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Objectives Methods Results Conclusions To identify sexual/sex‐associated risk factors for hepatitis C transmission among men who have sex with men (MSM) and visualise behavioural trajectories from 2019 to 2021.We linked a behavioural survey to a hepatitis C cohort study (NoCo), established in 2019 across six German HIV/hepatitis C virus (HCV) treatment centres, and performed a case–control analysis. Cases were MSM with recent HCV infection, and controls were matched for HIV status (model 1) or proportions of sexual partners with HIV (model 2). We conducted conditional univariable and multivariable regression analyses.In all, 197 cases and 314 controls completed the baseline questionnaire and could be matched with clinical data. For regression models, we restricted cases to those with HCV diagnosed since 2018 (N = 100). Factors independently associated with case status included sex‐associated rectal bleeding, shared fisting lubricant, anal douching, chemsex, intravenous and intracavernosal injections, with population‐attributable fractions of 88% (model 1) and 85% (model 2). These factors remained stable over time among cases, while sexual partner numbers and group sex decreased during COVID‐19 measures.Sexual/sex‐associated practices leading to blood exposure are key factors in HCV transmission in MSM. Public health interventions should emphasize the importance of blood safety in sexual encounters. Micro‐elimination efforts were temporarily aided by reduced opportunities for sexual encounters during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

The specific biology of the male breast remains relatively unexplored in spite of the increasing global prevalence of male breast cancer. Delineation of the microenvironment of the male breast is restricted by the low availability of human samples and a lack of characterisation of appropriate animal models. Unlike the mouse, the male ovine gland persists postnatally. We suggest that the male ovine mammary gland constitutes a promising adjunctive model for the male breast. In this study, we evaluate the male ovine mammary gland microenvironment, comparing intact and neutered males. Assessment of the glandular histo‐anatomy highlights the resemblance of the male gland to that of neonatal female sheep and confirms the presence of rudimentary terminal duct lobular units. Irrespective of neutered status, cell proliferation in epithelial and stromal compartments is similarly low in males, and cell proliferation in epithelial cells and in the intralobular stroma is significantly lower than in pubertal female sheep. Between 42% and 72% of the luminal mammary epithelial cells in the male gland express the androgen receptor and expression is significantly reduced by neutering. Luminal epithelial cells within the intact and neutered male gland also express oestrogen receptor alpha, but minimal progesterone receptor expression is observed. The distribution of leukocytes within the ducts and stroma is similar to the mammary gland of female sheep and females of other species. Both macrophages and T lymphocytes are intercalated in the epithelial bilayer and are more abundant in the intralobular stroma than the interlobular stroma, suggesting that they may have a protective immunological function within the vestigial glandular tissue of the male sheep. Mast cells are also observed within the stroma. These cells cluster near the glandular tissue and are frequently located adjacent to blood vessels. The abundance of mast cells is significantly higher in intact males compared to neutered males, suggesting that hormone signalling may impact mast cell recruitment. In this study, we demonstrate the utility of the male ovine mammary gland as a model for furthering our knowledge of postnatal male mammary biology. [ABSTRACT FROM AUTHOR]

Key Clinical Message: The presented primary thyroid leiomyosarcoma (TL) case report underscores the importance of recognizing and addressing the diagnostic challenges and management complexities associated with this exceedingly rare malignancy. Given the limited effective therapeutic strategies available, timely intervention, thorough diagnostics, and vigilant follow‐up are paramount in managing such intricate tumors. Further research focusing on molecular‐based treatment modalities is imperative to improve patient outcomes in cases of primary TL. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We present a rare case of primary antiphospholipid syndrome in a 38‐year‐old male who presented with painful digital ischemia. Early initiation of anticoagulation and addition of glucocorticoid led to a significant improvement in the patient. [ABSTRACT FROM AUTHOR]

Aim: Male dietitians are under‐represented in the global dietetics workforce, including in Australia. This study explores Australian males' experiences as dietitians in the Australian workforce, with the aim to identify influences that initially attracted them to dietetics, as well as barriers that may affect their decision to stay in or leave the profession. Methods: A cross‐sectional, semi‐quantitative web‐based survey was distributed to male dietitians using purposive, snowball sampling. Closed and open‐ended questions were included. Descriptive statistics were generated, and content analysis of free‐text responses identified major themes. Results: Seventy‐one respondents opened the survey link, of which 65 respondents attempted the survey. Fifty‐four (83.1%) respondents agreed that dietetics is female‐dominated. An interest in food and nutrition was the most reported reason for studying dietetics (73.8%). Of the 55 respondents who were not intending to retire in the next 5 years, 15 (27.3%) stated they were somewhat or extremely likely to leave the profession of dietetics. Respondents identified issues that impacted their experiences as a male dietitian, including gender differences, a lack of male role models, barriers to career progression/employment, and perceptions of a lack of respect and impact within healthcare. Conclusions: Australian male dietitians perceive systemic, social, and personal factors that have influenced their career experiences. Greater exposure to prominent male role models may be self‐perpetuating in improving male dietitian recruitment and eventually, retention. A multi‐pronged approach is needed to improve the rate of recruitment of male dietitians, with a role for tertiary education providers and peak dietetics bodies. [ABSTRACT FROM AUTHOR]

Aim: To determine whether there were differences between male and female infants in respiratory morbidity in a whole population of extremely preterm infants, including infants born below 24 weeks of gestation. Methods: Retrospective whole‐population study of all infants <28 weeks of gestation admitted to a neonatal unit in England from 2014 to 2019. Bronchopulmonary dysplasia (BPD) development was defined as any respiratory support at 36 weeks postmenstrual age. Results: The 11 844 infants had a median (IQR) gestational age of 26.0 (24.9–27.1) weeks and a birth weight of 0.81 (0.67–0.96) kg. The duration of invasive ventilation was longer in male compared to female infants who were born at 24–27 completed weeks of gestation (p < 0.001), but not significantly different between male and female infants born at 22 and 23 weeks of gestation (p = 0.446). The incidence of BPD was higher in male compared to female infants born at 24–27 weeks of gestation (p < 0.001) but not different between male and female infants born at 22 and 23 weeks of gestation (p = 0.148). Conclusion: Respiratory morbidity was more pronounced in male compared to female extremely preterms, only in gestations 24–27 completed weeks. Male predominance was absent in infants born below 24 weeks of gestation. [ABSTRACT FROM AUTHOR]

Given the unprecedented events unfolding around the globe over the past four years, psychoanalytic communities near and far have sought to ask and ventured to answer the question: What does psychoanalysis have to offer individuals, and the collective, as a way of seeing and being with the reality of what is? Taking up these questions in such a time as this, feels, perhaps inevitably, unsafe. Sometimes it can feel as if there is a silent and unspoken mandate to ensure safety at all costs when we seek to find a spirit of the depth's response to the spirit of the times. I propose that the work of psychoanalysis is grounded in nothing but the journey through that which is unsafe. This article will take up Ann Ulanov's notion that one's own evil is the hinge door into collective and archetypal evil. To become unhinged means to risk well‐formulated understandings, theories, and modalities about being and becoming for the other and instead to allow the other to penetrate that which is unknown in ourselves, upending our well‐formed theories and pressing us to take up our own lives in new and unpredictable ways. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical characteristics of male adolescents and young adults hospitalized for medical complications of atypical anorexia nervosa (atypical AN) and to compare their clinical characteristics with females with atypical AN and males with anorexia nervosa (AN). Method: A retrospective review of electronic medical records for patients with atypical AN and AN aged 9–25 admitted to the UCSF Eating Disorders Program from May 2012 to August 2020 was conducted. Results: Among 21 males with atypical AN (mean age 15.1 ± 2.7, mean %mBMI 102.0 ± 11.8), medical complications evidenced by admission laboratory values included anemia (52.9%), vitamin D insufficiency/deficiency (52.6%), and zinc deficiency (31.6%). Compared with females with atypical AN (n = 69), males with atypical AN had longer length of stay (11.4 vs 8.4 days, p =.004), higher prescribed kcal at discharge (4114 vs 3045 kcal, p <.001), lower heart rate nadir (40.0 vs 45.8, p =.038), higher aspartate transaminase (AST, 37.9 vs 26.2 U/L, p =.032), higher alanine transaminase (ALT, 30.6 vs 18.3 U/L, p =.005), and higher rates of anemia (52.9% vs 19.4%, p =.005), with no differences in vitamin D, zinc, and vital signs. Compared with males with AN (n = 40), males with atypical AN had no significant differences in vital signs or laboratory assessments during the hospitalization. Discussion: Atypical AN in males leads to significant medical comorbidity, and males with atypical AN require longer hospital stays compared to females with atypical AN. Rates of abnormal vital signs and abnormal serum laboratory values during hospital admissions do not differ in males with atypical AN compared to AN. Public Significance: Adolescent and young adult males with atypical anorexia nervosa experience significant medical complications. Males with atypical anorexia nervosa had longer hospitalizations and higher prescribed nutrition at discharge than females. Medical complications of atypical anorexia nervosa in male adolescents and young adults were generally equal to those of male adolescents and young adults with anorexia nervosa. Clinicians should be aware of unique medical complications of males with atypical anorexia nervosa. [ABSTRACT FROM AUTHOR]

