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ObjectiveThe aim of this study was to examine associations between empirically derived dietary pattern scores and cognition, as well as risk of cognitive decline, over an average of 4.6 (± 0.3) years in older men.Materials and methodsThis analysis was conducted as part of the Osteoporotic Fractures in Men (MrOS) prospective cohort study. Diet was assessed at Visit 1 (3/2000-4/2002) by food frequency questionnaire, and dietary patterns (Western and Prudent) were derived by factor analysis. The analytic cohort comprised 4231 community-dwelling American men who were aged 65 years or more. Cognitive function was assessed with the Modified Mini-Mental State exam (3MS) and the Trails B test at Visit 1 and at Visit 2 (3/2005-5/2006). Associations between dietary pattern score and cognition and risk of cognitive decline were estimated using mixed effects regression models. Model 1 was adjusted for age, clinic site and total energy intake (TEI). Model 2 was further adjusted for calcium and vitamin D supplement use, body mass index (BMI), physical activity, smoking, diabetes and hypertension (Western diet group) and education, calcium and vitamin D supplement use, depression, BMI, physical activity, smoking and stroke (Prudent diet group).ResultsAdherence to the Western dietary pattern was associated with higher 3MS scores and shorter Trails B test time at Visit 1 in Model 2. Adherence to the Prudent dietary pattern was associated with higher 3MS scores in Model 1 but not Model 2. There were no independent associations between dietary pattern scores and risk of cognitive decline 4.6 (± 0.3) years later at Visit 2.ConclusionThe results do not support a robust protective effect of the Prudent dietary pattern on cognition in the MrOS cohort. Associations between the Western dietary pattern and better cognitive scores should be interpreted with caution. Further research is needed to understand the complex interactions between dietary patterns and cognition in older men.

Background: To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up. Methods: In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA. Results: On average, a significant decrease in MVPA over 2 years was observed only in women (P <.001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years. Conclusions: Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women. [ABSTRACT FROM AUTHOR]

Background: Mental health among older women is substantial due to their longer life expectancy. They are more susceptible to mental disorders like depression and anxiety compared to older men. Additionally, older women fulfill essential family roles and depend on social support for age-related health issues. Family-centered education provides a platform to assist families and foster a collaborative relationship between the patient, family members, and health care providers in end-of-life care. The study aimed to explore how education based on family‑centered empowerment model affects mental health in aged women. Methods: This randomized controlled trial involved a group of 60 elderly women aged 60 years and older, specifically selected from elderly-friendly health centers in Tabriz-East Azerbaijan, who were randomly assigned to either an intervention or control group with an equal ratio. The intervention group received a family-centered healthy lifestyle intervention weekly for 10 sessions, while the control group received standard care from elderly-friendly centers. The mean score of mental health using a three-part questionnaire of demographic-anthropometric characteristics and a mental health questionnaire (GHQ) were assessed before the intervention, 4 and 8 weeks after the intervention through SPSS/version 13 using, ANCOVA, independent t‑test, and repeated measure analysis at a significant level of p < 0.05. Results: The average age (standard deviation: SD) was 64.0 (3.8) years. The literacy level of the more than half of the participants was primary school. Regarding occupation and marital status, the majority of them were married and housekeeper. Two months after the intervention (end of the intervention), a significant decrease was detected in terms of overall mental health score in the intervention group compared to the control (the adjusted difference was − 5.7 with a 95% CI from − 10.3 to -1.1, and the p-value was 0.015). In the intragroup analysis, two months after the intervention, there was a significant decrease in overall mental health score compared to baseline in the intervention group (the mean change was − 5.4, with a 95% CI from − 9.9 to -0.9, and a p-value of 0.015). Moreover, a significant decrease was indicated in the physical subscale score in the intervention group compared to the control group (the adjusted difference was − 5.7, with a 95% CI from − 10.2 to -1.2, and a p-value of 0.015). There was no significant difference between the two groups in other subscales (p > 0.05). In the intragroup analysis, there was a significant decrease in the physical subscale score (the mean change was − 1.7, with a 95% CI from − 2.9 to -0.2, and a p-value of 0.038) and anxiety symptoms (the mean change was − 1.8, with a 95% CI from − 3.4 to -1.0, and a p-value of 0.033) compared to the baseline in the intervention group. Conclusion: An education based on family-centered empowerment model could improve the overall mental health score in elderly women. Hence, it may be recommended to regard this approach as a practicable educational strategy for improving the well-being of the elderly. Trial registration: Iranian Registry of Clinical Trials; https://irct.behdasht.gov.ir/trial/30535 (IRCT20161126031087N2), registered (03/08/2018). [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions In long‐term care (LTC), the incidence of hip or vertebral fractures are eight times that in the community. Despite the wide availability of osteoporosis therapy, LTC residents are omitted from pivotal trials and not treated. Denosumab is a relatively new, monoclonal antibody therapy for osteoporosis treatment. Via a randomized trial, we sought to determine the safety and efficacy of denosumab in LTC residents.We conducted a 2‐year, double‐blind, placebo‐controlled, randomized clinical trial in 201 osteoporotic men and women aged ≥ 65 years, living in LTC communities. Participants with multimorbidity, dysmobility, and cognitive impairment were not excluded. The intervention was denosumab 60 mg subcutaneous every 6 months or placebo. Our primary outcome measures were hip and spine bone mineral density (BMD) improvement at 24 months. Secondary outcomes included BMD at other skeletal sites, function, and safety.We included 123 women and 78 men with a mean ± standard error age of 81.5 ± 0.6. Overall, 83% and 71% completed 12 and 24 months, respectively. Compared with placebo, the women receiving denosumab had a greater 24‐month percent increase in spine (7.41 ± 0.93 vs. 2.15 + 0.56; p = 0.014), and total hip BMD (4.62 ± 0.62 vs. −0.19 ± 0.79; p = 0.007); and men in spine (7.91 ± 0.96 vs. 1.12 ± 1.13; p = 0.002) and total hip (3.74 ± 0.55 vs. 0.48 ± 0.74; p = 0.018). There were no significant differences in safety metrics.Denosumab was a safe and effective therapy for improving BMD in osteoporotic older men and women with multiple comorbidities in LTC. [ABSTRACT FROM AUTHOR]

