Changes in the Prevalence of Hyperuricemia in Clients of Health Examination in Eastern China, 2009 to 2019

Background: With the continuous improvement of people's living standards, the incidence of hyperuricemia (HUA) is increasing globally. The prevalence of HUA ranged in terms of region, race, and age. This study aims to investigate the changes in the prevalence of HUA in clients of health examination in Eastern China between 2009 and 2019. Methods: Chinese men and women aged 20-79 years (n = 4847 in the 2009 cohort and n = 12188 in 2019) who had received health examinations were enrolled. Serum uric acid (UA) levels and biochemical parameters, including fasting blood-glucose (FBG), triglyceride (TG), total cholesterol (CHOL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine (Cr) and blood urea nitrogen (BUN) were evaluated. The prevalence of HUA in different age groups were measured, and the correlation of biochemical parameters with the onset of HUA were analyzed. Results: The prevalence of HUA was 18.7% in the 2019 cohort, which was significantly higher than that in 2009 (13.3%). In females, the prevalence of HUA was significantly higher in 2019 than 2009 for age groups of 20-29 and 30-39 years. In male population, 2019 cohort had significantly higher age-specific prevalence for all age groups than 2009 cohort. Young men aged 20-29 years became the main population of HUA in the 2019 male cohort, whereas middle-aged men aged 40-49 years had the highest prevalence of HUA in the 2009 male cohort. The prevalence rates of HUA in all BMI groups in 2019 cohort were significantly higher than those in 2009 cohort. Spearmen’s correlation analysis and Logistic regression analysis indicated that BMI was positively correlated with the onset of HUA. The receiver-operating characteristic curve (ROC) analysis showed BMI＞24.48kg/m2 and BMI＞23.84 kg/m2 displayed good capacities to discriminate the population with HUA from those without HUA in 2009 and 2019 cohort, respectively. Conclusions: In recent 10 years, the prevalence of HUA was increased rapidly in Chinese adults, especially in males. Young men aged 20-29 years in the 2019 cohort replaced the middle-aged males (40-49 years old) in the 2009 cohort, and became the main population of male HUA in the 2019 cohort. BMI was positively correlated with HUA, and might be a potential risk factors to predict the onset of HUA.

Judgments About Male Victims of Sexual Assault by Women: A 35-Year Replication Study

Sexual assault of men by women has received increasing attention in recent years, as has research on rape myths about male victims. This study is a cross-generational replication of a 1984 study of college students’ judgments about male and female victims in a scenario involving a sexual assault carried out by male or female assailants. The 1984 data ( n = 172) were compared with those of a 2019 cohort ( n = 372) in a 2 (participant gender) x 2 (assailant gender) x 2 (victim gender) x 2 (cohort) factorial design to assess potential generational changes in perceptions of victims. Judgments by male participants of male victims of assaults carried out by women changed notably over time. The 2019 male cohort was less likely to judge that the victim initiated or encouraged the incident (40% in 1984 compared with 15% in 2019) and derived pleasure from it (47.4% in 1984 compared with 5.8% in 2019). In contrast, the 2019 female cohort was more likely to attribute victim encouragement (26.9% compared with 4.3% in 1984) and pleasure to the male victim (25% in 2019 compared with 5% in 1984). A similar gender pattern occurred in judgments of how stressful the event was for the male victim. Analysis of the 2019 data revealed that overall, despite scientific and cultural shifts that have occurred over the past three decades, participants continued to judge the male victim of assault by a female to have been more encouraging and to have experienced more pleasure and less stress than in any other assailant/victim gender combination. Results are discussed in relation to gendered stereotypical beliefs and male rape myths, as well as possible sensitization to power differentials inspired by the #MeToo movement. We emphasize the need for greater awareness and empirical attention to abuse that runs counter to preconceived notions about sexual victimization.