Background: Whether the observed lower total testosterone (tT) levels in male patients with COVID‐19 are caused by a direct impact of SARS‐CoV‐2 infection or are collateral phenomena shared by other systemic inflammatory conditions has not yet been clarified. Objectives: To investigate the independent role of COVID‐19 in reducing circulating tT levels in men. Materials and methods: We compared demographic, clinical, and hormonal values of patients with laboratory confirmed COVID‐19 admitted during the first wave of the pandemic with a cohort of consecutive male patients admitted to the intensive care unit (ICU) of the same academic center because of severe acute respiratory distress syndrome (ARDS) but without SARS‐CoV‐2 infection and no previous history of COVID‐19. Linear regression model tested the independent impact of COVID‐19 on circulating tT levels. Logistic regression model was used to test predictors of death in the entire cohort. Results: Of 286 patients with COVID‐19, 70 men had been admitted to the ICU (= cases) and were compared to 79 patients equally admitted to ICU because of severe ARDS but negative for SARS‐CoV‐2 infection and without previous history of COVID‐19 (= controls). Controls were further grouped into noninfective (n = 49) and infective‐ARDS (n = 30) patients. At baseline, controls were older (p = 0.01) and had more comorbidities (p < 0.0001). Overall, cases admitted to ICU had significantly lower circulating tT levels compared to controls (0.9 nmol/L vs. 2.1 nmol/L; vs. 1.2 nmol/L; p = 0.03). At linear regression, being negative for COVID‐19 was associated with higher tT levels (Coeff: 2.13; 95% confidence interval ‐ CI 0.71‐3.56; p = 0.004) after adjusting for age, BMI, comorbidities and IL‐6 levels. Only age and IL‐6 levels emerged to be associated with higher risk of death regardless of COVID‐19 status. Conclusions: This case‐control ex post facto study showed lower tT levels in men with COVID‐19 compared to those without COVID‐19 despite both groups have been equally admitted to ICU for severe ARDS, thus suggesting a possible direct impact of SARS‐CoV‐2 infection toward circulating tT levels and a consequent more severe clinical outcome. [ABSTRACT FROM AUTHOR]

Background: Treatment‐related gonadal dysfunction leading to fertility problems is a frequently encountered late effect in childhood cancer survivors (CCSs). This study evaluated reproductive outcomes and reproductive health care utilization among male CCSs compared with male siblings. Methods: A nationwide cohort study was conducted as part of the Dutch Childhood Cancer Survivor LATER study part 1, a questionnaire and linkage study. A questionnaire addressing reproductive outcomes and reproductive health care was completed by 1317 male CCSs and 407 male siblings. A total of 491 CCSs and 185 siblings had a previous or current desire for children and were included in this study. Results: Fewer CCSs had biological children compared with siblings (65% vs. 88%; p <.001). The type of conception by men who fathered a child was comparable between CCSs and siblings (spontaneous conception of 90% of both groups; p =.86). The percentage of men who had consulted a reproductive specialist because of not siring a pregnancy was higher in CCSs compared with siblings (34% vs. 12%; p <.001). Following consultation, fewer CCSs underwent assisted reproductive techniques (ART) compared with siblings (41% vs. 77%; p =.001). After ART, fewer CCSs fathered a child compared with siblings (49% vs. 94%; p =.001). Conclusions: More male survivors consult a reproductive specialist, but fewer survivors undergo ART and father a child after ART compared with siblings. This insight is important for understanding potential problems faced by survivors regarding family planning and emphasizes the importance of collaboration between oncologists and reproductive specialists. This study showed that two‐thirds of male survivors of childhood cancer who had a desire for children fathered a biological child and that children of 90% of male survivors were conceived spontaneously. Compared with male siblings, more male survivors consulted a reproductive specialist because of not siring a pregnancy; however, both the application of and birth rates after assisted reproductive techniques in survivors were lower. [ABSTRACT FROM AUTHOR]

Background: Various infectious agents can infect the male reproductive system. Objectives: The aims of this study were to provide current data on fungal and yeast flora of the external organs of reproductive system of male short hair cats including penis and prepuce. Methods: In total 28 samples were taken from external genital system of male stray cats using sterilised cotton swabs. Samples were taken based on the absence of any reproductive complications using physical examinations. The samples were transferred to sterilised Stuart transport media and were then incubated in the Sabouraud dextrose agar with chloramphenicol at 32°C for 48 h. The identification of fungi and yeasts was confirmed by germ tube formation test, CHROM agar, urease testing and Corn meal agar medium with Tween 80. Results: Fungal agents were isolated from 7 (25%) out of 28 male stray cats. Fungal isolates were obtained from the penis and prepuce of 4 (36%) and 7 (100%) male cats, respectively. The most commonly recovered species samples were Candida krusei (3.75%) and Penicillum spp. (6.86%) from the penis and prepuce of the cats, respectively. The external organs of male reproduction of cats were infected with 2–4 different fungal agents. Only 5 (45%) cats were infected with one fungus; however, in 6 (55%) cats, mixed fungal infections were isolated. Cats 3–4 years old had the highest fungal contamination in the prepuce region (4/7), while the penis at this age had the least contamination (1/4). Conclusions: It is concluded that the external reproduction organs of male cats could be infected by different fungal agents. [ABSTRACT FROM AUTHOR]

Despite the growing numbers, awareness and reporting rates of male child sexual abuse (MCSA) are still well below the real values, especially in developing countries like Turkey. We examined MCSA to determine the predisposing factors, the characteristics of perpetrators and victims, and the consequences of sexual abuse in a Turkish sample. We retrospectively analysed the files and forensic reports of 51 MCSA victims aged between 6 and 18. The mean age of children was 13.6 ± 3.8 years, and the mean age at the time of abuse was 11.1 ± 3.52. The average exposure time for sexual abuse was 91 ± 226.8 days, and the frequency was 2.4 ± 2.47 times. 17.6 per cent of them had previously been sexually abused. Disclosure times until legal notification was 240.1 ± 552.25 days. Most (56.9 per cent) had suffered anal penetration, developed post traumatic stress disorder, and needed medical treatment. Most perpetrators (58.8 per cent) were strangers outside the family, reaching the children from the neighbourhood. In conclusion, although the number of our sample is limited, the results of our study will contribute valuably to the literature, given that there are few studies on MCSA. Further studies with large samples evaluating MCSA in multidimensional ways are needed to raise awareness and protect vulnerable children. [ABSTRACT FROM AUTHOR]

Objective: To determine sex differences in cholesterol and triglyceride levels among adolescents and young adults hospitalized for medical complications of eating disorders. Methods: A retrospective electronic medical record review of patients aged 9–25 years admitted to the University of California, San Francisco Eating Disorders Program for medical stabilization, between 2012 and 2020, was conducted. Non‐fasting total cholesterol and triglycerides were collected; however, LDL and HDL levels were not available. Results: Among 83 males and 441 females, mean ± SD age was 15.5 ± 2.8 years, 64.1% had anorexia nervosa, and admission percent median body mass index was 87.3 ± 13.9. The proportion of males and females with high total cholesterol (13.3% vs. 18.1%, Cramer's V = 0.05, p =.28) and high triglyceride levels (9.6% vs. 8.1%, Cramer's V = 0.02, p =.63) did not differ. Mean total cholesterol levels were higher in females compared to males (F 169.6 ± 41.1 mg/dL vs. M 154.5 ± 45.1 mg/dL, Cohen's d = 0.36, p =.003), although a majority were within the normal range. In adjusted linear regression models, male (compared to female) sex (B = −14.40, 95% CI −24.54, −4.27) and higher percent median body mass index (B = −0.33, 95% CI −0.60, −0.06) were associated with lower total cholesterol levels in adjusted models (R2 = 0.04). Discussion: Building on prior work showing equally severe complications of eating disorders in males compared to females, we did not find sex differences in those presenting with high total cholesterol or triglycerides. Future research is needed to understand the pathophysiology and role of dyslipidemia in acute malnutrition, and the impact of nutritional rehabilitation and weight restoration. Public Significance: We found that the proportion of male and female adolescents and young adults hospitalized for medical complications of an eating disorder with high total cholesterol did not significantly differ. Although average total cholesterol levels were higher in female compared to male patients with eating disorders, a majority of these levels remained within the normal range. Patients with more severe malnutrition had a higher risk of elevated total cholesterol levels. Clinicians should consider monitoring cholesterol levels in young people hospitalized for restrictive eating disorders. [ABSTRACT FROM AUTHOR]

