Search Results (2,126)

Background: Pericardial mesothelioma (PM) is an extremely rare cancer with a poor prognosis and no consensus on diagnostic and therapeutic management. We conducted a registry-based study on PM cases in Italy diagnosed between 1993 and 2021. Methods: Based on data from the Italian National Mesothelioma Registry (ReNaM), we performed a descriptive analysis of PM cases including clinical presentation, diagnostic work-up, asbestos exposure, and therapeutic management. Overall survival was calculated. Hazard ratios (HRs) and 95% confidence intervals (CI) for selected variables were estimated with univariate and multivariate Cox models. Results: We identified 72 cases (46 men and 26 women). Median age was 66 years (range 22–89). The most frequent histological subtypes were epithelioid and unspecified mesothelioma. Almost two-thirds of cases had been exposed to asbestos. The most common clinical presentation was pericardial effusion. Overall median survival was 2.8 months (95% CI 1.2–6.6) and older age at diagnosis was a negative prognostic factor. Clinical and treatment data were available for 47 patients (65%). Approximately one out of two patients underwent surgery (palliative, in one-third of cases). Adjuvant therapy was administered to seven patients (15%). In cases with treatment information, sarcomatoid subtype (HR 2.74, 95% CI: 1.06–7.06) was a negative prognostic factor; adjuvant therapy was associated with better survival (HR 0.38, 95% CI 0.14–1.02), but confounding by indication cannot be excluded. Conclusions: We confirmed the very poor prognosis of PM. An international network collecting PM cases with treatment information is needed to improve patient quality of life and survival. Full article

Steroid hormones (SHs), including sex steroids and corticosteroids, are crucial for a healthy pregnancy. We aimed to comprehensively characterize the maternal SH metabolome in late pregnancy and identify clinical, lifestyle, and sociodemographic determinants influencing SH metabolism with a replication in an independent cohort. Urinary SH metabolites were analyzed in 1221 third-trimester pregnant women (aged 28 to 37 years) from two Spanish cohorts, BiSC (2018–2021, n = 721) and INMA-Sabadell (2004–2006, n = 500), using targeted UHPLC-MS/MS. We quantified 50 SH metabolites, resulting in 13 hormone groups, 9 sulfate/glucuronide ratios, and 17 estimated steroid enzymatic activities across steroidogenesis pathways. We applied elastic net regression to identify determinants, and multivariable linear regression models to estimate variance explained. Among the 47 and 28 determinants from BiSC and INMA-Sabadell, respectively, 10 determinant-SH metabolome pairs showed statistically significant associations (p < 0.05), supporting robust replication. Maternal BMI was the main determinant linked to higher corticosteroid and androgen metabolites. Higher physical activity was associated with lower glucocorticoids and progestogen metabolites, while older maternal age was related with lower levels of androgen and corticosteroid metabolites. Tobacco exposure in the first trimester predicted higher levels of cortisol metabolites. Latin American women had lower cortolone levels compared with Spanish women. Parity, dietary fat intake, sleep, alcohol intake, and sex of the fetus contributed to smaller variations in different SHs. This dual-cohort analysis provides the most detailed and replicated evidence to date of how clinical, lifestyle, and sociodemographic factors shape the maternal SH metabolome during late pregnancy. Full article

Background/Objectives: Obstetric violence (OV) is a violation of women’s human rights during reproductive processes. Despite being the subject of debate among healthcare professionals, increasingly recognized, and legislated against in some countries, OV continues to be reproduced and normalized during training. The objective of this study was to determine the perception of OV among health sciences students and gynaecology and obstetrics residents. Methods: A cross-sectional observational study was conducted with 304 health sciences students and gynaecology and obstetrics residents in Spain. An online questionnaire was distributed that gathered information on sociodemographic variables and clinical experience and included the validated PercOV-S instrument. Descriptive and bivariate analyses were performed to explore associations between variables. Results: The overall perception of OV was moderately high (mean 3.93/5), with higher scores for visible or protocolized forms (4.27/5) than for invisible or subtle forms (2.87/5). Being a woman, being a midwifery resident, or having had personal experiences with pregnancy or childbirth increased sensitivity to OV. Clinical exposure in obstetrics and gynaecology services increased both awareness and the likelihood of witnessing OV. Twenty-eight percent of students reported having observed OV, and twenty percent reported emotional distress, even considering dropping out. Conclusions: Despite the recognition of OV, repeated exposure during training can promote its normalization. The results of this study highlight the need for safe, reflective training environments that mainstream feminist perspectives, sexual rights, and the detection of subtle forms of OV. Full article