Screening for hereditary haemochromatosis in patients undergoing knee arthroplasty

Aims Hereditary haemochromatosis is a genetic disorder that is caused by several known mutations in the human homeostatic iron regulator protein ( HFE) gene. Abnormal accumulation of iron causes a joint disease that resembles osteoarthritis (OA), but appears at a relatively younger age and is accompanied by cirrhosis, diabetes, and injury to other organs. Increased serum transferrin saturation and ferritin levels are known markers of haemochromatosis with high positive predictive values. Methods We have retrospectively analyzed the iron studies of a cohort of 2,035 patients undergoing knee joint arthroplasty due to OA. Results No patients had HFE gene C282Y, S65C, or H63D mutations testing. In total, 18 patients (2.96%) of the male cohort and 51 (3.58%) of the female cohort had pathologically increased ferritin levels that may be indicative of haemochromatosis. Seven patients (0.34%) had serum transferrin saturation above 45%. Conclusion The awareness for the diagnosis of this disorder in Orthopaedics is low and needs improvement. Osteoarthritic patients undergoing knee arthroplasty should be routinely screened for haemochromatosis by iron studies and referred to genetic testing when needed. Level of evidence: Level III - Retrospective cohort study. Cite this article: Bone Jt Open 2021;2(12):1062–1066.

GENDER-BASED DIFFERENCES IN CLINICAL PROFILE AND OUTCOME OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

Objectives: A conflict of evidence exists regarding the gender-based differences in outcomes after primary percutaneous coronary intervention (PCI), therefore, aim of this study was to compare the clinical characteristics, angiographic findings, and outcome of primary PCI for men and women. Methodology: Data for this study was extracted from a prospectively managed primary PCI database of the National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan. We included consecutive patients of either gender with STEMI undergone primary PCI. Data on clinical characteristics, angiographic finding, and post procedure outcomes for female were compared with male group and also with a propensity matched male cohort. Results: A total of 2400 patients were included with 421(17.5%) women. The mean age for the men and women were 54.44±11.16 and 57.17±11.01 years respectively; p<0.001. Women had significantly high prevalence of hypertension (61.0% vs. 39.1%; p<0.001), diabetes (37.1% vs. 23.9%; p<0.001), and obesity (18.5% vs. 13.5%; p=0.008). The median symptom onset to hospital arrival time was 216 [366-124] minutes vs. 180 [310-112] minutes; p=0.001 for women and men. In-hospital mortality rate was 3.8% vs. 2.5%; p=0.147 for female and unmatched male cohort, while it was 3.6% vs. 3.8%; p=0.855 for female and propensity matched male cohort. Conclusion: Gender-based differences persist in clinical profile of the patients with STEMI. Women are likely to be older in age with more diabetes, hypertension, and obesity. Gender-based difference in outcome of primary PCI is appears to be driven by differences in clinical profile as adjusted outcome is not different for men and women.

Calibrating a Discrete-Event Simulation for Quantification of Sex-Specific Colorectal Neoplasia Development

Background: Medical evidence collected from new observational studies can sometimes significantly alter our understanding of disease incidence and progression. This requires efficient and accurate calibration of disease models to help quantify the differences between observed cohorts. However, in model calibration, it is common to encounter overfitting with many model parameters but few observational outcomes. Additionally, the difficulty in evaluating fitting performance is significant due to a large degree of outcome variation and expensive computations for even a single simulation run. Methods: We developed a two-phase calibration procedure to address the above challenges. As a proof-of-the-concept study, we verified the procedure with a discrete-event-simulation-based study on sex-specific colorectal neoplasia development. For the study, we estimated eight disease model parameters that govern colorectal adenoma incidence risk and growth rates at three distinct states: non-advanced, advanced adenoma, and adenoma becoming cancerous. For the calibration, we defined the likelihood measure by a relative weighted sum-of-squares difference between the three actual prevalence values reported in a recent publication and those predicted by a discrete-event colorectal cancer simulation. In phase I of the calibration procedure, we performed a series of low-dimensional sampling-based grid searches to identify reasonably good candidate parameter designs. In phase II, we performed a local search-based approach to further improve the model fit.Results: Overall, our two-phase procedure showed better goodness of fit than a straightforward implementation of the Nelder-Mead algorithm, yielding a 10-fold reduction in calibration error (0.0025 vs. 0.0251 for an all-white mixed-family-history male cohort on the likelihood measure defined above). Further, the two-phase procedure was more effective in calibrating a validated simulation model for a female cohort than a male cohort. Finally, in phase II, performing local search on each of the parameters sequentially is more effective than searching the entire parameter space simultaneously. Conclusions: The proposed two-phase calibration procedure is effective for estimating computationally expensive stochastic dynamic disease models. In addition, initial parameter search range truncation and sensitivity analysis on various parameters can be computationally cost-effective.