Design: The androgen receptor (AR) mediates peripheral effects of testosterone. Previous data suggests an association between the number of CAG repeats in exon‐1 of the AR gene and AR transcriptional activity. The aim of this analysis was to determine the association between the number of AR CAG repeats and all‐cause mortality in men and the influence of testosterone level on the association. Patients and Measurements: Follow‐up data to 27 January 2018 were available for men aged 40–79 years recruited across six countries of the European Male Aging Study between 2003 and 2005. Cox proportional hazards modelling was used to determine the association between CAG repeat number/mortality. Results were expressed as hazard ratios (HR)/95% confidence intervals (CI). Results: One thousand nine hundred and seventy‐seven men were followed up. Mean baseline age was 60 ± 11.1 years. Mean duration of follow‐up was 12.2 years. At follow up 25.1% of men had died. CAG repeat length ranged from 6 to 39, with the highest proportion of CAG repeat number at 21 repeats (16.4%). In a multivariable model, compared to men with 22–23 AR CAG repeats: for men with <22 and >23 AR CAG HR, 95% CI for mortality were, <22 CAG repeats 1.17 (0.93–1.49) and >23 CAG repeats 1.14 (0.88–1.47). In a post‐hoc analysis, the association was significant for men in the lowest tertile of baseline testosterone (<14.2 nmol/L) with >23 CAG repeats: in the adjusted model for <22 and >23 CAG repeats, respectively, 1.49 (0.97–2.27) and 1.68 (1.06–2.67) versus 22–23 repeats. Conclusions: Our European‐wide cohort data overall found no association of androgen receptor CAG repeat number and mortality in men. However, post hoc analysis suggested that an association might be present in men with lower baseline testosterone concentrations, which merits further investigation. [ABSTRACT FROM AUTHOR]

Fertility preservation is a growing field in reproductive medicine that may raise ethical questions. Preservation of fertility must be discussed with the patient if gonadotoxic treatment is required, whether in the case of benign or malignant pathology, or in the management of transgender identity. As a result, surgery or chemotherapy that has fewer adverse impacts on fertility should be proposed if this does not alter the prognosis of the disease. If the risk of infertility persists, then fertility cryopreservation should be proposed for children and adults of reproductive age. Sperm, oocytes, and gonadal tissue can be cryopreserved for many years. FIGO wishes to emphasize the importance of fertility preservation in the medical and surgical management of patients, and the importance of a specialized, multidisciplinary approach. Synopsis: Fertility preservation is a major concern of 21st century reproductive medicine, and FIGO wishes to support its development worldwide. [ABSTRACT FROM AUTHOR]

Obesity rates are increasing globally, making it imperative to comprehend the effects of parental obesity on human reproduction. This review aims to highlight the impact of male obesity on reproductive and offspring outcomes. Male obesity has been shown to affect fertility through various mechanisms, including changes in semen quality, difficulty with natural conception, and worsened assisted reproductive technology outcomes. The evidence regarding the impact of male obesity on success of sperm retrieval is conflicting, but all aforementioned adverse effects may be modifiable with weight loss. Moreover, paternal obesity may influence atypical offspring outcomes, such as placental abnormalities and disruptions in fetal development, which may be moderated by epigenetic pathways. Further research is needed to fully understand the complex relationships and underlying mechanisms involved. Gaining more insight into the impact of male obesity on fertility and offspring outcomes can aid in the development of targeted interventions to improve family planning and the health of future generations. [ABSTRACT FROM AUTHOR]

Background: Men harboring prolactinomas frequently suffer from central hypogonadism with secondary anemia. They present insidious and nonspecific symptoms of hypogonadism, making it difficult to diagnose the disease and determine its duration. The result is a delay in diagnosis, which may have harmful hormonal and metabolic consequences. We hypothesized that a decrease in hemoglobin (HB) levels prior to prolactinoma diagnosis, may signal hyperprolactinemia onset and estimate disease duration. Methods: We retrospectively evaluated the prediagnosis temporal trends in HB levels of 70 males with prolactinoma, diagnosed from January 2010 to July 2022. Men without hypogonadism, patients that received testosterone, and those with unrelated anemia were excluded. Results: Sixty‐one of seventy men (87%) with prolactinoma presented with hypogonadism, and forty men (57%) had HB levels ≤13.5 g/dL at diagnosis. We identified 25 patients with "informative" HB curves (mean age, 46.1±14.9 years; median prolactin, 952 ng/mL; median follow‐up, 14.0 years), demonstrating an obvious prediagnosis HB decrease (greater than 1.0 g/dL), from a prediagnosis baseline HB of 14.4 ± 0.3 to 12.9 ± 0.5 g/dL at diagnosis. The median "low‐HB duration" (from the first low HB measurement to hyperprolactinemia diagnosis) was 6.1 years (IQR, 3.3–8.8 years). In symptomatic patients, we identified a correlation between "low‐HB duration" and patient‐reported sexual dysfunction duration (n = 17, R = 0.502, p = 0.04). The "low‐HB duration" was significantly longer than the reported sexual dysfunction duration (7.0 ± 4.5 vs. 2.9 ± 2.5 years, p = 0.01). Conclusions: In our cohort of men with prolactinomas and hypogonadism, we found a marked decrease in HB levels that preceded prolactinoma diagnosis by a median of 6.1 years, with a mean delay of 4.1 years between HB decrease and hypogonadal symptoms appearance. These results suggest that HB decline prior to prolactinoma diagnosis may serve as a marker for hyperprolactinemia onset in a subset of hypogonadal men and allow a more accurate assessment of disease duration. [ABSTRACT FROM AUTHOR]

Background: Sexual dimorphism is observed in the occurrence, course, and severity of human disease. The difference in immune response between males and females can in part be attributed to sexual genotype. However, immunological differences can also be explained by endocrine–immune interactions. Specifically, androgens possess the ability of directly modulating the development and function of immune cells. Although androgens generally contribute to immunosuppressive effects, this is not necessarily always the case. Aim: The aim of the review is to uncover the role of androgens in shaping the innate immune response. Material & Methods: Authors included papers in this review which discussed the impact of androgens on specific innate immune cells. Results: Androgens modulate the innate immune response through various mechanisms. However, there is conflicting evidence in the literature regarding the interplay betwen androgens and the innate immune system. Discussion: Conflicting evidence presented in this review could in part be explained by the limitations present in interpreting results. Conclusion: This review is of great importance for our understanding of occurence and mechanism of human inflammatory disease. [ABSTRACT FROM AUTHOR]

Mechanistic insight into ageing may empower prolonging the lifespan of humans; however, a complete understanding of this process is still lacking despite a plethora of ageing theories. In order to address this, we investigated the association of lifespan with eight phenotypic traits, that is, litter size, body mass, female and male sexual maturity, somatic mutation, heart, respiratory, and metabolic rate. In support of the somatic mutation theory, we analysed 15 mammalian species and their whole‐genome sequencing deriving somatic mutation rate, which displayed the strongest negative correlation with lifespan. All remaining phenotypic traits showed almost equivalent strong associations across this mammalian cohort, however, resting heart rate explained additional variance in lifespan. Integrating somatic mutation and resting heart rate boosted the prediction of lifespan, thus highlighting that resting heart rate may either directly influence lifespan, or represents an epiphenomenon for additional lower‐level mechanisms, for example, metabolic rate, that are associated with lifespan. [ABSTRACT FROM AUTHOR]

Primary mediastinal choriocarcinoma, also known as non‐pregnant choriocarcinoma, is a rare malignancy unrelated to pregnancy, with a higher incidence in males. And primary mediastinal choriocarcinoma is mostly associated with organ and lymph node metastasis, with rapid progression and poor prognosis. Here, we report an extremely rare case of the primary anterior mediastinal choriocarcinoma that occurred in an 18‐year‐old man with multiple metastases of the lung and brain. [ABSTRACT FROM AUTHOR]

