Access to gender-affirming hormones during adolescence and mental health outcomes among transgender adults

Objective To examine associations between recalled access to gender-affirming hormones (GAH) during adolescence and mental health outcomes among transgender adults in the U.S. Methods We conducted a secondary analysis of the 2015 U.S. Transgender Survey, a cross-sectional non-probability sample of 27,715 transgender adults in the U.S. Using multivariable logistic regression adjusting for potential confounders, we examined associations between access to GAH during early adolescence (age 14–15), late adolescence (age 16–17), or adulthood (age ≥18) and adult mental health outcomes, with participants who desired but never accessed GAH as the reference group. Results 21,598 participants (77.9%) reported ever desiring GAH. Of these, 8,860 (41.0%) never accessed GAH, 119 (0.6%) accessed GAH in early adolescence, 362 (1.7%) accessed GAH in late adolescence, and 12,257 (56.8%) accessed GAH in adulthood. After adjusting for potential confounders, accessing GAH during early adolescence (aOR = 0.4, 95% CI = 0.2–0.6, p < .0001), late adolescence (aOR = 0.5, 95% CI = 0.4–0.7, p < .0001), or adulthood (aOR = 0.8, 95% CI = 0.7–0.8, p < .0001) was associated with lower odds of past-year suicidal ideation when compared to desiring but never accessing GAH. In post hoc analyses, access to GAH during adolescence (ages 14–17) was associated with lower odds of past-year suicidal ideation (aOR = 0.7, 95% CI = 0.6–0.9, p = .0007) when compared to accessing GAH during adulthood. Conclusion Access to GAH during adolescence and adulthood is associated with favorable mental health outcomes compared to desiring but not accessing GAH.

Non-respiratory functions of lungs in experimental intracerebral hemorage during fingolimod injection

Introduction. Intracerebral hemorrhage (ICH) is frequently accompanied by respiratory system complications. One of the correction method of post stroke complications is administration of immunosuppressive drug fingolimod. Theobjective of the study is to investigate non-respiratory lung functions in experimental ICH during fingolimod treatment. Materials and methods. Animals were divided into 3 groups: group 1 with ICH, group 2 with ICH receiving fingolimod and group 3 as reference group. Intracranial hemorrhage was modelled by 160 μl autologic blood injection into lateral brain ventricle (P=0.6; D=1.5; V=3.5). Fingolimod (FTY 720, «Sigma») was administered within 1 hour after ICH (intraabdominal, 1 mg/kg). Biochemistry and functional parameters of the lung surfactant in animals were studied. Phospholipids fractions spectrum was assessed by thin-layer chromatography, superficial surfactant activity by Wilhelmi method. Parameters of water metabolism, pulmonary blood filling were studied by gravimetric method. Level of blood nitric oxide was estimated by amount of nitrates and nitrites stable terminal metabolites. Results. We revealed that experimental ICH causes a decrease of alveolar stability index by 9 %, decrease of total alveolar phospholipids content by 25 % and change of its fraction composition, i.e. decrease of major surface active fraction (phosphatidylcholine) by 68 %, increase of phosphatidic acid amount by 151 % and increase of lisophosphatidylcholine by 163 %. Besides that, experimental ICH is followed by lung edema on the lung blood filling background and increase of blood NO. Fingolimod administration does not affect surfactant surface activity but totally corrects water balance, lung blood filling and blood NO content.

How Bark Beetle Attack Changes the Tensile and Compressive Strength of Spruce Wood (Picea abies (L.) H. Karst.)

Since 2014, forestry in the Czech Republic has been significantly affected by a bark beetle outbreak. The volume of infested trees has exceeded processing capacity and dead standing spruce (Picea abies) remain in the forest stands, even for several years. What should be done with this bark beetle wood? Is it necessary to harvest it in order to preserve the basic mechanical and physical properties? Is it possible to store it under standard conditions, or what happens to it when it is “stored” upright in the forest? These are issues that interested forest owners when wood prices were falling to a minimum (i.e., in 2018–2019) but also today, when the prices of quality wood in Central European conditions are rising sharply. To answer these questions, we found out how some of the mechanical properties of wood change in dead, bark beetle-infested trees. Five groups of spruce wood were harvested. Each of these groups was left upright in the forest for a specified period of time after bark beetle infestation, and one group was classified as a reference group (uninfested trees). Subsequently, we discovered what changes occurred in tensile and compressive strength depending on the time left in the stand and the distance from the center of the trunk. When selecting samples, we eliminated differences between individual trees using a CT scanning technique, which allowed us to separate samples, especially with different widths of annual rings and other variations that were not caused by bark beetle. The results showed the effect of log age and radial position in the trunk on tensile and compressive strength. The values for tensile strength in 3-year infested trees decreased compared to uninfested trees by 14% (from 93.815 MPa to 80.709 MPa); the values for compressive strength then decreased between the same samples by up to 25.6% (from 46.144 MPa to 34.318 MPa). A significant decrease in values for compressive strength was observed in the edges of the trunks, with 44.332 MPa measured in uninfested trees and only 29.750 MPa in 3-year infested trees (a decrease of 32.9%). The results suggest that the use of central timber from bark beetle-infested trees without the presence of moulds and fungi should not be problematic for construction purposes.

