vary widely (3–52.5%) due to differences in study populations and methodology. Commonly used substances include synthetic cathinones, amphetamines/methamphetamines, MDMA, GHB/GBL, ketamine, alkyl nitrites, and PDE-5 inhibitors. Methods: A narrative review was conducted using PubMed through 11 December 2025. Search terms combined chemsex-related terminology, substance names, and health outcomes. Recent English-language publications (2020–2025) were prioritized. Evidence was synthesized thematically across epidemiology, health complications, motivations, and interventions. Results: Chemsex is strongly associated with unprotected sex, multipartner encounters, and prolonged intercourse, leading to significantly increased rates of HIV, syphilis, gonorrhoea, and chlamydia. Psychiatric complications include depression, anxiety, compulsive sexual behavior, and psychosis, with higher risks in individuals engaging in slamming or polysubstance use. Somatic complications vary by substance and include cardiovascular disease, hyponatremia, rhabdomyolysis, ulcerative cystitis, methemoglobinemia, and overdose. Motivational factors extend beyond sexual enhancement and include minority stress, internalized and externalized stigma, and maladaptive coping mechanisms. Integrated interventions combining harm reduction, cognitive–behavioral therapy, peer-led services, and pharmacotherapy, alongside digital health tools to support PrEP adherence and risk reduction, show promise in mitigating these harms. Conclusions: Chemsex represents a complex interplay of biological, psychological, and sociocultural factors that contribute to elevated STI risk and psychiatric and somatic morbidity. Addressing chemsex requires destigmatized, multidisciplinary approaches that integrate behavioral, pharmacological, and community-based interventions. Digital health innovations can further enhance engagement, risk reduction, and access to timely care. Full article

(1) Background: Prosthesis–patient mismatch (PPM) after aortic valve replacement (AVR) impairs left ventricular (LV) recovery and is more common in women due to smaller aortic dimensions. Although the Perceval sutureless valve provides larger effective orifice areas, sex-specific PPM outcomes remain unclear. This study evaluated sex-related differences in PPM incidence, severity, and early impact after Perceval AVR. (2) Methods: We retrospectively analyzed 139 patients (68 males, 71 females) who underwent Perceval AVR between 2016 and 2020. PPM was defined per Valve Academic Research Consortium-3 (VARC-3) criteria using indexed effective orifice area (EOAi) and stratified by body-mass-index (BMI) (<30 vs. ≥30 kg/m²). Echocardiography assessed hemodynamic performance. (3) Results: PPM was markedly more frequent in women than men (74.6% vs. 22.1%, p < 0.001). Among non-obese patients, 47.9% of females versus 16.2% of males developed PPM (p < 0.001). Women received smaller valves and consistently exhibited lower EOAi despite similar gradients. Postoperatively, females had reduced EOAi (0.8 vs. 0.9 cm²/m², p < 0.001) but higher LV ejection fraction (55.8% vs. 49.5%, p = 0.004). Early clinical outcomes were comparable between sexes. (4) Conclusions: Despite favorable hemodynamics of sutureless AVR, anatomical sex differences result in persistently higher PPM rates in women, predominantly of moderate severity. Tailored strategies—including aortic root enlargement and sex-specific EOAi thresholds—may improve prosthesis selection and outcomes in female patients. Full article

Despite South Africa being the epicentre of HIV, some progress was made in the fight against HIV, i.e., the implementation of HIV programmes, provision of antiretroviral therapy (ART), etc. However, little is known about the association between HIV testing modalities and ART initiation. This study aimed to determine the association between HIV testing modalities and ART initiation among men who have sex with men (MSM) in selected provinces of South Africa. Following a retrospective cohort design, this study analysed programme data on 3345 MSM aged 16 years and older who were living with HIV and eligible for ART initiation. Logistic regression assessed the association between HIV testing modalities and ART initiation, controlling for age group, location, and the COVID-19 period. All analyses were done using SPSS version 30. Significance was set at p < 0.05. Participants who tested for HIV using the social network strategy (SNS) (98.6%) or index testing (96.3%) showed the highest proportions of ART initiation. Logistic regression showed that MSM who tested for HIV using the SNS had over 12 times higher odds of initiating ART (aOR = 12.166; 95% CI: 7.617–19.430; p < 0.001), compared to those who used a rapid test. A significant association was observed between HIV testing modalities and ART initiation, with SNS and index testing demonstrating higher odds of ART initiation. Full article