Background/Objectives: Childbirth, although generally a positive life event, can sometimes be experienced as traumatic, leading to postpartum post-traumatic stress disorder. Emergency caesarean section and operative vaginal delivery are associated with elevated psychological distress, while factors such as lifetime trauma, domestic violence, anxiety, and coping strategies may further increase vulnerability. Methods: This prospective cohort study included 113 postpartum women who delivered via emergency caesarean section (73.5%) or operative vaginal delivery (26.5%) in two tertiary hospitals in Athens, Greece (March–July 2023). Data were collected at three time points: the second postpartum day, six weeks postpartum, and three months postpartum. Descriptive statistics were used to summarize sample characteristics. Chi-square tests were performed for categorical variables and independent sample t-tests for continuous variables. Multivariate logistic regression analyses were conducted to identify predictors of postpartum post-traumatic stress disorder, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results: At six weeks postpartum, 14.2% of participants met full diagnostic criteria for P-PTSD. Postpartum post-traumatic stress was strongly associated with higher state and trait anxiety, fewer positive coping strategies, and exposure to domestic violence (lifetime, during pregnancy, and in the past year). Women with traumatic childbirth experiences had a 14.7-fold higher risk of developing P-PTSD. Lifetime trauma, particularly physical or sexual abuse and exposure to disasters, further increased vulnerability. Over the last three months, 50% of those initially diagnosed continued to meet the diagnostic criteria. Multivariate analysis identified traumatic childbirth, state anxiety, and domestic violence during pregnancy as significant predictors of postpartum post-traumatic stress. Conclusions: Postpartum post-traumatic stress is a significant and underestimated consequence of high-risk deliveries. Screening for domestic violence and trauma history during pregnancy, assessing perinatal anxiety, and providing trauma-informed psychological support are critical to reducing maternal psychiatric morbidity and promoting maternal-infant well-being. Full article

Bisphenol A, Bisphenol S, and Bisphenol F are widely used plastic additives and endocrine-disrupting chemicals with potential adverse health effects. Limited research has examined lifestyle and dietary factors influencing human exposure to these compounds. This study investigated associations between urinary bisphenol concentrations and demographic, lifestyle, dietary, and food-handling factors in 4239 Korean adults aged 19 to 82 years (1889 men, 44.6%; 2350 women, 55.4%) from the Korean National Environmental Health Survey (2018–2020). Median urinary concentrations with interquartile ranges were 1.15 µg/L (IQR: 0.45–2.27) for BPA, 0.17 µg/L (IQR: 0.06–0.41) for BPF, and 0.15 µg/L (IQR: 0.06–0.38) for BPS. Urinary bisphenol concentrations differed significantly by gender, age, smoking status, alcohol consumption, and education level (p < 0.001), with higher concentrations in younger males, smokers, and alcohol consumers. Frequent consumption of instant noodles, microwaveable foods, canned foods, and plastic-wrapped takeout was significantly associated with elevated bisphenol levels (p < 0.001). Use of plastic containers, coated cookware, and electric rice cookers was linked to higher urinary BPA and BPS concentrations. BPA showed statistically significant but weak positive correlations with serum creatinine (r = 0.044, p < 0.05) and height (r = 0.037, p < 0.05), as assessed using Pearson’s correlation test. BPF was negatively correlated with aspartate aminotransferase (AST) levels (r = −0.042). Public health strategies should prioritize safer food storage practices and enhance awareness of health risks associated with these chemicals. Full article

Sexual health includes psychosocial and physical competencies related to sexual well-being. It is unknown whether violent pornography is associated with sexual health. The objective of this study is to analyze whether different types of pornography are associated with sexual health in young adults. A cross-sectional study was conducted using an online survey with 3607 people aged 18–35 living in Spain. Association of pornography with the dependent variables was estimated with generalized linear and logistic models. Compared to exposure to pornography with no explicit violence, men exposed to pornography with physical violence scored lower on empathy (coef: −0.054) and sexual assertiveness (coef: −0.034) and higher on acceptance of violence against women (coef: 0.122). Women who watch physical violence pornography scored higher on acceptance of violence against women (coef: 0.076). In men, watching pornography with physical violence was associated with poorer sexual function (OR = 1.9). In women, pornography with physical violence was associated with difficulty having an orgasm in a relationship (OR = 1.7). Violent pornography could have wide negative effects on men sexual health. In both sexes, violent pornography was associated with greater acceptance of violence against women. Inequalities were observed between women and men in the enjoyment of sexual relations, to the detriment of women. Full article