Objective: Cognitive behavioral therapy for Avoidant Restrictive Food Intake Disorder (ARFID; CBT‐AR) is an emerging treatment for ARFID. However, this treatment modality has yet to be examined among older adults (e.g., older than 50 years) or with adults presenting with feeding tubes. To inform future versions of CBT‐AR, we present the results of a singular case study (G) of an older male with the sensory sensitivity phenotype of ARFID who presented for treatment with a gastrostomy tube. Methods: G was a 71‐year‐old male who completed eight sessions of CBT‐AR in a doctoral training clinic. ARFID symptom severity and comorbid eating pathology changes were examined pre‐ and post‐treatment. Results: Posttreatment, G reported significant decreases in ARFID symptom severity and no longer met diagnostic criteria for ARFID. Furthermore, throughout treatment, G reported significant increases in his oral food consumption (vs. calories being pushed through the feeding tube), solid food consumption, and the feeding tube was ultimately removed. Discussion: This study provides proof of concept that CBT‐AR is potentially effective for older adults and/or those presenting for treatment with feeding tubes. Validation of patient efforts and severity of ARFID symptoms emerged as core to treatment success and should be emphasized when training clinicians in CBT‐AR. Public Significance: Cognitive behavior therapy for ARFID (CBT‐AR) is the leading treatment for this disorder; however, it has yet to be tested among older adults or those with feeding tubes. This single‐patient case study demonstrates that CBT‐AR may be efficacious in reducing ARFID symptom severity among older adults with a feeding tube. [ABSTRACT FROM AUTHOR]

First reported in the 1800s, germ cell granules are small nonmembrane bound RNA‐rich regions of the cytoplasm. These sites of critical RNA processing and storage in the male germ cell are essential for proper differentiation and development and are present in a wide range of species from Caenorhabditis elegans through mammals. Initially characterized by light and electron microscopy, more modern techniques such as immunofluorescence and genetic models have played a major role in expanding our understanding of the composition of these structures. While these methods have given light to potential granule functions, much work remains to be done. The current expansion of imaging technologies and omics‐scale analyses to germ cell granule research will drive the field forward considerably. Many of these methods, both current and upcoming, have considerable caveats and limitations that necessitate a holistic approach to the study of germ granules. By combining and balancing different techniques, the field is poised to elucidate the nature of these critical structures. [ABSTRACT FROM AUTHOR]

Thus, I wonder whether classroom discussions of plant gender might, in fact, help to promote awareness of the importance of variation and diversity and to cast doubt on the validity of conventional notions of sex and gender. Keywords: bisexual; female; functional gender; gametophyte; hermaphrodite; male; metaphor; quantitative gender; sex change; sporophyte EN bisexual female functional gender gametophyte hermaphrodite male metaphor quantitative gender sex change sporophyte 1 6 6 07/19/23 20230701 NES 230701 "When we view gender as an accomplishment, an achieved property of situated conduct, our attention shifts from matters internal to the individual and focuses on interactional and, ultimately, institutional arenas. Bisexual, functional gender, female, hermaphrodite, gametophyte, metaphor, quantitative gender, sex change, male, sporophyte Distinguishing between sexes and sex roles, using the notion of gender, also helps maintain clarity in the context of the complexities of the alternation of generations between gametophyte and sporophyte generations in land plants. [Extracted from the article]

Aim: During infertility treatment, distress increases and the quality of life declines in both men and women over time. Thus, both men and women need equal support and care. In this study, we aimed to explore the effectiveness of a web‐based partnership support program in preventing quality of life deterioration and reducing emotional distress in men undergoing infertility treatment. Methods: We conducted a non‐randomized controlled trial involving 151 infertile couples in Japan from January to April of 2022. The program consisted of couple discussion, information provision for couple cooperation, and communication techniques. We used a quasi‐experimental design (non‐equivalence two groups pre‐test and post‐test with comparison) involving purposive sampling. Data were collected using the FertiQoL tool and Distress scales. Analyses were conducted by a two‐way factorial analysis of variance using SPSS software. Results: Data for the analysis were included for the intervention group (n = 58) and the control group (n = 62) (valid response rate 79.5%). There were no significant interaction effects between program and time in the FertiQoL and Distress scales. However, there were significant interaction effects between program and time in the Relational (p <.001) and Social (p =.044) subscales. Subgroup analysis showed that in the non‐assisted reproductive technologies group, deterioration in the quality of life was more effectively prevented in the intervention group than in the control group. Conclusions: The web‐based partnership support program appeared to be effective in preventing the deterioration of the quality of life of only men undergoing non‐assisted reproductive technology treatment. [ABSTRACT FROM AUTHOR]

There is renewed interest in the potential for interval (INT) training to increase skeletal muscle mitochondrial content including whether the response differs from continuous (CONT) training. Comparisons of INT and CONT exercise are impacted by the manner in which protocols are "matched", particularly with respect to exercise intensity, as well as inter‐individual differences in training responses. We employed single‐leg cycling to facilitate a within‐participant design and test the hypothesis that short‐term INT training would elicit a greater increase in mitochondrial content than work‐ and intensity‐matched CONT training. Ten young healthy adults (five males and five females) completed 12 training sessions over 4 weeks with each leg. Legs were randomly assigned to complete either 30 min of CONT exercise at a challenging sustainable workload (~50% single‐leg peak power output; Wpeak) or INT exercise that involved 10 × 3‐min bouts at the same absolute workload. INT bouts were interspersed with 1 min of recovery at 10% Wpeak and each CONT session ended with 10 min at 10% Wpeak. Absolute and mean intensity, total training time, and volume were thus matched between legs but the pattern of exercise differed. Contrary to our hypothesis, biomarkers of mitochondrial content including citrate synthase maximal activity, mitochondrial protein content and subsarcolemmal mitochondrial volume increased after CONT (p < 0.05) but not INT training. Both training modes increased single‐leg Wpeak (p < 0.01) and time to exhaustion at 70% of single‐leg Wpeak (p < 0.01). In a work‐ and intensity‐matched comparison, short‐term CONT training increased skeletal muscle mitochondrial content whereas INT training did not. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the desire for children among childhood cancer survivors (CCSs) is scarce. This study evaluated the desire for children in male CCSs in comparison with male siblings. Methods: A nationwide cohort study was conducted as part of the Dutch Childhood Cancer Survivor Study LATER study: 1317 male CCSs and 407 male sibling controls completed a questionnaire addressing the desire for children. Logistic regression analyses were used to explore the independent association between survivorship status and the desire for children. Furthermore, additional analyses were performed to identify which cancer‐related factors were associated with the desire for children in male CCSs. Results: After adjustments for the age at assessment, the percentage of men who had a desire for children was significantly lower among CCSs compared with the siblings (74% vs. 82%; odds ratio [OR], 0.61; 95% CI, 0.46–0.82; p =.001). The association between survivorship status and the desire for children was attenuated after adjustments for marital status, level of education, and employment status (OR, 0.83; 95% CI, 0.61–1.14; p =.250). The percentage of men who had an unfulfilled desire for children remained significantly higher among CCSs compared with the siblings after adjustments for sociodemographic factors (25% vs. 7%; OR, 5.14; 95% CI, 2.48–10.64; p <.001). Conclusions: The majority of male CCSs have a desire for children. The likelihood of having to deal with an unfulfilled desire for children is 5 times higher among CCSs compared with their siblings. This insight is important for understanding the needs and experienced problems of CCSs regarding family planning and fertility issues. Male survivors of childhood cancer report a lower desire for children in comparison with male siblings, and this can be explained by differences in marital status, level of education, and employment status. The likelihood of having to deal with an unfulfilled desire is 5 times higher among male survivors compared with siblings, and cancer diagnosis, allogeneic hematopoietic stem cell transplantation, and cancer treatment are associated with an unfulfilled desire for children. [ABSTRACT FROM AUTHOR]

Objectives: To investigate alterations in depicted penis size by evaluating nude male paintings from the 15th to 21st centuries. Materials and Methods: Nude‐male paintings were identified from various art history websites and analysed to determine changes in penis size over time. Two observers organised the paintings according to the century in which they were created and made the calculations. Penile length to ear length (PtEL) or penile length to nose length (PtNL) were calculated to standardise the measurements using professional image analysis software. PtEL was first attempted for all paintings; if PtEL could not be ascertained, then nose length was used instead of the ear, as the nose length is defined as equal to ear length according to the golden ratio. Thus, PtNL was ensured and both ratios were then referred to using a common term: penis depiction ratio (PDR). Further analysis was performed by dividing the paintings into three groups according to the historical development of art: Renaissance Period (1400–1599; 15th–16th centuries), Baroque–Rococo and Impressionism Period (1600–1899; 17th–19th centuries) and Contemporary Art Period (1900–2020; 20th and 21st centuries). Results: Of 232 identified paintings, 72 (31.1%) were excluded because they depicted images of adolescents or an erect penis. The PDR was found to differ significantly between paintings created in different centuries (P < 0.001). Subgroup analysis revealed that paintings from the 21st century demonstrated significantly higher PDRs than paintings from previous centuries (P = 0.001). Conclusions: In paintings depicting nude males, the size of the penis has gradually increased throughout the past seven centuries, and especially after the 20th century. This observation illustrates the changing sociocultural inputs into male body image and emphasises the need for improved understanding of the sociocultural factors associated with the perception of penis size in men. [ABSTRACT FROM AUTHOR]