Objective: This study analyzes temporal trends in occupational cancer mortality in Brazil and its federative units from 1990 to 2023, focusing on regional and gender disparities. Methods: We conducted an ecological time-series analysis using data from the Global Burden of Disease (GBD) database. We included deaths from malignant neoplasms attributable to occupational exposures and calculated age-standardized mortality rates. We applied segmented regression with the Joinpoint Regression Program (version 5.4) to estimate the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) for Brazil and its states, stratified by sex. Results: Occupational cancer mortality declined nationally (AAPC = −1.08; 95% CI: −1.37 to −0.85), with a more substantial decrease among men. Marked regional differences emerged: the South, Southeast, and Midwest regions showed consistent declines, while several states in the North and Northeast exhibited stable or rising rates, especially among women. Part of the observed recent decline coincided with the COVID-19 pandemic (2019–2023), suggesting potential underdiagnosis or underreporting. Conclusion: Brazil has experienced a national decline in occupational cancer mortality; however, regional and gender inequalities persist. Territorial, economic, and occupational contexts shape these differences. Strengthening surveillance systems, updating exposure registries, and developing policies sensitive to regional and gender disparities may contribute to improving occupational cancer prevention and control. Full article

Many countries have introduced HPV screening and vaccination programs to reduce the burden of cervical cancer. In Poland, before 2023, HPV vaccination was available only on an individual, non-universal basis, using all types of vaccines, while in 2023, a nationwide vaccination program for boys and girls aged 12–13 years was introduced alongside updated screening guidelines. This retrospective study analyzed 2296 HPV-positive test results obtained from adult patients in Poland, including demographic data, HPV genotypes distribution, infection intensity, and cytological findings. HPV genotyping was performed using the Anyplex™ II HPV28 assay. HR-HPV genotypes accounted for 64.53% of all detected infections, with the highest prevalence observed in individuals aged 26–35 years of both sexes. HPV-18 was significantly more frequently in women (p = 0.0430), whereas HPV-53 predominated in men (p = 0.0030). Men more often presented low-intensity infections, while women showed higher viral load. Multigenotypic infections occurred in 46.5% of cases, particularly among younger patients (p < 0.001), and were significantly associated with LSIL changes in cytology. The HSIL type correlated most strongly with HPV-16 (p < 0.001). These findings confirm the high burden of HR-HPV infections in the Polish adult population and provide an essential epidemiological baseline for evaluating the impact of universal HPV vaccination and updated screening strategies. Full article

Background/Objectives: Teaching is a profession characterized by a high burden of stress. This study examined sex differences in autonomic regulation by analysing heart rate variability (HRV) and body fat percentage (BF%) in teachers, explicitly hypothesizing that the association between adiposity and autonomic modulation (HRV) would be more consistent in men. Methods: A cross-sectional study was conducted with 253 teachers from compulsory and university education during the 2022–2023 academic year. HRV was obtained from heart rate recordings, and body composition was assessed using bioelectrical impedance analysis. Analyses were stratified by sex and, in addition to comparisons based on the sex-specific median of fat mass (kg), ANCOVA models were performed and adjusted for age, teaching experience, and educational level. Results: Teachers with higher BF% were older (43.46 vs. 40.65 years; p = 0.007) and reported higher perceived stress (7.60 vs. 6.83; p = 0.034). In men, HRV was lower in the ≥p50 adiposity group, with reductions in RMSSD and pNN50 (p = 0.015–0.016). In women, RMSSD and pNN50 were not significant (p > 0.20; small effect sizes). In adjusted analyses (ANCOVA), no significant differences were found in men for any index; in women, HRmax and the LF/HF ratio were significant (small effects), whereas the remaining indices were not. Conclusions: Greater adiposity was associated with higher stress and lower HRV, particularly in men. In women, the pattern was more heterogeneous, and significance after adjustment was limited to HRmax and the LF/HF ratio, suggesting the need for sex-specific approaches to the assessment and promotion of psychophysiological well-being in teachers. Full article

Background: Wavelight technology (WT) has recently been introduced in international track meetings as a pacing aid designed to enhance consistency and performance. This study aimed to analyze the influence of WT on mean race speed and pacing profiles in 800 m Diamond League (DL) races and to compare its effects between men and women. Methods: Official results from 800 m DL races held between 2018 and 2025 (excluding 2020) were examined. A total of 689 performances (364 men, 325 women) were included, of which 403 used WT. Split times, each 200 mm, were extracted and expressed relative to mean race speed (%RS). WT implementation was confirmed through official race broadcasts. Results: Mean race speed differed significantly across years in both sexes (p < 0.001), with faster performances in 2024–2025 for men and in 2025 for women. In years where WT and non-WT races coexisted, WT was associated with higher mean speed in both men (7.60 ± 0.11 vs. 7.54 ± 0.14 m·s⁻¹; p = 0.007; small d = 0.47) and women (6.71 ± 0.09 vs. 6.67 ± 0.08 m·s⁻¹; p = 0.023; small d = 0.40). Regarding the pacing profiles, WT increased %RS in the first split (106.0 ± 1.7 vs. 104.9 ± 2.8; p = 0.014) and decreased it in the last split (96.5 ± 2.5 vs. 98.4 ± 4.4; p = 0.006) in men, whereas women showed no differences between conditions. Conclusions: WT was associated with faster mean race speeds in DL 800 m races and with more homogeneous pacing in men. However, WT modified pacing strategy only in men—inducing a faster start and slower finish—while women maintained similar pacing profiles regardless of WT use. WT thus enhances absolute performance but does not influence effort distribution equally across sexes. Full article