"Going It Alone": Following the Male Cohort of Survivors of Sex Trafficking of the Chai Dai Butterfly Longitudinal Research Project

Over the past ten years, the Butterfly Longitudinal Research Project has followed 128 survivors of trafficking through their experiences in aftercare, reintegration, and beyond to better understand the recovery and reintegration of trafficking survivors within a Cambodian context. This paper focuses on the 19 males who were available to interview. Despite the project’s wealth of data and analysis, there are notable gaps regarding the male cohort. In response, this paper examines this cohort holistically, considering their statements and broader narratives, merging them with previous collective observations of the Butterfly Project. Throughout this paper, data indicates a pattern of violence among the male cohort. The paper finds high rates of both physical and emotional peer-to-peer violence during the male cohort’s time in residential care, as well as emotional violence from families following their community reintegration. Difficulties in work and school, frequent migration and housing instability are also prevalent. During aftercare, peer-to-peer violence is cited, with a majority describing a lack of trusting relationships. As respondents are reintegrated back into their communities, the majority report struggles with poverty and emotional violence from parents/carers. There is evidence of more positive peer relationships, fewer feelings of shame, and more trusting relationships. However, the majority still struggles with poverty, pressure to support their families, and poor emotional health. While peers are the primary source of violence experienced during aftercare, parents are most generally the source during the Reintegration and Life Beyond phases. Respondents describe deteriorating relationships with families/carers, increasing responsibility to be more independent, and continuing struggles to maintain their studies or employment.

Risk of Myocarditis from COVID-19 Infection in People Under Age 20: A Population-Based Analysis

Background There have been recent reports of myocarditis (including myocarditis, pericarditis or myopericarditis) as a side-effect of mRNA-based COVID-19 vaccines, particularly in young males. Less information is available regarding the risk of myocarditis from COVID-19 infection itself. Such data would be helpful in developing a complete risk-benefit analysis for this population. Methods A de-identified, limited data set was created from the TriNetX Research Network, aggregating electronic health records from 48 mostly large U.S. Healthcare Organizations (HCOs). Inclusion criteria were a first COVID-19 diagnosis during the April 1, 2020 - March 31, 2021 time period, with an outpatient visit 1 month to 2 years before, and another 6 months to 2 years before that. Analysis was stratified by sex and age (12-17, 12-15, 16-19). Patients were excluded for any prior cardiovascular condition. Primary outcome was an encounter diagnosis of myocarditis within 90 days following the index date. Rates of COVID-19 cases and myocarditis not identified in the system were estimated and the results adjusted accordingly. Wilson score intervals were used for 95% confidence intervals due to the very low probability outcome. Results For the 12-17-year-old male cohort, 6/6,846 (0.09%) patients developed myocarditis overall, with an adjusted rate per million of 876 cases (Wilson score interval 402 - 1,911). For the 12-15 and 16-19 male age groups, the adjusted rates per million were 601 (257 - 1,406) and 561 (240 - 1,313). For 12-17-year-old females, there were 3 (0.04%) cases of myocarditis of 7,361 patients. The adjusted rate was 213 (73 - 627) per million cases. For the 12-15- and 16-19-year-old female cohorts the adjusted rates per million cases were 235 (64 - 857) and 708 (359 - 1,397). The outcomes occurred either within 5 days (40.0%) or from 19-82 days (~60.0%). Conclusions Myocarditis (or pericarditis or myopericarditis) from primary COVID19 infection occurred at a rate as high as 450 per million in young males. Young males infected with the virus are up 6 times more likely to develop myocarditis as those who have received the vaccine.

