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Scientific Reports Jun 2024The incidence and prevalence of dialysis in Taiwan are high compared to other regions. Consequently, mitigating chronic kidney disease (CKD) and the worsening of kidney...
The incidence and prevalence of dialysis in Taiwan are high compared to other regions. Consequently, mitigating chronic kidney disease (CKD) and the worsening of kidney function have emerged as critical healthcare priorities in Taiwan. Heat stress is known to be a significant risk factor for CKD and kidney function impairment. However, differences in the impact of heat stress between males and females remains unexplored. We conducted this retrospective cross-sectional analysis using data from the Taiwan Biobank (TWB), incorporating records of the wet bulb globe temperature (WBGT) during midday (11 AM-2 PM) and working hours (8 AM-5 PM) periods based on the participants' residential address. Average 1-, 3-, and 5-year WBGT values prior to the survey year were calculated and analyzed using a geospatial artificial intelligence-based ensemble mixed spatial model, covering the period from 2010 to 2020. A total of 114,483 participants from the TWB were included in this study, of whom 35.9% were male and 1053 had impaired kidney function (defined as estimated glomerular filtration rate < 60 ml/min/1.73 m). Multivariable analysis revealed that in the male participants, during the midday period, the 1-, 3-, and 5-year average WBGT values per 1 ℃ increase were significantly positively associated with eGFR < 60 ml/min/1.73 m (odds ratio [OR], 1.096, 95% confidence interval [CI] = 1.002-1.199, p = 0.044 for 1 year; OR, 1.093, 95% CI = 1.000-1.196, p = 0.005 for 3 years; OR, 1.094, 95% CI = 1.002-1.195, p = 0.045 for 5 years). However, significant associations were not found for the working hours period. In the female participants, during the midday period, the 1-, 3-, and 5-year average WBGT values per 1 ℃ increase were significantly negatively associated with eGFR < 60 ml/min/1.73 m (OR, 0.872, 95% CI = 0.778-0.976, p = 0.018 for 1 year; OR, 0.874, 95% CI = 0.780-0.978, p = 0.019 for 3 years; OR, 0.875, 95% CI = 0.784-0.977, p = 0.018 for 5 years). In addition, during the working hours period, the 1-, 3-, and 5-year average WBGT values per 1 ℃ increase were also significantly negatively associated with eGFR < 60 ml/min/1.73 m (OR, 0.856, 95% CI = 0.774-0.946, p = 0.002 for 1 year; OR, 0.856, 95% CI = 0.774-0.948, p = 0.003 for 3 years; OR, 0.853, 95% CI = 0.772-0.943, p = 0.002 for 5 years). In conclusion, our results revealed that increased WBGT was associated with impaired kidney function in males, whereas increased WBGT was associated with a protective effect against impaired kidney function in females. Further studies are needed to elucidate the exact mechanisms underlying these sex-specific differences.
Topics: Humans; Female; Male; Taiwan; Middle Aged; Cross-Sectional Studies; Retrospective Studies; Aged; Glomerular Filtration Rate; Adult; Kidney; Renal Insufficiency, Chronic; Sex Factors; Risk Factors; Heat-Shock Response; Heat Stress Disorders
PubMed: 38918487
DOI: 10.1038/s41598-024-65741-7 -
PloS One 2024Early life adversity (ELA) increases the likelihood of later-life neuropsychiatric disorders and cognitive dysfunction. Importantly, ELA, neuropsychiatric disorders, and...
Early life adversity (ELA) increases the likelihood of later-life neuropsychiatric disorders and cognitive dysfunction. Importantly, ELA, neuropsychiatric disorders, and cognitive deficits all involve aberrant immune signaling. Microglia are the primary neuroimmune cells and regulate brain development. Microglia are particularly sensitive to early life insults, which can program their responses to future challenges. ELA in the form of maternal separation (MS) in rats alters later-life microglial morphology and the inflammatory profile of the prefrontal cortex, a region important for cognition. However, the role of microglial responses during MS in the development of later cognition is not known. Therefore, here we aimed to determine whether the presence of microglia during MS mediates long-term impacts on adult working memory. Clodronate liposomes were used to transiently deplete microglia from the brain, while empty liposomes were used as a control. We hypothesized that if microglia mediate the long-term impacts of ELA on working memory in adulthood, then depleting microglia during MS would prevent these deficits. Importantly, microglial function shifts throughout the neonatal period, so an exploratory investigation assessed whether depletion during the early versus late neonatal period had different effects on adult working memory. Surprisingly, empty liposome treatment during the early, but not late, postnatal period induced microglial activity changes that compounded with MS to impair working memory in females. In contrast, microglial depletion later in infancy impaired later life working memory in females, suggesting that microglial function during late infancy plays an important role in the development of cognitive function. Together, these findings suggest that microglia shift their sensitivity to early life insults across development. Our findings also highlight the potential for MS to impact some developmental processes only when compounded with additional neuroimmune challenges in a sex-dependent manner.