Aims Materials and Methods Results Conclusion Clinical trial registration number To compare the effects of semaglutide and testosterone replacement therapy (TRT) on semen quality and parameters of functional hypogonadism (FH) in men with type 2 diabetes mellitus and obesity.We designed a randomised open‐label trial in 25 men with type 2 diabetes (aged 50 [46–60] years, BMI 35.9 [32.8–38.7] kg/m2) and FH randomised to semaglutide (SEMA) 1 mg/week or intramuscular testosterone undecanoate (TRT) 1000 mg/10–12 weeks for 24 weeks. Semen analysis and parameters of FH were measured at baseline and after 24 weeks of treatment. Participants completed questionnaires of the International Index of Erectile Function‐15 (IIEF‐15) and the Aging Symptoms in Men (AMS).The quality of baseline sperm parameters of our study cohort was poor, below the 5th percentile of reference values. In the SEMA group, there was a significant increase in morphologically normal sperm from baseline to the end of the study (2% [2; 3.5] vs. 4% [2; 5.5]; p = 0.012), whereas sperm concentration and total number decreased significantly in the TRT group. Compared to TRT, the SEMA group had a significantly higher number of morphologically normal sperm, sperm concentration and total number. Both groups experienced an increase in total testosterone and improvement in the AMS score, whereas the IIEF‐15 score significantly improved only in the TRT group.Semaglutide markedly improved sperm morphology, total testosterone levels and symptoms of hypogonadism. These findings highlight semaglutide's potential as a therapeutic approach for men with obesity‐related FH who desire fertility.NCT06489457, www.clinicaltrials.gov. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To estimate the prevalence of nocturia in middle‐aged and elderly men and evaluate its associated factors and changes over time.Data of middle‐aged and older men aged ≥40 years from the 2007–2008 and 2017–2020 cycles of the National Health and Nutrition Examination Survey were retrospectively analyzed. The prevalence of nocturia was estimated using participant questionnaires on nocturia, lifestyle‐related factors, and health factors, and its decadal changes were examined using multivariate logistic regression analysis to determine related factors associated with the prevalence of nocturia.The prevalence of nocturia was 38.0% in 2007–2008 and 39.6% in 2017–2020, with no significant increase observed (P = 0.3989). Being a non‐Hispanic black was positively correlated with nocturia (adjusted odds ratio [AOR] = 1.54, 1.22–1.93, P < 0.001), whereas the correlation with being a Mexican American disappeared (AOR = 1.25, 0.90–1.73, P = 0.187). Diabetes (AOR = 1.32, 1.07–1.64, P = 0.010) and sleep disorders (AOR = 1.31, 1.07–1.60, P = 0.008) showed a statistically significant positive correlation with nocturia, whereas a significant negative correlation was observed between employment (AOR = 0.66, 0.54–0.82, P < 0.001) and nocturia. Above‐high‐school education (AOR = 0.60, 0.47–0.76, P < 0.001) showed a constant trend toward a negative correlation with nocturia. The correlation between high school education or general educational development and nocturia disappeared (AOR = 0.81, 0.62–1.05, P = 0.112).Diabetes and sleep disorders contribute to the development of nocturia, while work and high educational attainment can actively combat nocturia. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