Background: In patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension (summarized as pulmonary vascular disease; PVD), it is unclear whether the brain is protected against acute hypoxia and whether acute pulmonary vascular dilatation by sildenafil would influence cerebral and muscle tissue oxygenation whilst breathing normoxia or hypoxia. Methods: Adult patients with PVD underwent right heart catheterization, while cerebral and muscular tissue oxygenation and tissue hemoglobin index were measured using near-infrared spectroscopy along with arterial and mixed-venous blood gases. Participants underwent a four-stage protocol in which they were blinded to breathing either normoxia (FiO₂ 0.21) or normobaric hypoxia (FiO₂ 0.15), both before and after a single oral dose of sildenafil (50 mg) according to a randomized, cross-over design. Results: In 22 PVD patients (9 women, age 54 ± 14 y) under hypoxia, mean cerebral tissue oxygenation decreased by −2% (95% CI −4 to 0%, p = 0.046), muscular tissue oxygenation by −1% (95% CI −3 to 0%, p = 0.011) and mean arterial partial pressure of oxygen by −2.3 kPa (95% CI −2.7 to −1.8 kPa, p < 0.0001). Sildenafil improved the cerebral tissue hemoglobin index under hypoxia compared to hypoxia without sildenafil by 0.12 (95% CI 0.00 to 0.23, p = 0.049), but not the muscular tissue hemoglobin index. Conclusions: In PVD patients, acute exposure to normobaric hypoxia leads to a reduction in arterial oxygenation as well as cerebral and muscular tissue oxygenation. Sildenafil improves cerebral blood flow but has no effect on arterial, cerebral or muscular oxygenation. Full article

Background/Objectives: This study aimed to assess the associations between the Lifestyle Inflammation Score (LIS) and gestational diabetes mellitus (GDM), and glucose metabolism alterations (GMA) postpartum. Methods: A secondary analysis was conducted on 378 pregnant women at the end of pregnancy. Anthropometric, clinical, biochemical, and dietary parameters were evaluated. Postpartum reclassification was based on fasting serum glucose (>100 mg/dL), HbA1c (>5.7%), and/or a 2-h oral glucose tolerance test (>140 mg/dL). The LIS was calculated using a proxy index including smoking status, physical activity, and pregestational BMI, applying the beta coefficient from the original LIS model. Tertiles were created, with T3 indicating the highest level of proinflammatory exposure. Statistical analyses included Kruskal–Wallis, one-way ANOVA, linear-by-linear association, and multivariate logistic regression, adjusted for family history, gestational weight gain, carbonylated proteins, and adiponectin to evaluate associations between LIS and GDM, and adjusted for pharmacological treatment, gestational weight gain, and breastfeeding for LIS and GMA. Results: Higher LIS values were more common among women with GDM (T1 = 45.9%, T2 = 62.2%, T3 = 74.8%, p < 0.001) and among those with GMA (T1 = 34.4%, T2 = 45.6%, T3 = 53.7%, p = 0.019). Compared with the lowest tertile, the highest tertile of LIS was associated with greater odds of GDM (OR 3.72; 95% CI: 1.19–11.64, p = 0.024) and GMA (OR 2.69; 95% CI: 1.25–5.76, p = 0.011). Conclusions: A more proinflammatory lifestyle, as reflected by a higher LIS, increases the risk of progression to GDM and later to GMA. Full article

The prevalence of maternal obesity is rapidly increasing, which represents a major public health concern worldwide. Currently more than 50% of all adult women are overweight or obese, and this trend is reflected in women of child-bearing age. Maternal obesity is characterized by metabolic dysfunction and chronic inflammation, and is associated with health problems in both the mother and the offspring. Intrauterine programming occurs during embryonic and fetal development, a critical period not only for the formation of tissues and organs but also for the etiology of diseases later in life. The principal mechanisms underlying fetal programming in the offspring of obese mothers appear to involve DNA methylation and chromatin remodeling within progenitor cells. Aberrant DNA methylation patterns have been identified in genes involved in insulin signaling, lipid metabolism, and appetite regulation in the placenta and fetal tissues. Histone modifications, such as acetylation and methylation of histone tails, may also play a crucial role in modulating chromatin structure and accessibility of transcriptional machinery to DNA. The persistence of such modifications throughout life, and potentially across generations, can lead to permanent alterations in gene expression, thereby contributing to the intergenerational transmission of metabolic disorders. The aim of this paper is to present an overview of the current knowledge regarding the effects of maternal obesity on fetal development and the occurrence of fetal complications, as well as long-term complications observed in adulthood related to intrauterine exposure to maternal obesity, including hypertension and cardiovascular diseases, impaired insulin secretion and resistance, diabetes mellitus, and metabolic syndrome. The mechanisms underlying fetal programming are also discussed. Full article