Topics: Animals; Microglia; Female; Maternal Deprivation; Rats; Male; Cognition; Memory, Short-Term; Animals, Newborn; Prefrontal Cortex; Rats, Sprague-Dawley; Age Factors
PubMed: 38917075
DOI: 10.1371/journal.pone.0306022 -
BJPsych Bulletin Jun 2024Chemsex occurs primarily among gay, bisexual and other men who have sex with men (GBMSM), and there is evidence of a subgroup of users who carry out chemsex-related... (Review)
Review
Chemsex occurs primarily among gay, bisexual and other men who have sex with men (GBMSM), and there is evidence of a subgroup of users who carry out chemsex-related criminal offences and experience harm. Challenges with chemsex can present to various settings; there are concerns that harm is increasing, including at interfaces between health, social care and criminal justice systems. The UK response to date has lacked a coordinated approach. An expert reference group was convened to share chemsex knowledge, articulate priorities for research and pathway development, and foster collaborative working between agencies. It made three key recommendations: develop and increase training and awareness across all services; implement a coordinated research programme with the development of a common data-set and assessment tool to fully characterise population-level needs; develop a professional network to share information, provide professional support and act as a knowledge hub. There was support for a unified multi-agency strategy incorporating the priorities identified as overarching principles.
PubMed: 38916191
DOI: 10.1192/bjb.2024.46 -
Frontiers in Genetics 2024Differences/disorders of sex development (DSDs) in individuals with a 46, XY karyotype are a group of congenital disorders that manifest as male gonadal hypoplasia or... (Review)
Review
Differences/disorders of sex development (DSDs) in individuals with a 46, XY karyotype are a group of congenital disorders that manifest as male gonadal hypoplasia or abnormalities of the external genitalia. Approximately 50% of patients with 46, XY DSDs cannot obtain a molecular diagnosis. The aims of this paper were to review the most common causative genes and rare genes in patients with 46, XY DSDs, analyze global molecular diagnostic cohorts for the prevalence and geographic distribution of causative genes, and identify the factors affecting cohort detection results. Although the spectrum of genetic variants varies across regions and the severity of the clinical phenotype varies across patients, next-generation sequencing (NGS), the most commonly used detection method, can still reveal genetic variants and aid in diagnosis. A comparison of the detection rates of various sequencing modalities revealed that whole-exome sequencing (WES) facilitates a greater rate of molecular diagnosis of the disease than panel sequencing. Whole-genome sequencing (WGS), third-generation sequencing, and algorithm advancements will contribute to the improvement of detection efficiency. The most commonly mutated genes associated with androgen synthesis and action are , , and , and the most commonly mutated genes involved in gonadal formation are and Detection results are affected by differences in enrollment criteria and sequencing technologies.
PubMed: 38915825
DOI: 10.3389/fgene.2024.1387598 -
Lipids in Health and Disease Jun 2024Uric acid (UA), a liver-derived metabolite, is intimately tied to metabolic disorders. Although ample research underscores its connection with hypertriglyceridemia...
BACKGROUND
Uric acid (UA), a liver-derived metabolite, is intimately tied to metabolic disorders. Although ample research underscores its connection with hypertriglyceridemia (HTG), studies focusing on adolescents remain limited. To fill the gaps in epidemiology,this study focused on analyzing the relationship between the levels of uric acid and HTG in a demographic sample comprising adolescents from the United States.
METHODS
In this study, a total of 4,435 participants through the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020. The exposure variable was serum uric acid (SUA), the effect variable was HTG, and the covariates included demographic, questionnaire, physical examination and laboratory indicators. We utilized weighted logistic regression and meticulous subgroup evaluations to discern the intrinsic link between SUA and HTG. Stratified analyses augmented the validation of this association, while smooth curve fitting probed for potential nonlinear correlations.
RESULTS
The study included 4,435 participants. Male adolescents exhibit elevated SUA levels. After adjusting for all variables, the weighted multiple logistic regression model revealed that SUA was positively correlated with HTG risk (OR = 1.006, 95% CI: 1.005-1.007). This relationship was consistent across the three tertiles group of SUA (T1: OR = 1.006 [95% CI: 1.005-1.007]; T2: OR = 1.006 [95% CI: 1.005-1.007]; T3: OR = 1.004 [95% CI: 1.003-1.006]; P for trend < 0.001). Stratified analyses confirmed that the positive correlation between SUA and HTG risk was significant, irrespective of sex, age or race.