Association between serum low-density lipoprotein cholesterol and metabolic syndrome in a working population

Background The studies, investigating the association of low-density lipoprotein cholesterol (LDL-C) with metabolic syndrome (MetS) are limited with controversial conclusions. Therefore, this study aimed at revealing the specific relationship between the serum LDL-C levels and MetS prevalence in a large working population. Methods Secondary data analysis of a cross-sectional study, conducted between 2012 and 2016 in Spain on participants aged within the range of 20–70 years, involved 60,799 workers. Logistic regression analysis was applied to evaluate the association between the levels of serum LDL-C and MetS prevalence. Results Among the 60,799 workers, the prevalence of MetS was 9.0%. The odds ratios (95% confidence intervals) of MetS prevalence were 1.27 (1.16–1.39) and 1.53 (1.41–1.65) for the individuals with the LDL-C levels in lower (< 103.8 mg/dL) and upper (> 135.8 mg/dL) tertiles as compared to those with the LDL-C levels in middle tertile (103.8–135.8 mg/dL) in the studied population. Similarly, a U-shaped relationship was also observed in male cohort. The serum LDL-C levels associated with the lowest risk of current MetS were 113.6 mg/dL and 117.6 mg/dL in the overall studied population and male cohort, respectively. The female workers with the levels of LDL-C higher than 135.0 mg/dL had an increased prevalence of MetS (P < 0.05). Conclusions The low and high levels of serum LDL-C were associated with an increased prevalence of MetS in the working population and in male workers. Only the high (> 135.0 mg/dL) levels of LDL-C increased MetS prevalence in female workers.

Higher Prevalence of Non-thyroidal-Illness Syndrome in Elderly Male Patients With Active Helicobacter pylori Infection

Objective: It is currently unclear whether the Helicobacter pylori (H. pylori) infection leads to associated alterations in thyroid functions and thyroidal illnesses. This study aims to analyse this relationship in an elderly male cohort over a five-year period.Design: A case retrospective study.Methods: A longitudinal study was designed to collect subjects (≥65 years old) receiving both a thyroid examination and H. pylori infection status determined by 13C-urea breath test in 2013 at our unit. Subjects were followed every 1 to 2 years until December 2017 for laboratory results, visits to outpatient clinics/emergency departments etc. Blood tests and thyroid ultrasonography were performed to determine thyroid function and morphology.Results: 356 male subjects with mean age 78.5 ± 9.8 years were included. Active H. pylori infection was positive in 88 subjects (24.7%). Thyroid function tests and ultrasonography showed similar patterns between H. pylori positive and negative groups. Non-thyroidal-illness syndrome (NTIS) was diagnosed in 30/210 (14%) patients who experienced acute illnesses and hospitalization over five-year follow-up. Notably, NTIS demonstrated significantly higher prevalence in the H. pylori positive group compared to the negative group (17.1 vs. 5.6%, P = 0.001). Multivariate analysis showed that when age, APACHE II score and hemoglobin levels were adjusted, H. pylori status still has significant interrelationship with NTIS (OR = 3.497, P = 0.003).Conclusions: There is a positive association between chronic active H. pylori infection and NTIS prevalence in this elderly male cohort. Further studies are needed to elucidate the role of H. pylori infection on NTIS in elderly male patients.