Longitudinal Effects of Serum Calcium and Phosphate Levels and Their Ratio on Incident Ischemic Heart Disease among Korean Adults

Serum calcium and phosphate levels are controlled by a regulatory system, but their individual concentration tendencies and interactions may affect long-term vascular health. This study aimed to assess the effects of serum calcium and phosphate levels on incident ischemic heart disease (IHD) in a large-scale community-dwelling Korean cohort. We evaluated 15,259 non-diabetic individuals (median age, 45 years; range, 30–85) without previous IHD or ischemic stroke using the Korean National Health Insurance data. The study population was classified based on the calcium, phosphate, and calcium/phosphate ratios. Using Cox proportional hazards regression models, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD over 50 months after baseline enrolment. The age- and sex-adjusted incidence of IHD gradually increased with serum calcium and phosphate quartiles and decreased with calcium/phosphate ratio quartiles, with an overall crude rate of 2.1% (315/15,259). After setting the lowest calcium, phosphate, and calcium/phosphate ratio quartiles as a reference group, the HRs (95% CIs) of the highest calcium, phosphate, and calcium/phosphate ratio quartiles for IHD were 1.77 (1.15–2.72), 1.73 (1.18–2.55), and 0.58 (0.39–0.87), respectively, after adjusting for potential confounding variables. Serum calcium and phosphate levels were positively associated with IHD incidence, while the serum calcium/phosphate ratio exhibited an inverse relationship. Serum calcium and phosphate homeostasis may merit serious consideration to understand the pathogenesis of coronary atherosclerosis as a risk modifier for IHD.

Joint effect of particulate matter and cigarette smoke on women’s sex hormones

Background Although relationships between exposure to air pollution and reproductive health are broadly studied, mechanisms behind these phenomena are still unknown. The aim of the study was to assess whether exposure to particulate matter (PM10) and tobacco smoking have an impact on menstrual profiles of 17β-estradiol (E2) and progesterone (P) and the E2/P ratio. Methods Levels of sex hormones were measured daily in saliva during the entire menstrual cycle among 132 healthy, urban women. Exposure to smoking (active or passive) was assessed by questionnaire, whilst exposure to PM10 with municipal monitoring data. Results During the early luteal phase, profiles of E2 were elevated among women with higher versus lower exposure to PM10 (p = 0.02, post-hoc tests). Among those who were exposed versus unexposed to tobacco smoking, the levels of mean E2 measured during the entire cycle were higher (p = 0.02). The difference in mean E2 levels between the group of joint exposure (i.e. to high PM10 and passive or active smoking) versus the reference group (low PM10, no smoking) was statistically significant at p = 0.03 (18.4 vs. 12.4 pmol/l, respectively). The E2/P ratios were higher among women with higher versus lower exposure to PM10 and this difference was seen only in the early luteal phase (p = 0.01, exploratory post-hoc tests). Conclusions We found that PM10 and tobacco smoking affect ovarian hormones independently and do not interact with each other. Both exposures appear to have estrogenic effects even though women's susceptibility to these effects differs across the menstrual cycle. We propose that the hormonal mechanisms are involved in observed relationships between air pollution and smoking with women’s reproductive health.

Social determinants of malnutrition in Chilean children aged up to five

Background This study aimed to ascertain the Social Determinants (SDs) of malnutrition (over and undernutrition) of Chilean children aged up to five. Methods The study was carried out using a sample of children from zero to five years old (n = 1,270,485; 52.2% female) from the National Socioeconomic Characterization Survey (CASEN) 2017. A multinomial logistic regression model was used, where the “child nutritional status” outcome variable assumed three possible values: normal nutrition, overnutrition, and undernutrition, while taking those variables reported in previous literature as independent variables. Results The model, by default, set normal nutrition as the reference group, Count R2 = 0.81. Results show a higher likelihood of both overnutrition and undernutrition among male children from the lowest quintiles, with native ethnic backgrounds, reporting health problems, having public health insurance, and who attend kindergarten. Additionally, higher probabilities of undernutrition in younger than two and living in the north of the country, while overnutrition is more likely in the south. Conclusions Socioeconomic variables are fundamentally related to both over and undernutrition; the current single schema program to prevent malnutrition should consider SDs such as ethnicity and geographical location, among others; moreover, successful nutritional programs—which focused on the lowest quintiles, need to be expanded to other vulnerable groups and pay more attention to overnutrition.