CONCLUSIONS
In American children and adolescents aged 12 to 18 years, there was a pronounced association between SUA and HTG. SUA could serve as a risk indicator for HTG. It is recommended that children diagnosed with HTG should be regularly tested for SUA levels. In addition, it is recommended that SUA be included in the comprehensive care of children diagnosed with HTG.
Topics: Humans; Uric Acid; Adolescent; Hypertriglyceridemia; Male; Female; Child; Cross-Sectional Studies; Nutrition Surveys; Logistic Models; Risk Factors; United States; Triglycerides
PubMed: 38915087
DOI: 10.1186/s12944-024-02182-1 -
Gynecological Endocrinology : the... Dec 2024To investigate the association between female sexual function and metabolic features among women with polycystic ovary syndrome (PCOS) during reproductive age.
OBJECTIVE
To investigate the association between female sexual function and metabolic features among women with polycystic ovary syndrome (PCOS) during reproductive age.
METHOD
This was a cross-sectional study in which 288 women with PCOS and 180 women without PCOS between the ages of 20 and 40 years were evaluated. All women had serum total testosterone, androstenedione, DHEA-S, fasting glucose, total cholesterol, HDL-C, LDL-C, and triglyceride levels analyzed. The McCoy Female Sexual Questionnaire (MFSQ) was applied to all studied women. Exploratory factor analysis and reliability analysis were done after data collection. The factor loadings of MFSQ domains were compared between women with PCOS and controls.
RESULTS
Average factor loadings of the MFSQ sexuality domain and MFSQ sexual partner domain were significantly lower in the PCOS group when compared to controls. There was no correlation between the two sexual function domains of the MFSQ and the PCOS features either in the PCOS group or the controls.
CONCLUSION
PCOS is a heterogeneous disease with different metabolic components, such as insulin resistance, obesity, and hyperandrogenism. Although sexual function among women with PCOS was lower than controls, no differences were found in metabolic features of the PCOS and non-PCOS groups with relation to sexual function determined by the MFSQ.
Topics: Humans; Female; Polycystic Ovary Syndrome; Adult; Cross-Sectional Studies; Turkey; Young Adult; Insulin Resistance; Sexual Dysfunction, Physiological; Testosterone; Surveys and Questionnaires; Case-Control Studies; Hyperandrogenism; Sexual Behavior; Androstenedione; Dehydroepiandrosterone Sulfate; Obesity
PubMed: 38913084
DOI: 10.1080/09513590.2024.2362249 -
Journal of Clinical Research in... Jun 202417α‑hydroxylase/17,20‑lyase deficiency (17OHD) is a rare form of congenital adrenal hyperplasia that causes decreased cortisol and sex steroid levels and leads to...
17α‑hydroxylase/17,20‑lyase deficiency (17OHD) is a rare form of congenital adrenal hyperplasia that causes decreased cortisol and sex steroid levels and leads to high production of adrenocorticotropic hormone (ACTH). Although affected patients have absolute cortisol deficiency, they do not show clinical signs of cortisol deficiency or hyperpigmentation. These patients most commonly present with delayed puberty and amenorrhea at late pubertal age. Impaired production of sex steroids leads to ambiguous or female external genitalia in affected 46, XY individuals. In this report, we describe a patient with 17OHD who presented with hyperpigmentation and hypergonodotropic hypogonadism while receiving chemotherapy.
PubMed: 38912718
DOI: 10.4274/jcrpe.galenos.2024.2024-3-13 -
International Journal of Applied &... 2024A male patient in his late twenties presented with ambiguous genitalia to our tertiary specialist unit with complaints of short stature and inadequate copulation. There...
A male patient in his late twenties presented with ambiguous genitalia to our tertiary specialist unit with complaints of short stature and inadequate copulation. There was no history of consanguinity, and a physical examination raised concerns about possible disorders of sexual development (DSD). Karyotyping and fluorescence hybridization results were consistent with the presence of two X chromosomes, revealing the patient to be a genotypic female. Sanger sequencing showed a heterozygous pathogenic mutation in the CYP21A2 gene known to be associated with 21-hydroxylase deficiency, thus confirming the diagnosis of congenital adrenal hyperplasia (CAH), Prader stage V. DSD with CAH is distressing for the patient and their families, and the management needs a multidimensional approach involving diverse medical, genetic, and psychological considerations. Cytogenetic and molecular genetic studies play an essential role in diagnosis and decision-making and should be made affordable in developing countries for better patient care.
PubMed: 38912360
DOI: 10.4103/ijabmr.ijabmr_473_23 -
Indian Journal of Endocrinology and... 2024Assessment of genitalia is an important part of the neonatal examination. Regional, racial, and ethnic variations in phallic length have been documented. Clitoral...