AbstractObjectiveStudy designMethodsResultsConclusionOur objective was to assess trends in three sexually transmitted infections (STIs) – gonorrhoea, chlamydia and syphilis – in Spain, by age group and sex from 2016 to 2022.Retrospective observational studyData from epidemiological surveillance system were used to calculate the incidence rate for each STIs by age group and sex. Poisson regression was employed to examine the trends for 2016 to 2022.For gonorrhoea, higher incidence rates were observed among men than women for all period. The incidence rate ratio (IRR) varied between 1.14 (95% CI 1.12–1.16) for the 15–19 age group to 1.24 (1.23–1.25) for the 35–44 age group among men, and between 1.14 (1.09–1.19) for 55 years or more to 1.27 (1.24–1.29) for the 15–19 age group among women. For chlamydia, women showed higher incidence rate for all age groups than men during the period. Individuals aged 55 years and over showed the highest increase, IRR = 1.30 (1.27–1.34) for men, while it was the lowest for women, IRR = 1.22 (1.16–1.27). The incidence rates for syphilis were lower than for the other STIs. IRR values varied between 1.04 (1.02–1.06) in the 20–24 age group and 1.15 (1.14–1.16) in the 35–44 age group for males; and between 1.13 (1.06–1.16) for the 25–34 age group and 1.18 (1.13–1.25) for the 25–34 age group for females.STIs are more frequent in people aged 25–34 and are increasing in all age groups. However, the rise is most pronounced among older men and among younger women. [ABSTRACT FROM AUTHOR]

Introduction: Benign prostatic hyperplasia (BPH) is the enlargement of the prostate gland, primarily occurring in aging men, in which transforming growth factor-beta (TGF-β) plays a critical role in prostate cell hyperproliferation and leads to uncomfortable urinary symptoms in BPH patients. Pterocarpus indicus Willd. is well known for its ethnopharmacological applications for treating ailments such as diuresis and bladder stones. Methods: This study aimed to examine the effect of P. indicus extract (PI extract) on TGF-β-induced WPMY-1 cell proliferation, followed by bioassay-guided fractionation to isolate the active metabolites. Angolensin (Ang) and maackiain (Mac) were isolated from bioassay-guided fractionation. Network analysis was performed to investigate the potential mechanisms. Furthermore, network analysis of the Ang-Mac combination in BPH highlighted the potential top ten pathways, including PI3K/AKT signaling pathway. Accordingly, subsequent investigation focused on evaluating the effect of PI extract, Ang, Mac, and Ang-Mac combination on the expression of PCNA, p53, and PI3K/AKT protein localization and expression. Results and discussion: Results revealed inhibition of cell proliferation in TGF-β-induced WPMY-1 cells, correlating with downregulated PCNA expression. While PI extract and Mac induced apoptosis via p53 upregulation, Ang and Ang-Mac combination did not significantly affect apoptosis through the p53 pathway. Additionally, both metabolites exhibited potent inhibition of p-PI3K and p-AKT protein localization and expression in the nucleus of TGF-β-induced WPMY-1 cells. This study suggests that PI extract, Ang, and Mac are promising compounds for treating BPH, as evidenced by in silico and in vitro studies. Additionally, Ang and Mac could be used to standardize PI extract in future investigations. [ABSTRACT FROM AUTHOR]