Residual Impact Performance of ECC Subjected to Sub-High Temperatures

Despite the fact that the mechanical properties of Engineered Cementitious Composites (ECC) after high-temperature exposure are well investigated in the literature, the repeated impact response of ECC is not yet explored. Aiming to evaluate the residual impact response of ECC subjected to sub-high temperatures under repeated drop weight blows, the ACI 544-2R repeated impact test was utilized in this study. Disk impact specimens (150 mm diameter and 64 mm thickness) were prepared from the M45 ECC mixture but using polypropylene fibers, while similar 100 mm cube specimens and 100 × 100 × 400 mm prism specimens were used to evaluate the compressive and flexural strengths. The specimens were all cast, cured, heated, cooled, and tested under the same conditions and at the same age. The specimens were subjected to three temperatures of 100, 200 and 300 °C, while a group of specimens was tested without heating as a reference group. The test results showed that heating to 100 and 200 °C did not affect the impact resistance noticeably, where the retained cracking and failure impact numbers and ductility were higher or slightly lower than those of unheated specimens. On the other hand, exposure to 300 °C led to a serious deterioration in the impact resistance and ductility. The retained failure impact numbers after exposure to 100, 200, and 300 °C were 313, 257, and 45, respectively, while that of the reference specimens was 259. The results also revealed that the impact resistance at this range of temperature showed a degree of dependency on the compressive strength behavior with temperature.

Effect of Respiratory Training Combined with Core Muscle Training on the Overall Motor Function and Activities of Daily Living of Patients with Early and Midterm Stroke

Stroke is a cerebral ischemic or hemorrhagic disease with sudden onset and rapid progress. To analyze the effect of respiratory training combined with core muscle training on the overall motor function and activities of daily living of patients with early and midterm stroke, 90 cases with early and midterm stroke admitted to the neurological department of our hospital from April 2018 to April 2019 were chosen as the research objects. According to the odd or even hospitalization numbers, they were equally divided into the study group and the reference group. Both groups received basic drug treatment. On this basis, the reference group was given routine rehabilitation training, while the study group was given respiratory training combined with core muscle training. The clinical indexes of both groups before and after intervention were evaluated to analyze the effect of different training methods on the rehabilitation of patients with early and midterm stroke. There was no significant difference in gender ratio, average age, average BMI, average course of disease, stroke types, MAS grading, location of limb dysfunction, and combined disease between the two groups ( P < 0.05 ). The total clinical effective rate of the study group after intervention was obviously higher than that of the reference group ( P < 0.05 ). The MoCA scores of both groups after intervention were obviously higher than those before intervention, and the score of the study group after intervention was obviously higher than that of the reference group. The scores of limb motor function, activities of daily living, and balance function at T2, T3, and T4 in the study group were obviously higher than those in the reference group ( P < 0.001 ). At 4 and 8 weeks after intervention, the 10 m MWS of the study group was obviously higher than that of the reference group ( P < 0.001 ), while the TUGT was obviously lower ( P < 0.001 ). Respiratory training combined with core muscle training can obviously improve the activities of daily living, cognitive function, and limb motor function of patients with early and midterm stroke, which is worth popularizing and using.

COVID-19 related outcomes among individuals with neurodegenerative diseases: a cohort analysis in the UK biobank

Background An increased susceptibility to COVID-19 has been suggested for individuals with neurodegenerative diseases, but data are scarce from longitudinal studies. Methods In this community-based cohort study, we included 96,275 participants of the UK Biobank who had available SARS-CoV-2 test results in Public Health England. Of these, 2617 had a clinical diagnosis of neurodegenerative diseases in the UK Biobank inpatient hospital data before the outbreak of COVID-19 (defined as January 31st, 2020), while the remaining participants constituted the reference group. We then followed both groups from January 31st, 2020 to June 14th, 2021 for ascertainment of COVID-19 outcomes, including any COVID-19, inpatient care for COVID-19, and COVID-19 related death. Logistic regression was applied to estimate the association between neurogenerative disease and risks of COVID-19 outcomes, adjusted for multiple confounders and somatic comorbidities. Results We observed an elevated risk of COVID-19 outcomes among individuals with a neurodegenerative disease compared with the reference group, corresponding to a fully adjusted odds ratio of 2.47 (95%CI 2.25–2.71) for any COVID-19, 2.18 (95%CI 1.94–2.45) for inpatient COVID-19, and 3.67 (95%CI 3.11–4.34) for COVID-19 related death. Among individuals with a positive test result for SARS-CoV-2, individuals with neurodegenerative diseases had also a higher risk of COVID-19 related death than others (fully adjusted odds ratio 2.08; 95%CI 1.71–2.53). Conclusion Among UK Biobank participants who received at least one test for SARS-CoV-2, a pre-existing diagnosis of neurodegenerative disease was associated with a subsequently increased risk of COVID-19, especially COVID-19 related death.