INTRODUCTION
Assessment of genitalia is an important part of the neonatal examination. Regional, racial, and ethnic variations in phallic length have been documented. Clitoral dimensions may also show similar variations. Normal values for neonatal clitoral measurements may help the pediatrician/neonatologist to accurately diagnose clitoromegaly and underlying etiology to guide appropriate investigations. Data on clitoral measurements is limited with only one study from India (Kolkata). Hence we aimed in this study to generate south Indian data on neonatal clitoral dimensions, anogenital distance, and anogenital ratio. Two hundred and fifty two hemodynamically stable term female neonates without ambiguous genitalia/vulval masses born in a community hospital. Hospital-based cross-sectional study. 1. To measure clitoral dimensions, anogenital distance, and anogenital ratio in female neonates. 2. To correlate clitoral dimensions, anogenital distance, and ratio with anthropometric measurements, gestational age, and maternal comorbidities.
METHODS
Measurements were recorded using a digital vernier caliper, under strict aseptic precautions with labia majora gently separated and the baby held in a frog-leg position. Clitoral length, width, and anogenital distance were measured and anogenital ratio and clitoral index were calculated.
RESULTS
In term neonates, the mean ± SD of clitoral length (CL), clitoral width (CW), anogenital ratio (AGR) were 6.34 ± 1.75 mm, 6.39 ± 1.27 mm and 0.39 ± 0.05, respectively. The 3 and 97 centiles for mean clitoral length were 3.55 and 9.93 mm, for mean clitoral width were 3.37 and 8.35 mm, and for AGR were 0.28 and 0.48, respectively. These clitoral dimensions in south Indian neonates were higher than those from East India (Kolkata), lower than Nigerian babies, and similar to Israeli neonates. Mean CL and CW had no statistical correlation with birth weight, gestational age, head circumference, or length in term neonates. A significant correlation was noted between pregnancy-induced hypertension and mean clitoral width, and between gestational diabetes and AGR.
CONCLUSION
Normative values for clitoral dimensions (length and width) and AGR for south Indian term female neonates have been established. 97 centiles of 9.93 mm (CL) and 8.35 mm (CW) and 0.48 mm (AGR) may be used as practical cut-offs to diagnose clitoromegaly and virilization. Clitoral measurements had no statistical correlation with birth weight, gestational age, or anthropometry. Clitoral measurements exhibit ethnic and racial differences, thus emphasizing the importance of regional cut-offs and need for more studies from different parts of India on CL.
PubMed: 38911105
DOI: 10.4103/ijem.ijem_145_23 -
Pediatric Radiology Jun 2024Magnetic resonance diffusion tensor imaging (DTI) has recently been used to evaluate the developing cartilage of children, but the influencing factors have not been well...
BACKGROUND
Magnetic resonance diffusion tensor imaging (DTI) has recently been used to evaluate the developing cartilage of children, but the influencing factors have not been well studied.
OBJECTIVE
The objective of this study was to investigate the influence of the diffusion gradient strength (b value), diffusion gradient direction, age and sex on knee cartilage DTI in healthy children aged 6-12 years.
MATERIALS AND METHODS
A total of 30 healthy child volunteers, with an average age of 8.9 ± 1.6 (mean ± standard deviation) years, were enrolled in this study. They were categorized into three groups according to their age range: 6-8 years, 8-10 years and 10-12 years, ensuring equal sex distribution in each group (5 boys and 5 girls). These volunteers underwent routine left knee joint magnetic resonance imaging (MRI) and serial DTI scans. DTI parameters were altered as follows: when b value = 600 s/mm, diffusion gradient direction was set to 6, 15, 25, 35 and 45; and when diffusion gradient direction = 25, b value was set to 300, 600, 900 and 1200 s/mm. The values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were separately acquired using image post-processing techniques. The correlation between various b values, diffusion gradient directions, age and sex on the one hand and FA and ADC values on the other, was investigated.
RESULTS
(1) When diffusion gradient direction was fixed and the b value was varied, both FA and ADC exhibited a decreasing trend as the b value increased (P < 0.001). (2) When the b value was fixed and diffusion gradient direction was varied, the FA of knee cartilage showed a decreasing trend with increasing diffusion gradient direction (P < 0.001). (3) The FA value increased with age (P < 0.05).
CONCLUSION
The b value, diffusion gradient direction value and age exert a significant impact on both FA and ADC values in MR DTI of knee cartilage in children aged 6-12 years. In order to obtain a stable DTI, it is recommended to select a b value ≥ 600 s/mm and a diffusion gradient direction ≥ 25 during scanning.
PubMed: 38910223
DOI: 10.1007/s00247-024-05965-x