Background: Concomitant disease is associated with poor breast cancer survival in women and is more prevalent in racial/ethnic minority groups than individuals who are non‐Hispanic White. The purpose of this study was to determine if race/ethnicity is associated with survival among men with breast cancer when stratifying analyses by level of comorbidity. Methods: We used the California Cancer Registry to identify 1730 cases of men and 259,828 cases of women with breast cancer and documented Charlson Comorbidity Index (CCI). Kaplan–Meier survival and Cox regression analyses were used to compare breast cancer–specific survival and risk of mortality for African American/Black, Hispanic, and Asian/Pacific Islander men with White women and White men. Results: When compared with White women, Black men with a CCI of 0 (hazard ratio [HR], 3.09; 95% CI, 1.10–1.16) and a CCI of 2+, (HR, 2.51; 95% CI, 1.42–4.42) had an increased risk of mortality when compared with White women. When compared with White men, African American men with a CCI of 0 (HR, 2.36; 95% CI, 1.45–3.85) and 2+ (HR, 2.44; 95% CI, 1.26–4.74) had an increased unadjusted risk of mortality, but these disparities were neutralized when controlling for sociodemographic and clinical factors. Conclusions: Black men with both low and high levels of concomitant disease have an increased risk of mortality when compared with both White men and women, but demographic and clinical factors are contributors to this disparity. Black men with both low and high levels of concomitant disease have increased mortality when compared with both White men and women, but demographic and tumor characteristics are contributors to the disparity. [ABSTRACT FROM AUTHOR]

Background and Aim: The incidence of early‐onset colorectal neoplasms has been increasing in both Western and Eastern countries. However, the risks and preventive factors for these neoplasms in Eastern countries remain unclear. Methods: The data of 5580 patients who underwent colonoscopy between 2016 and 2021 were retrospectively evaluated. The primary outcome was advanced colorectal neoplasm (ACRN), defined as advanced adenomas (adenoma ≥10 mm, or with high‐grade dysplasia or villous component) or adenocarcinoma. The clinical factors associated with ACRNs were determined for each age category (≤50 and >50 years), and the differences between the two categories were assessed. Odds ratios adjusted for age and sex were calculated. Results: Among 1001 patients (age ≤50 years), ACRN was found in 94 (9.4%). In this younger category, male sex (adjusted odds ratio [aOR]:2.34, 95% confidence interval [CI]:1.51–3.63) and a family history of colorectal cancer (aOR:2.14, 95% CI:1.17–3.89) were significantly associated with higher odds of developing ACRNs. ACRNs were detected in 726 (15.9%) of 4579 patients (age >50 years). In the older age category, smoking (aOR:1.32, 95% CI:1.08–1.63) was significantly associated with a higher risk of ACRNs. Exercise of >3.5 metabolic equivalent of task (METs) (aOR,0.80; 95% CI:0.67–0.96) was significantly associated with a lower risk of ACRNs. Conclusion: The development of early‐onset ACRNs was primarily associated with congenital factors, whereas that of late‐onset ACRNs was associated with acquired ones. Colonoscopy is recommended for young male patients, particularly for those with a family history of colorectal cancer. [ABSTRACT FROM AUTHOR]

Biomedical and social scientists are increasingly calling the biological sex into question, arguing that sex is a graded spectrum rather than a binary trait. Leading science journals have been adopting this relativist view, thereby opposing fundamental biological facts. While we fully endorse efforts to create a more inclusive environment for gender‐diverse people, this does not require denying biological sex. On the contrary, the rejection of biological sex seems to be based on a lack of knowledge about evolution and it champions species chauvinism, inasmuch as it imposes human identity notions on millions of other species. We argue that the biological definition of the sexes remains central to recognising the diversity of life. Humans with their unique combination of biological sex and gender are different from non‐human animals and plants in this respect. Denying the concept of biological sex, for whatever cause, ultimately erodes scientific progress and may open the flood gates to "alternative truths." [ABSTRACT FROM AUTHOR]

Background: The identification of biomarkers correlated with coronavirus disease 2019 (COVID‐19) outcomes is a relevant need for clinical management. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection is characterized by elevated interleukin (IL)‐6, IL‐10, HLA‐G, and impaired testosterone production. Objectives: We aimed at defining the combined impact of sex hormones, interleukin‐10, and HLA‐G on COVID‐19 pathophysiology and their relationship in male patients. Materials and methods: We measured by chemiluminescence immunoassay, electrochemiluminescent assays, and enzyme‐linked immunosorbent assay circulating total testosterone, 17β‐estradiol (E2), IL‐10, and ‐HLAG5 as well as SARS‐CoV‐2 S1/S2 Immunoglobulin G from 292 healthy controls and 111 COVID‐19 patients with different disease severity at hospital admission, and in 53 COVID‐19 patients at 7‐month follow‐up. Results and discussion: We found significantly higher levels of IL‐10, HLA‐G, and E2 in COVID‐19 patients compared to healthy controls and an inverse correlation between IL‐10 and testosterone, with IL‐10, progressively increasing and testosterone progressively decreasing with disease severity. This correlation was lost at the 7‐month follow‐up. The risk of death in COVID‐19 patients with low testosterone increased in the presence of high IL‐10. A negative correlation between SARS‐CoV‐2 Immunoglobulin G and HLA‐G or IL‐10 at hospitalization was observed. At the 7‐month follow‐up, IL‐10 and testosterone normalized, and HLA‐G decreased. Conclusion: Our findings indicate that combined evaluation of IL‐10 and testosterone predicts the risk of death in men with COVID‐19 and support the hypothesis that IL‐10 fails to suppress excessive inflammation by promoting viral spreading. [ABSTRACT FROM AUTHOR]

Background: Male patients with COVID‐19 have been found with reduced serum total testosterone (tT) levels and with more severe clinical outcomes. Objectives: To assess total testosterone (tT) levels and the probability of recovering eugonadal tT levels during a minimum 12‐month timespan in a cohort of men who have been followed over time after the recovery from laboratory‐confirmed COVID‐19. Materials and methods: Demographic, clinical and hormonal values were collected for the overall cohort. Hypogonadism was defined as tT ≤9.2 nmol/l. The Charlson Comorbidity Index was used to score health‐significant comorbidities. Descriptive statistics was used to compare hormonal levels at baseline versus 7‐month (FU1) versus 12‐month (FU2) follow‐up, respectively. Multivariate cox proportional hazards regression model was used to identify the potential predictors of eugonadism recovery over time among patients with hypogonadism at the time of infection. Results: Of the original cohort of 286 patients, follow‐up data were available for 121 (42.3%) at FU1 and 63 (22%) patients at FU2, respectively. Higher median interquartile range (IQR) tT levels were detected at FU2 (13.8 (12.3–15.3) nmol/L) versus FU1 (10.2 [9.3–10.9] nmol/L) and versus baseline (3.6 [3.02–4.02] nmol/L) (all p < 0.0001), whilst both LH and E2 levels significantly decreased over the same time frame (all p ≤ 0.01). Circulating IL‐6 levels further decreased at FU2 compared to FU1 levels (19.3 vs. 72.8 pg/ml) (p = 0.02). At multivariable cox regression analyses, baseline tT level (HR 1.19; p = 0.03 [1.02–1.4]) was independently associated with the probability of tT level normalization over time, after adjusting for potential confounders. Conclusions: Circulating tT levels keep increasing over time in men after COVID‐19. Still, almost 30% of men who recovered from COVID‐19 had low circulating T levels suggestive for a condition of hypogonadism at a minimum 12‐month follow‐up. [ABSTRACT FROM AUTHOR]

Background: Male circumcision is a well‐known old surgery, and several recently developed techniques have been scaled up, including the introduction of laser technology, as alternative approaches to overcome morbidity of conventional surgery scalpel/suture method Objectives: We aimed to perform a systematic review and meta‐analysis of studies comparing laser circumcision versus conventional circumcision technique in terms of perioperative outcomes and efficacy (complications, unacceptable appearance, reoperation rate) both in children and adults. Materials and methods: This review was performed following the 2020 Preferred Reporting Items for Systematic Reviews and Meta‐Analyses framework. Continuous variables were analyzed using the inverse variance of the mean difference with a random effect, 95% confidence interval (CI), and p‐value. The incidence of complications, unacceptable appearance, and reoperation rate were pooled using the Cochran‐Mantel‐Haenszel Method with the random effect model and reported as odds ratio (OR), 95% CI, and p‐value. Significance was set at p‐value ≤0.05 and 95%CI. Results: Seven studies were included. In comparison to the conventional circumcision, laser circumcision shoved lower visual analogue score at 24‐h, and 7 days after surgery, a lower rate of overall complication rate (OR 0.33, 95% CI 0.24–0.47, p < 0.001), scarring (OR 0.09, 95% CI 0.02, 0.41, p = 0.002), and unacceptable appearance (OR 0.09, 95% CI 0.05, 0.15, p < 0.001). We found no statistically significant difference in surgical time, and incidence of bleeding, infection, wound dehiscence, and reoperation rate. Discussion and conclusion: Our review infers that laser‐assisted circumcision is certainly a safe and strong contender as the procedure of choice in both children and adult populations. [ABSTRACT FROM AUTHOR]