Background/Objectives: Atrial fibrillation (AF) is one of the most common forms of persistent arrhythmia in adults worldwide. The aim of this study was to present recent data on the epidemiology of patients hospitalized with AF in Poland. Methods: This is a retrospective, population-based study conducted using hospital discharge records. The data covered 1,225,424 cases of AF hospitalization reported in 2017–2021. Results: The study group consisted of 51.36% men and 48.64% women. The mean and median ages were 73.6 and 74 years, respectively. Women were older than men (77 vs. 70 years, p < 0.001). The mean and median lengths of hospitalization were 6.9 and 4 days. The mean annual hospitalization rate was 640.0 per 100,000 person-years. In the group of patients aged ≥65 years, the hospitalization rate was 2870.4 per 100,000 person-years. Men were hospitalized more frequently than women (p < 0.001). The total in-hospital mortality rate was 37.7 per 100,000 person-years, and it was higher in women than in men (p < 0.001). There was a significant downward trend in first-time hospitalizations during the analyzed period and a significant downward trend in mortality rates with a marked increase in the years 2020–2021. Conclusions: Although women are less frequently hospitalized for AF, they show a higher risk of fatal hospitalizations. The pandemic may have reduced new AF diagnoses and increased mortality in this group of patients. The results of this study may be helpful in making comparative analyses in the European and global contexts and taking actions aimed at improving the health condition of the Polish population. [ABSTRACT FROM AUTHOR]

Objectives: Second to fourth digit ratio is widely known indicator of prenatal sex hormones proportion. Higher prenatal androgenization results in longer fourth finger and lower 2D:4D index. The aim of this study was to determine whether the 2D:4D digit ratio is associated with DNA methylation (DNAm) age dependently on sex. Material and Methods: The study included 182 adults (106 females and 76 males) with a mean age of 51.5 ± 13 years. The investigation consisted of three main parts: a survey, anthropometric dimensions measurements (fingers length) and methylome analysis using collected blood samples. Genome‐wide methylation was analyzed using EPIC microarray technology. Epigenetic age and epigenetic age acceleration were calculated using several widely applied algorithms. Results: Males with the female left hand pattern had more accelerated epigenetic age than those with the male pattern as calculated with PhenoAge and DNAmTL clocks. Conclusions: Finger female pattern 2D:4D above or equal to 1 in males is associated with epigenetic age acceleration, indicating that prenatal exposure to estrogens in males may be related to aging process in the later ontogenesis. [ABSTRACT FROM AUTHOR]

Background: The link between the pre‐diagnostic use of statins and testosterone replacement therapy and their impact on hormone‐related cancers, prostate cancer, colorectal cancer, and male breast cancer survival remains a topic of controversy. Further, there is a knowledge gap concerning the joint effects of statins and testosterone replacement therapy on hormone‐related cancer survival outcomes. Objective: To examine the independent and joint effects of pre‐diagnostic use of statins and testosterone replacement therapy on the risk of all‐cause and cause‐specific mortality among older men diagnosed with hormone‐related cancers, including prostate cancer, colorectal cancer, and male breast cancer. Methods: In 41,707 men (≥65 years) of Surveillance, Epidemiology, and End Results‐Medicare 2007–2015, we identified 31,097 prostate cancer, 10,315 colorectal cancer, and 295 male breast cancer cases. Pre‐diagnostic prescription of statins and testosterone replacement therapy was ascertained and categorized into four groups (Neither users, statins alone, testosterone replacement therapy alone, and Dual users). Multivariable‐adjusted Cox proportional hazards and competing‐risks (Fine‐Gray subdistribution hazard) models were conducted. Results: No significant associations were found in Cox‐proportional hazard models for hormone‐related cancers. However, in the Fine‐Gray competing risk models among high‐grade hormone‐related cancers, statins alone had an 11% reduced risk of hormone‐related cancer‐specific death (hazard ratio: 0.89; 95% confidence interval: 0.81–0.99; p 0.0451). In the prostate cancer cohort with both statistical models, the use of testosterone replacement therapy alone had a 24% lower risk of all‐cause death (hazard ratio: 0.76; 95% confidence interval: 0.59–0.97; p 0.0325) and a 57% lower risk of prostate cancer‐specific death (hazard ratio: 0.43; 95% confidence interval: 0.24–0.75; p 0.0029). Similar inverse associations were found among aggressive prostate cancer cases with testosterone replacement therapy alone and statins alone. No significant associations were found in the colorectal cancer and male breast cancer sub‐groups. Conclusion: Pre‐diagnostic use of statins and testosterone replacement therapy showed a survival benefit with reduced mortality in high‐grade hormone‐related cancer patients (only statins) and aggressive prostate cancer patients in both statistical models. Findings of testosterone replacement therapy use in aggressive prostate cancer settings could facilitate clinical trials. Further studies with extended follow‐up periods are needed to substantiate these findings. [ABSTRACT FROM AUTHOR]