Background/Objectives: Hodgkin lymphoma (HL) primarily affects individuals of reproductive age, making gonadal dysfunction after chemotherapy a critical survivorship concern. While fertility preservation options including gamete and gonadal tissue cryopreservation are available before treatment, evidence-based counseling requires regimen-specific risk estimates accounting for patient age and sex. Therefore, a meta-analysis was performed to assess presumed infertility in HL patients, stratified by chemotherapy regimen, age, and sex. Methods: This systematic review and meta-analysis, conducted within the FertiTOX project, included studies published between 2000 and February 2024. Eligible studies reported gonadal function outcomes ≥ 1 year after chemotherapy, excluding patients who received pelvic radiotherapy or stem cell transplantation, or had recurrent disease. Presumed infertility was defined by surrogate markers, including amenorrhea, premature ovarian failure, or abnormal hormonal levels in women, and azoospermia, oligozoospermia, or abnormal hormonal levels in men. Results: Of 2376 screened studies, 50 were included (meta-analysis: 43 studies; 5564 female and 1631 male patients). Overall presumed infertility prevalence was 21% in women (95% CI: 0.14–0.29) and 45% in men (95% CI: 0.29–0.62). The highest prevalence occurred after BEACOPP (women 38%; men 81%), while ABVD was associated with the lowest (6% each in women and men). Childhood/adolescent HL treatment resulted in lower prevalence in women (8%) but remained high in men (67%). Conclusions: Fertility risk depends on regimen, age, and sex, requiring tailored counseling. For female children/adolescents and all patients receiving ABVD, post-treatment fertility evaluation and treatment may suffice. However, pre-treatment fertility preservation is strongly recommended for male adolescents and patients receiving other regimens. Full article

Although scholarship has long called for attention to the intersection of race and gender in workplace harassment, the experiences of Black Americans remain insufficiently theorized. Existing frameworks often assume harassment to be gender-based in ways that center White women’s victimization, leaving limited conceptual space to understand how Black women and Black men are targeted. In this essay, we synthesize research on racialized sex-based harassment (RSBH) to illustrate how harassment directed at Black Americans is shaped by cultural narratives that simultaneously sexualize, criminalize, and devalue them. Specifically, we introduce sociohistorical archetypes (e.g., Jezebel, Mammy, Sapphire, Mandingo, Brute, Uncle Tom) as cultural mechanisms through which RSBH is enacted, rationalized, and normalized within organizational contexts. We argue that RSBH functions as a mechanism for enforcing racialized gender hierarchy: it draws on sociohistorical meanings attached to Black femininity and masculinity to mark certain identities as inherently available, threatening, or subordinate. We further review evidence linking RSBH to psychological distress, social identity threat, physiological strain, and career stagnation, as well as factors that shape vulnerability and adaptation. By conceptualizing RSBH as a patterned and predictable form of identity-based harm, grounded in the lasting impact of sociohistorical archetypes, rather than a variation of generalized sexual harassment, this work advances theories of harassment and race in organizations. We conclude by outlining implications for measurement, organizational policy, and intervention efforts aimed at disrupting the reproduction of racialized gender inequality at work. Full article

Background: Subclinical respiratory impairment among non-smokers in regions with haze-affected regions is still under-recognized, particularly in low- and middle-income countries (LMICs). This study assessed the prevalence of subclinical respiratory impairment among non-smoking adults and examined its determinants and associations with health-related quality of life (HRQoL) in Chiang Mai, Thailand. Methods: In this cross-sectional study, 244 non-smoking adults (18–65 years) from three rural districts underwent standardized spirometry and completed the Thai WHOQOL-BREF-26. Subclinical impairment was defined as an FEV₁/FVC < 0.70 or FVC < 80% predicted in the absence of symptoms. Demographic, occupational, and environmental information was obtained through structured questionnaires. Statistical analyses included non-parametric tests, univariate linear regression, and logistic regression. Results: A total of 37 participants (15.2%) had subclinical respiratory impairment. No demographic, occupational, or environmental factors such as sex, age, BMI category, agricultural work, marital status, and self-reported pollution exposure were found to be independently linked to impaired lung function. There was no correlation between spirometry indices and any WHOQOL-BREF domain. Elderly participants (>50 years) reported a higher level of physical and psychological HRQoL. Those with a higher Body Mass Index (BMI) were more likely to have a lower environmental quality of life. Farmers reported a better QoL, while women reported a lower QoL than men. Conclusions: Subclinical respiratory impairment occurs frequently in non-smoking rural adults exposed to haze pollution in Chiang Mai, and isn’t presently assessed by general HRQoL instruments. These findings support early spirometry screening for asymptomatic adults in polluted regions, as well as more stringent air cleanliness strategies to prevent the evolution towards overt respiratory pathology. Full article