Background: Social attention affords learning opportunities across development and may contribute to individual differences in developmental trajectories, such as between male and female individuals, and in neurodevelopmental conditions, such as autism. Methods: Using eye‐tracking, we measured social attention in a large cohort of autistic (n = 123) and nonautistic females (n = 107), and autistic (n = 330) and nonautistic males (n = 204), aged 6–30 years. Using mixed Growth Curve Analysis, we modelled sex and diagnostic effects on the temporal dynamics of proportional looking time to three types of social stimuli (lean‐static, naturalistic‐static, and naturalistic‐dynamic) and examined the link between individual differences and dimensional social and nonsocial autistic traits in autistic females and males. Results: In the lean‐static stimulus, average face‐looking was higher in females than in males of both autistic and nonautistic groups. Differences in the dynamic pattern of face‐looking were seen in autistic vs. nonautistic females, but not males, with face‐looking peaking later in the trial in autistic females. In the naturalistic‐dynamic stimulus, average face‐looking was higher in females than in males of both groups; changes in the dynamic pattern of face looking were seen in autistic vs. nonautistic males, but not in females, with a steeper peak in nonautistic males. Lower average face‐looking was associated with higher observer‐measured autistic characteristics in autistic females, but not in males. Conclusions: Overall, we found stronger social attention in females to a similar degree in both autistic and nonautistic groups. Nonetheless, the dynamic profiles of social attention differed in different ways in autistic females and males compared to their nonautistic peers, and autistic traits predicted trends of average face‐looking in autistic females. These findings support the role of social attention in the emergence of sex‐related differences in autistic characteristics, suggesting an avenue to phenotypic stratification. [ABSTRACT FROM AUTHOR]

Background: Several studies indicate adverse effects of selected heat exposures on semen quality, but few studies have directly evaluated fertility as an endpoint. Objective: We evaluated prospectively the association between male heat exposures and fecundability, the per‐cycle probability of conception. Materials and methods: We analyzed data from 3041 couples residing in the United States or Canada who enrolled in a prospective preconception cohort study (2013–2021). At enrollment, males reported on several heat‐related exposures, such as use of saunas, hot baths, seat heaters, and tight‐fitting underwear. Pregnancy status was updated on female follow‐up questionnaires every 8 weeks until conception or a censoring event (initiation of fertility treatment, cessation of pregnancy attempts, withdrawal, loss to follow‐up, or 12 cycles), whichever came first. We used proportional probabilities regression models to estimate fecundability ratios (FR) and 95% confidence intervals (CIs) for the association between heat exposures and fecundability, mutually adjusting for heat exposures and other potential confounders. Results: We observed small inverse associations for hot bath/tub use (≥3 vs. 0 times/month: FR = 0.87, 95% CI: 0.70–1.07) and fever in the 3 months before baseline (FR = 0.94, 95% CI: 0.79–1.12; one cycle of follow‐up: FR = 0.84, 95% CI: 0.64–1.11). Little association was found for sauna use, hours of laptop use on one's lap, seat heater use, time spent sitting, and use of tight‐fitting underwear. Based on a cumulative heat metric, FRs for 1, 2, 3, and ≥4 versus 0 heat exposures were 0.99 (95% CI: 0.87–1.12), 1.03 (95% CI: 0.89–1.19), 0.94 (95% CI: 0.74–1.19), and 0.77 (95% CI: 0.50–1.17), respectively. Associations were stronger among men aged ≥30 years (≥4 vs. 0 heat exposures: FR = 0.60, 95% CI: 0.34–1.04). Conclusion: Male use of hot tubs/baths and fever showed weak inverse associations with fecundability. Cumulative exposure to multiple heat sources was associated with a moderate reduction in fecundability, particularly among males aged ≥30 years. [ABSTRACT FROM AUTHOR]

Aims: Treatment with the wearable cardioverter defibrillator (WCD) may protect against sudden cardiac death (SCD) as a bridging therapy until a cardioverter‐defibrillator may be implanted. We analyzed in a multicenter setting a consecutive patient cohort wearing WCD to explore sex differences. Methods and Results: We analyzed 708 consecutive patients, 579 (81.8%) from whom were males and 129 (18.2%) females (age, 60.5 ± 14 vs. 61.6 ± 17 years old; p =.44). While the rate of ischemic cardiomyopathy (ICM) as a cause of prescription of WCD was significantly higher in males as compared to females (42.7% vs. 26.4%; p =.001), females received it more frequently due to nonischemic cardiomyopathy (NICM) (55.8% vs. 42.7%); p =.009). The wear time of WCD was equivalent in both groups (21.1 ± 4.3 h/days in males vs. 21.5 ± 4.4 h/days in females; p =.27; and 62.6 ± 44.3 days in males vs. 56.5 ± 39 days in females; p =.15). Mortality was comparable in both groups at 2‐year‐follow‐up (6.8% in males vs. 9.7% in females; p =.55). Appropriate WCD shocks and the incidence of ICD implantations were similar in both groups (2.4% in males vs. 3.9% in females; p =.07) (35.1% in males vs. 31.8% in females; p =.37), respectively. In age tertile analysis, compliance was observed more in 73–91 years old group as compared with 14–51 years old group (87.8% vs. 68.3%; p <.001). Conclusion: Compliance for wearing WCD was excellent regardless of sex. Furthermore, mortality and the incidence of ICD implantations were comparable in both sexes. Appropriate WCD shocks were similar in both sexes. [ABSTRACT FROM AUTHOR]

Background: Despite diversity initiatives, inequities persist in medicine with negative implications for the workforce and patients. Little is known about workplace inequity in nephrology. Aim: To describe perceptions and experiences of bias by health professionals in the Australian and New Zealand Society of Nephrology (ANZSN), focussing on gender and race. Methods: A web‐based survey of ANZSN members recorded degree of perceived inequity on a Likert scale, ranging from 1 (none) to 5 (complete). Groups were compared using Mann–Whitney U‐test and logistic regression. Comments were synthesised using qualitative methods to explore themes of inequity and pathways to an inclusive future. Results: Of the 620 members of the ANZSN, there were 134 (22%) respondents, of whom 57% were women and 67% were White. The majority (88%) perceived inequities in the workforce. Perceived drivers of inequity were gender (84/113; 75%), carer responsibilities (74/113; 65%) and race (64/113; 56%). Half (74/131) had personally experienced inequity, based on gender in 70% (52/74) and race in 39% (29/75) with perceived discrimination coming from doctors, patients, academics and health administrators. White males were least likely (odds ratio 0.39; 95% confidence interval 0.18–0.90) to experience inequity. Dominant themes from qualitative analysis indicated that the major impacts of inequity were limited opportunities for advancement and lack of formal assistance for those experiencing inequities. Proposed solutions to reduce inequity included normalising the discourse on inequity at an organisational level, with policy changes to ensure diverse representation on committees and in executive leadership positions. Conclusions: Inequity, particularly driven by gender and race, is common for nephrology health professionals in Australia and New Zealand and impacts career progression. [ABSTRACT FROM AUTHOR]

Objectives: To identify the risk factors associated with developing complications after transection of the urethral plate for proximal hypospadias with severe chordee. Methods: We used a prospective database to identify patients with proximal hypospadias and severe chordee who underwent transection of the urethral plate and primary hypospadias repair in 2011 and 2021. All patients underwent urethroplasty with a follow‐up period of >12 months. The association between variables (age, surgical technique, length of urethral defect, and surgeon volume) and postoperative complications (fistulas, urethral strictures, diverticula and glans dehiscence) was analyzed. Results: Altogether, 493 patients were included, of whom 133 (26.9%) had postoperative complications. Univariate and multivariate analyses revealed that the preoperative proximal meatal position, one‐stage repair, longer urethral defect length, and low surgeon volume were significant risk factors for postoperative complications with proximal hypospadias with severe chordee who underwent transection of the urethral plate. A urethral defect length of ≥4.55 cm was considered the best cutoff value for predicting postoperative complications. Conclusions: Preoperative proximal meatal location, one‐stage repair, longer urethral defect length, and low surgeon volume were associated with postoperative complications in patients with proximal hypospadias with severe chordee who underwent transection of the urethral plate. A urethral defect length of ≥4.55 cm was significantly associated with the development of complications. [ABSTRACT FROM AUTHOR]