Prostate cancer (PCa) is one of the most important health problems among elderly men in China, with the increasing aging of the population. A cross-sectional survey was conducted in eastern China from 2022 to 2023. Recruitment included a total of 70,342 participants aged 60 or older. Social demographic information, such as individual factors like age, education levels and behavior habits, physical examination and laboratory tests results were collected. Age-standardized prevalence rates were estimated by a direct method with a standard population. T test and chi-square test were used to compare the statistical differences. Multivariate regression models were used to identify the risk factors of PCa. Overall, the crude and age-standardized PCa prevalence is 0.93% and 0.91%, respectively in eastern China. When we adjusted all the co-variables, it showed that high age, smoking, having a higher BMI and higher CA19-9 were associated with a higher risk for a prostate cancer diagnosis. Faced with the demographic transition, innovative strategies are needed to control and prevent PCa. Conducting early screening among male population in community health service centers in eastern of China, especially among a population with associated risk factors such as high age, obesity, and conducting community-based intervention programs might be helpful to address this increasingly significant health problem. [ABSTRACT FROM AUTHOR]

Background: Men exhibit higher prevalence of modifiable risk factors, such as smoking and alcohol consumption, leading to greater cancer incidence and lower survival rates. Comprehensive evidence on global cancer burden among men, including disparities by age group and country, is sparse. To address this, the authors analyzed 30 cancer types among men in 2022, with projections estimated for 2050. Methods: The 2022 GLOBOCAN estimates were used to describe cancer statistics for men in 185 countries/territories worldwide. Mortality‐to‐incidence ratios (MIRs) were calculated by dividing age‐standardized mortality rates by incidence rates. Results: In 2022, a high MIR (indicating poor survival) was observed among older men (aged 65 years and older; 61%) for rare cancer types (pancreatic cancer, 91%) and in countries with low a Human Development Index (HDI; 74%). Between 2022 and 2050, cancer cases are projected to increase from 10.3 million to 19 million (≥84%). Deaths are projected to increase from 5.4 million to 10.5 million (≥93%), with a greater than two‐fold increase among men aged 65 years and older (≥117%) and for low‐HDI and medium‐HDI countries/territories (≥160%). Cancer cases and deaths are projected to increase among working‐age groups (≥39%) and very‐high‐HDI countries/territories (≥50%). Conclusions: Substantial disparities in cancer cases and deaths were observed among men in 2022, and these are projected to widen by 2050. Strengthening health infrastructure, enhancing workforce quality and access, fostering national and international collaborations, and promoting universal health coverage are crucial to reducing cancer disparities and ensuring cancer equity among men globally. In 2022, notable cancer disparities were observed between men's age groups and between countries/territories, and these disparities are projected to widen by 2050. Strengthening health system infrastructure, improving access to universal health coverage, and multidisciplinary approaches are essential for narrowing existing and projected cancer disparities, ultimately ensuring cancer equity in men worldwide. [ABSTRACT FROM AUTHOR]