Carbon programs often assume that uniform cash transfers are sufficient to change land use, yet the design of benefits may be the controlling factor. We test payment complementarity—the coordinated use of cash and community benefits—in the International Small Group and Tree Planting Program across Kenya, Tanzania, Uganda, and India. Using administrative and survey data from 8432 participants, we classify realized mechanisms into cash-only, alternative-only, and mixed categories, and examine their associations with conservation adoption and land-use intensity. Mixed arrangements are associated with 73% higher conservation farming adoption (68.4% vs. 36.6% under cash-only) and greater tree density (281 vs. 215 and 115 trees/ha for cash-only and alternative-only, respectively). Formal tests reject simple averaging, consistent with super-additive effects. Adoption of mixed mechanisms clusters in districts that exceed an organizational participation threshold (approximately 38.9%), suggesting peer exposure and social learning. Gender-disaggregated patterns indicate that women receiving alternatives (predominantly in mixed regimes) manage nearly three times as many trees as their cash-only peers and are the only subgroup surpassing the USD 2/day poverty threshold. Each alternative arrangement benefits an average of 167 community members; accounting for spillovers implies an approximate 191-times village-level multiplier. Mixed designs require greater administrative effort but deliver larger community returns. We report associations, not causal effects, and employ controls, fixed effects, matching, and stability checks to probe our selection. Policy implications are immediately clear: outcome-based standards that permit mixed payments, credit spillovers, and paired flexibility with safeguards (transparent negotiation, verified delivery, documented consent) can multiply the land-use impact of climate finance. The results are associative rather than causal and generalize primarily to contexts with similar institutional prerequisites, including established organizational capacity and program rules permitting benefit negotiation. Full article

A strong body of evidence indicates that social determinants impact health. While this research has identified a range of risk factors for health, health equity goals require recalibration further “upstream” towards structural drivers of health and aging inequities. Recognizing how systems of power and chronic exposures are embodied and facilitate differential risks and opportunities is important for expanding research at the gender–race–age nexus. Specifically, adopting a structural aging approach can help contextualize health outcomes for older Black women. Drawing from previous research, we explore how structural drivers shape health, examine their impact on Black women’s life experiences, stress exposures, and present a model for interpreting social trajectories of oppression, resistance, and marginalization (i.e., the STORM model) across the lifespan. Extending research on strength, resistance, resilience, and coping may open new opportunities to reframe and understand older Black women’s health. Importantly, developing structural competence can facilitate “seeing structures” and advocating for structural interventions leading to critically minded theory, practice, and policy that properly situate aging processes within broader, intersectional contexts. Full article

Background/Objectives: Evidence regarding the associations between coffee and tea consumption and bone mineral density (BMD) in postmenopausal women remains inconclusive. Prior studies have not examined these relationships using repeated measures of both beverage intake and BMD over an extended follow-up. This study aimed to evaluate the longitudinal associations of coffee and tea consumption with BMD in older women. Methods: Data were drawn from the Study of Osteoporotic Fractures (SOF), a prospective cohort of 9704 women aged ≥65 years. Coffee and tea intake were repeatedly assessed via self-administered questionnaires at visits 2, 4, 5, and 6, spanning approximately 10 years. Femoral neck and total hip BMD were repeatedly measured by dual-energy X-ray absorptiometry. Linear mixed-effects models with random intercepts were used to estimate associations, adjusting for demographic, physical activity, comorbidities, and medication use. Nonlinear relationships were assessed using natural splines, and subgroup analyses were conducted using exposure-by-covariate interaction terms. Results: During the 10-year follow-up, tea consumption was positively associated with total hip BMD (least squares mean: 0.718 vs. 0.715 g/cm²; mean difference: 0.003; 95% CI: 0.000–0.005; p = 0.026). No significant overall association was observed on coffee consumption with femoral neck or total hip BMD. However, spline analyses suggested that consuming more than five cups of coffee per day may be associated with lower BMD. Interaction analyses indicated significant interactions between coffee and alcohol intake (p = 0.0147) and between tea consumption and BMI (p = 0.0175). Conclusions: Tea consumption was associated with higher total hip BMD in postmenopausal women, whereas excessive coffee intake (>5 cups/day) may adversely affect BMD. Coffee consumption was negatively associated with femoral neck BMD in women with higher alcohol intake, while tea consumption appeared particularly beneficial for those with obesity. Full article