We determine whether a suspected seasonal variability in semen quality affect subsequent live birth rates. This is a retrospective, cohort analysis of men who provided semen analyses as part of fertility workup through a large andrology lab between 1996 and 2013 and corresponding birth rates using the Utah Population Database (UPDB). Semen parameters were analysed including total motile count (TMC), total sperm count, sperm concentration and progressive motility. Corresponding live births reflect those born in the state of Utah and were derived from birth certificate data available in the UPDB. Descriptive statistics were reported along with linear regression analysis with mixed effected models to test for an interaction between seasonal variation in semen quality and birth rates, accounting for age at the time of the semen analysis and abstinence time. A total of 11,929 patients and 14,765 semen samples were included. Only 3597 men (39% of men) had one or more values outside the World Health Organization reference range for their semen parameters. Linear regression demonstrated a consistent U‐shaped relationship between TMC, total sperm count, and sperm concentration and season, with spring and winter yielding the highest values with a decline in the summer and fall. 7319 of these males had recorded live births for a total of 13,502 live births during the study period after a median follow‐up of 7.2 years (IQR: 3.9–11.0). We did not find a significant interaction between specific semen parameters for a specific season and subsequent live births. Semen quality was the highest in the spring and winter, however there was no interaction between seasonal variability in semen quality and subsequent births. This is one of the largest studies describing seasonal variation in semen quality in humans. [ABSTRACT FROM AUTHOR]

Aim: To analyze the relationships between the ultrasonographic features and the molecular subtypes of breast cancer in men and women. Methods: Data were collected from 43 males and 80 females with breast cancer who were treated at our hospital. The following ultrasonographic characteristics of the tumors were evaluated: shape, orientation, margin, echo pattern, posterior features, calcifications, Color Doppler Flow Imaging, and Breast Imaging Reporting and Data System (BI‐RADS) category. Results: On ultrasound, a nonparallel orientation, noncircumscribed margin, and attenuating posterior features were associated with luminal A lesions. A parallel orientation (P = 0.002), circumscribed margin (P = 0.04), no change in posterior features (P < 0.001), and the BI‐RADS 4 category (P = 0.001) were significantly associated with luminal B lesions. In the group with luminal A lesions, male patients were older (P = 0.001) and a greater number of the tumors exhibited a regular shape (P = 0.009), circumscribed margin (P < 0.001), no change in posterior features (P < 0.001), and the BI‐RADS 4 category (P < 0.001) than those in female patients. Male patients were older (P < 0.001) and a greater number showed a no change in posterior features (P < 0.001), spotty blood flow (P = 0.002), and the BI‐RADS 4 category (P < 0.001) than female patients with masses of the luminal B subtype. Conclusion: Obvious differences in the ultrasonographic and pathological features were noted between breast cancer in males and females, which provided the theoretical basis for the individualized treatment of breast cancer, particularly breast cancer in males. [ABSTRACT FROM AUTHOR]

Background: Angiotensin‐converting enzyme 2 and transmembrane protease serine 2 are critical factors of virus transmission. Expression of angiotensin‐converting enzyme 2 is highest in testes, and testicular function and testosterone levels were affected by coronavirus disease 2019. Low testosterone levels are related to infections, especially respiratory tract infections, and could worsen clinical conditions by exacerbating cytokine storms and increasing pro‐inflammatory cytokines. Objectives: We aimed to evaluate the acute and chronic effects of coronavirus disease 2019 on gonadal functions. Our second aim was to detect the relationship between free testosterone levels and disease prognosis and determine the impact of low‐free testosterone on admission to the intensive care unit. Methods: Eighty‐one patients with reverse‐transcription polymerase chain reaction‐confirmed coronavirus disease 2019 were enrolled. Twenty‐nine patients were assessed again for 6 months post‐coronavirus disease 2019 follow‐up, and seven of them had a semen analysis. Serum follicle‐stimulating hormone, luteinizing hormone, sex hormone‐binding globulin, and total testosterone levels were measured. Results: In this observational study, 71.6% (n = 58) of patients had low free testosterone levels at baseline, in which 69% were considered secondary hypogonadism. A longer length of hospitalization and increased inflammatory markers (d‐dimer, high‐sensitive C‐reactive protein, and procalcitonin) were detected in the low‐free testosterone group. Follicle‐stimulating hormone, total, free, and bioavailable testosterone levels were lower in patients who required admission to the intensive care unit. Free testosterone levels were inversely correlated with the length of hospitalization and prognostic disease factors. Oligozoospermia and impaired progressive motility were present in 42.8% (3/7) of the patients. In 6 months post‐coronavirus disease 2019 follow‐up, out of 29 patients, 48.2% still had low testosterone levels. Conclusion: A high rate of hypogonadism (71.6%) was found, especially secondary hypogonadism, and about half of the patients had hypogonadism in the sixth months' follow‐up. Low free testosterone levels were correlated with inflammatory parameters, and it is related to the intensive care unit admission. Studies with long‐term follow‐up data in larger groups are needed to determine persistent hypogonadism and impaired spermatogenesis. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate diabetes patients over a 10‐year period that visited our outpatient clinic for prevention of diabetic foot ulcers and then investigate the incidence and aetiology of diabetic foot ulcers. The Department of Diabetes and Metabolic Diseases of a university hospital was in charge of the clinic that provided diabetes patients with individual education via the use of visualisation techniques. In this prospective cohort study, a total of 942 diabetes patients who visited the clinic were evaluated for neuropathy, angiopathy and medical history between November 2006 and March 2017. Using the patients' medical records, diabetic foot ulcer development was evaluated between the day of the first visit and December 31, 2018, with 20 out of 942 participants developing these ulcers. Over a period of 12, 60 and 120 months, the diabetic foot ulcer cumulative incidence was 0.2%, 2.4% and 5.8%, respectively. A history of diabetic foot ulcers and the male sex were shown by a Cox regression analysis to be correlated with diabetic foot ulcer development (Hazard Ratio [HR] 11.55, 95%CI 4.600–29.004, p < 0.001; and HR 3.55, 95%CI 1.031–12.196, p = 0.045, respectively). However, only five out of 20 participants with ulceration returned to the clinic for re‐examination. In conclusion, a 12‐month evaluation showed there was a low incidence of diabetic foot ulcers. These results might suggest that patients with a diabetic foot ulcer history need to undergo at least an annual follow‐up in order to further reduce diabetic foot ulcer incidence, although studies involving control groups needs to be conducted, in presenting these as evidence. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effects of device‐based circumcisions compared with standard surgical techniques in adolescent and adult males (10 years old and above). Methods: We performed a comprehensive search with no restrictions to the language of publication or publication status. We included randomised controlled trials (RCTs) of device‐based circumcisions compared to standard surgical dissection‐based circumcision conducted by health professionals in a medical setting. We reported study results as risk ratios (RRs) or mean differences (MDs) using 95% confidence intervals (CIs) and a random‐effects model. We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to evaluate the overall certainty of the evidence for each outcome. Results: A total of 18 trials met the inclusion criteria. These trials did not report severe adverse events (AEs; 11 trials, 3472 participants). There may be a slight increase in moderate AEs for devices compared to surgical techniques (RR 1.31, 95% CI 0.55–3.10; I2 = 68%; 10 trials, 3370 participants; low‐certainty evidence); this corresponds to eight more (ranging from 15 fewer to 84 more) moderate AEs per 1000 participants. We are uncertain about the difference in mild AEs between groups when devices are used compared to surgical techniques (RR 1.09, 95% CI 0.44–2.72; I2 = 91%; 10 trials, 3370 participants; very low‐certainty evidence). Conclusions: We found no serious AEs using a circumcision device compared to surgical techniques. Still, they may slightly increase moderate AEs, and it is unclear whether there is a difference in mild AEs. High‐quality trials evaluating this intervention are needed to provide further certainty regarding the rates of AEs. Clinicians, patients, and policymakers can use these results combined with their contextual factors to inform the best approach that suits their healthcare settings. [ABSTRACT FROM AUTHOR]