This study explored the effects of soil restoration on cadmium (Cd) body burden and renal tubular damage in inhabitants of Cd-polluted areas by estimating the lifetime Cd (LCd) intake and expected LCd intake without soil restoration. In total, 1819 participants (991 men and 828 women) were included in the analysis. Furthermore, 845 participants (503 men and 342 women) who had lived in Cd-polluted areas before soil restoration were selected to estimate LCd intake with and without soil restoration. LCd intake was estimated based on residential history and rice Cd concentrations in each area. First morning urine samples were collected for urinary Cd (U-Cd, as the Cd body burden) and β2-microglobulin (as the renal tubular marker) measurements. The mean LCd intake was 3.0 g for men and 2.6 g for women in Cd-polluted areas with soil restoration. The mean expected LCd intake without soil restoration was 5.1 g for men and 4.6 g for women, indicating that soil restoration reduced LCd intake by approximately 2 g for both sexes. Soil restoration significantly reduces LCd intake, Cd body burden, and renal tubular effects. This information is crucial for developing strategies to reduce Cd exposure worldwide. Full article

Background and Objectives: Sexual function often fluctuates during pregnancy, yet the contributions of body image-related quality of life (BI-QoL)—operationalized via body image instruments such as the Body Exposure during Sexual Activities Questionnaire (BESAQ) and pregnancy-specific body image scales—and relationship satisfaction remain inconsistently quantified. This systematic review aimed to synthesize evidence on the associations between BI-QoL, relationship satisfaction, and female sexual function in pregnant women. Methods: Following PRISMA 2020, PubMed/MEDLINE, Scopus, and Web of Science were searched up to 23 August 2025. Eligible studies enrolled pregnant women and reported quantitative data on BI-QoL and/or relationship satisfaction alongside sexual outcomes. Risk-of-bias used design-appropriate tools; findings were narratively synthesized due to heterogeneity. Results: Thirteen studies met criteria (predominantly cross-sectional; sample sizes 107–472; one RCT; several couples/longitudinal cohorts). Female Sexual Function Index (FSFI) means clustered in the mid-20s; in a randomized trial, the intervention arm improved FSFI by +1.76 points (22.95 → 24.71; p = 0.002). Overall female sexual dysfunction reached 54.7% in the largest cross-sectional sample. Higher body exposure anxiety was associated with ~4.24-fold greater odds of dysfunction across trimesters. Marital satisfaction explained ≈36% of FSFI variance in multivariable models. Pregnancy context factors related to BI-QoL included planned pregnancy (β = −0.273) and third trimester (β = −0.280) indicating better BI-QoL, while more children predicted worse BI-QoL (β = +0.317). In one cohort, BI during sexual activity worsened postpartum versus pregnancy (p = 0.01). Conclusions: Across diverse settings, poorer BI-QoL and lower relationship satisfaction were consistently linked to reduced sexual function during pregnancy, with desire/arousal most affected. Routine screening and couple-sensitive counseling should be considered as promising, yet still under-tested, strategies that warrant further evaluation in intervention studies. Full article

Background. Climate change is increasingly recognized as a threat to mental health, giving rise to constructs such as eco-anxiety and solastalgia. Although these phenomena have gained attention, quantitative data from European populations remain scarce. Objectives. This study investigated the prevalence and correlates of eco-anxiety in an Italian sample, focusing on associations with demographics, environmental disaster exposure, psychological distress, psychosis-risk indicators, and quality of life. Methods. A cross-sectional online survey was conducted with 1051 participants. Measures included the Hogg Eco-Anxiety Scale (HEAS-13), Brief Symptom Inventory (BSI), Prodromal Questionnaire (PQ-16), SF-36 Health Survey, and a socio-demographic/environmental exposure questionnaire. Data were analyzed using correlations, t-tests, and regression analyses. Results. Eco-anxiety was higher among younger participants, women, and individuals without children, while education showed a weak negative association. No differences emerged by rural vs. urban residence. Participants exposed to floods, droughts, wildfires, and landslides reported elevated eco-anxiety. Scores correlated strongly with general distress (r = 0.57), positively with psychosis-risk indicators (PQ-16 distress, r = 0.42), and negatively with quality of life (r = −0.25). Conclusions. Eco-anxiety in Italy is linked to socio-demographic vulnerabilities, disaster exposure, and impaired mental health. These findings highlight eco-anxiety as a pressing public health concern and stress the need for prevention and interventions that promote adaptive coping and engagement with climate change. Full article