Background: While men in the United States consume more alcohol than women, rates of drinking are converging. Nevertheless, females remain underrepresented in preclinical alcohol research. Here, we examined rats' sex‐related differences in patterns of ethanol (EtOH) drinking and the effects of this drinking on exploratory and anxiety‐like behavior. Methods: Adult male and female Long‐Evans rats were given 20% ethanol under the intermittent‐access two‐bottle‐choice paradigm. Their intake was measured daily for the first 7 weeks. During the eighth week, intake was measured over the 24 h of daily access. During the ninth week, they, along with EtOH‐naive controls, were tested prior to daily access in a novel chamber, light–dark box, and hole board apparatus. During the tenth week, blood ethanol concentration (BEC) was assessed after 30 to 40 min of access. Results: Females overall demonstrated higher ethanol intake and preference across all access weeks than males, although only half of females drank significantly more than males. Across 24 h of daily access, both sexes had their highest intake in the first 30 min and their lowest in the middle of the light phase of the light/dark cycle. Despite their greater ethanol intake, females did not show significantly different BECs than males. In behavioral tests, females showed less vertical time in a novel activity chamber, more movement between chambers in a light–dark box, and more nose pokes in a hole‐board apparatus than males. While a history of ethanol drinking led to a trend for lower vertical time in the activity chamber and greater chamber entries in the light–dark box, the effects were not sex‐dependent. Conclusions: These results suggest that female and male rats could both be tested for acute effects of ethanol after 30 min of daily access, but that nuanced considerations are needed in the design of these experiments and the interpretation of their findings. [ABSTRACT FROM AUTHOR]

Introduction: Male breast cancer (MBC) is rare, representing <1% of all breast cancers. Treatment recommendations have been extrapolated from trial data of female breast cancer patients. This study aims to report our institutional experience of MBC across a 20 year period, analyse the survival outcome and prognosis of this group against female breast cancer patients treated at the same centre. Methods: Clinical, histopathological, treatment and survival data of male and female breast cancer patients treated between Jan 1999 and July 2019 at Singapore General Hospital and National Cancer Centre Singapore were identified and analysed. Results: Fifty‐seven male patients were identified. The median age at diagnosis was 63 years. Majority had invasive ductal carcinoma (86%) and presented at an early disease stage: 70.2% presented as Tis/T1/T2 and 49.1% had no axillary nodal involvement. 84.2% had a simple mastectomy with either a sentinel lymph node biopsy or axillary clearance. The median follow up was 5.69 years for males and 5.83 years for females. The median survival was 11.86 years for males and 16.3 years for females. At 5 years, overall survival (OS) was 69.9% (52.3–82.1%) and disease free survival (DFS) was 62.9% (44.9–76.5%) for males compared with OS 83.8% (83.21–84.39%) and DFS 74.5% (73.91–75.09%) for females. Conclusion: MBC remains understudied. Our institutional data indicates that good long term survival in South‐East Asian patients can be achieved with treatment protocols that are similar to female breast cancer. More prospective studies are required. [ABSTRACT FROM AUTHOR]

Objective: Globally, suicide affects more men than women. Emotional pain underpins many theoretical accounts of suicidality, yet little is known about the role of disgust in suicide. Self‐directed disgust, whereby aspects of the self‐serve as an object of disgust, has been hypothesised to factor in suicide. This research aimed to explore the processes which link self‐disgust to attempted suicide in males. Method: Nine men who had attempted suicide completed semi‐structured interviews. The interview data were analysed using a constructivist grounded theory methodology. Results: Three concepts emerged out of the analysis: (1) self‐disgust; (2) worthlessness; and (3) the endured emotional distress of 'the abyss'" – these concepts interweaved, leading the men to experience hopelessness, disconnection and an inability to cope, leading ultimately to their suicide attempt. Throughout this journey, various disgust‐related processes worsened men's distress and increased their suicidal risk. Historic adversities prevailed across the data, as did the men's difficulties in understanding their emotions. Conclusion: Self‐disgust was an important emotion in the men's experiences of suicide and shaped their views of themselves and their lives. The distancing and repellent properties of self‐disgust, in addition to the fear of having their 'disgustingness' exposed, increased suicidal risk. Self‐disgust appeared more pervasive in the suicidality of men with a history of multiple childhood adversities. The limitations of this research are discussed as implications for clinical practice and directions for future research. [ABSTRACT FROM AUTHOR]

MalE is a maltose/maltodextrin‐binding protein (MBP) that plays a critical role in most bacterial maltose/maltodextrin‐transport systems. Previously reported wild‐type MBPs are monomers comprising an N‐terminal domain (NTD) and a C‐terminal domain (CTD), and maltose‐like molecules are recognized between the NTD and CTD and transported to the cell system. Because MBP does not undergo artificial dimerization, it is widely used as a tag for protein expression and purification. Here, the crystal structure of a domain‐swapped dimeric MalE from Salmonella enterica (named SeMalE) in complex with maltopentaose is reported for the first time, and its structure is distinct from typical monomeric MalE family members. In the domain‐swapped dimer, SeMalE comprises two subdomains: the NTD and CTD. The NTD and CTD of one molecule of SeMalE interact with the CTD and NTD of the partner molecule, respectively. The domain‐swapped dimeric conformation was stabilized by interactions between the NTDs, CTDs and linkers from two SeMalE molecules. Additionally, a maltopentaose molecule was found to be located at the interface between the NTD and CTD of different SeMalE molecules. These results provide new insights that will improve the understanding of maltodextrin‐binding MalE proteins. [ABSTRACT FROM AUTHOR]

The oral administration of Tribulus terrestris and Lepidium meyenii extracts on reproductive, biochemical and body parameters was evaluated in rats. Thirty‐six male Wistar rats weighting 210 ± 18 g were divided into six experimental groups (n = 6). Each group received, daily for 28 days, different solutions: T. terrestris (100 mg/kg), L. meyenii (1 g/kg) and T. terrestris at doses of 75, 50 and 25 mg/kg combined with L. meyenii at doses of 0.25, 0.5 and 0.75 g/kg, respectively, and distilled water (control). T. terrestris increased (p < 0.05) the serum testosterone, regardless of dose. Combined use of the extracts increased (p < 0.05) the diameter of the epididymal duct and epididymis lumen. The combinations of T. terrestris (75 and 50 mg/kg) with L. meyenii increased (p < 0.05) the sperm concentration. There were no differences (p > 0.05) in the other semen characteristics; relative weight of organs; and serum levels of urea, creatinine, alanine and aspartate transaminase, gamma glutamyl transferase, cholesterol, triglycerides, glucose, follicle‐stimulating hormone and luteinizing hormone. No histopathological changes were observed (p > 0.05). It is concluded that the association of T. terrestris and L. meyenii has positive effects on serum testosterone, sperm concentration and epididymal morphology, with no evidence of effects in the testis, liver, spleen and kidneys. [ABSTRACT FROM AUTHOR]

Background: Obesity is a worldwide problem affecting the health of millions of people throughout the life course. Studies reveal that obesity impairs sperm parameters and epigenetics, potentially influencing embryonic development. Objective: To investigate the association between preconceptional paternal body mass index (BMI) and embryo morphokinetics using a time‐lapse incubator and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) outcomes. Materials and methods: Participants were recruited from a tertiary hospital in this prospective periconceptional cohort study. A total of 211 men were included: 86 with normal weight (BMI < 25.0), 94 overweight (BMI 25–29.9), and 41 obese (BMI ≥ 30). These men were part of a couple that underwent IVF/ICSI treatment with ejaculated sperm after which 757 embryos were cultured in a time‐lapse incubator. The main outcome parameters consisted of fertilization rate, embryo developmental morphokinetics, embryo quality assessed by a time‐lapse prediction algorithm (KIDScore), and live birth rate. Results: A higher paternal BMI was associated with faster development of the preimplantation embryo, especially during the first cleavage divisions (t2: −0.11 h (p = 0.05) and t3: −0.19 h (p = 0.01)). Embryo quality using the KIDScore was not altered. The linear regression analysis, after adjustment for confounders (paternal age, ethnicity, smoking, alcohol use, education, total motile sperm count, and maternal age and BMI), showed an inverse association between paternal BMI and fertilization rate (effect estimate: −0.01 (p = 0.002)), but not with the live birth rate. Discussion and conclusion: Our data demonstrate that a higher preconceptional paternal BMI is associated with a reduced fertilization rate in IVF/ICSI treatment. Our findings underline the importance of a healthy paternal weight during the preconception period. [ABSTRACT FROM AUTHOR]

As science culture gravitates toward a more holistic inclusion of both males and females in research design, the outlining of sex differences and their respective intersections with disease physiology and pathophysiology should see reciprocal expansion. Melanoma skin cancer, for example, has observed a female advantage in incidence, mortality, and overall survival since the early 1970s. The exact biological mechanism of this trend, however, is unclear and further complicated by a layering of clinical variables such as skin phototype, age, and body mass index. In this perspective, we highlight epidemiological evidence of sex differences in melanoma and summarize the landscape of their potential origin. Among several biological hallmarks, we make a note of sex‐specific immune profiles—along with divergent hormonal regulation, social practices, DNA damage and oxidative stress responses, body composition, genetic variants, and X‐chromosome expression—as probable drivers of disparity in melanoma initiation and progression. This review further focuses the conversation of sex as an influencing factor in melanoma development and its potential implication for disease management and treatment strategies. [ABSTRACT FROM AUTHOR]