Testicular germ cell tumours (GCT) are divided into three different subtypes (types I–III) regarding to their developmental origin, histological differences and molecular features. Type I GCT develop from disturbed primordial germ cells and most commonly occur in children and young adolescents, which is why they are referred to as prepubertal GCT. Type II GCT develop from a non‐invasive germ cell neoplasia in situ (GCNIS) and show an isochromosome 12p (i12p) or gain of 12p material as a common and characteristic molecular alteration. Type III GCT originate from distorted postpubertal germ cells (e.g. spermatogonia) in adult patients and have changes on chromosome 9 with amplification of the DMRT1 gene. Type I GCT encompass prepubertal‐type teratomas and yolk‐sac tumours (YST). Type II GCT include seminoma, embryonal carcinoma, choriocarcinoma, postpubertal‐type teratoma and postpubertal‐type YST. Types I and II GCT both show similar morphology, but are separated from each other by the detection of a GCNIS and an i12p in type II GCT. For type II GCT it is especially important to detect non‐seminomatous elements, as these tumours have a worse biological behaviour and need a different treatment to seminomas. In contrast to types I and II GCT, type III tumours are equivalent to spermatocytic tumours and usually occur in elderly men, with few exceptions in young adults. The development of types I and II GCT seems to depend not upon driver mutations, but rather on changes in the epigenetic landscape. Furthermore, different pluripotency associated factors (e.g. OCT3/4, SOX2, SOX17) play a crucial role in GCT development and can be used as immunohistochemical markers allowing to distinguish the different subtypes from each other in morphologically challenging tissue specimens. Especially in metastatic sites, a morphological and immunohistochemical diagnostic algorithm is important to detect small subpopulations of each non‐seminomatous GCT subtype, which are associated with a poorer prognosis and need a different treatment. Furthermore, primary extragonadal GCT of the retroperitoneum or mediastinum develop from misguided germ cells during embryonic development, and might be challenging to detect in small tissue biopsies due to their rarity at corresponding sites. This review article summarises the pathobiological and developmental aspects of the three different types of testicular GCT that can be helpful in the histopathological examination of tumour specimens by pathologists. [ABSTRACT FROM AUTHOR]

Background: Pancreatic cancer (PC) is a malignant tumour with poor prognosis and high mortality, and high fasting plasma glucose (HFPG) is considered to be one of its important risk factors. Methods: PC disease burden data were obtained from the Global Burden of Disease Study 2021 (GBD 2021) database. Annual percent change (APC), average APC (AAPC), and 95% confidence interval (95% CI) were analysed using joinpoint linkpoint regression models to assess the trend of PC burden of disease between 1990 and 2021. An age-period-cohort model was used to estimate the independent effects of age, period, and cohort on PC burden, and data on PC mortality attributable to HFPG in China from 2022 to 2032 were analysed on the basis of a Bayesian age-period-cohort model projection. Results: The number of Pc deaths due to HFPG continue to rise in China from 1990 to 2021, with age-standardised mortality (ASMR) and age-standardised disability-adjusted life-year rates with increasing AAPC values of 1.12% (95% CI, 0.73-1.52) and 1.00% (95% CI, 0.63-1.37), respectively. Throughout the study, we found that the overall level of PC disease burden was significantly higher in men than that in women. In age-period-cohort analyses, the age effect of PC showed an increasing and then decreasing trend, the period effect showed an overall increasing trend during the study period, and the cohort effect showed an overall slow decreasing trend. In addition, the BAPC model predicted that ASMR is expected to decline significantly in both men and women from 2022 to 2032. Conclusions: It was found that PC attributable to HFPG was generally on the rise in China from 1990 to 2021 and has been on the decline in recent years, and projections suggest that the country's future PC disease burden will continue to show a downward trend. Age and period of birth are the main factors affecting the disease burden, especially in men and older age groups. Early prevention, regular screening, and research into the pathogenesis of PC have, therefore, become particularly important. [ABSTRACT FROM AUTHOR]

Background and objective: Prostate cancer (PCa) was the leading incident cancer and 3rd leading cause of cancer death in men in France in 2015 with inter-regional disparities. The objectives were to describe PCa incidence and mortality in France and by region, using real life data from the National Health Data System and to identify the factors associated with all-cause or PCa-specific mortality. Methods: Men aged ≥ 18years hospitalized and/or on long-term care for PCa (ICD-10 code C61) in France between 2010 and 2021 were included. An incident case was defined by the absence of any cancer in the five years preceding the first coding. Incidence and mortality estimates were age-standardized: France 2018f standardized rates (FSR), all-cause mortality (SMR) and PCa-specific mortality (SMRspe). Factors associated with death were identified using cause-specific Cox models. Results: The mean annual incidence was 47,081cases/year (FSR:179.6/100,000men), increasing over the period except 2020. All-cause mortality was 20,259 deaths/year (77.3/100,000men), and PCa-specific mortality was 7,265 deaths/year (27.7/100,000men). A PCa-specific mortality excess was found in Centre-Val-de-Loire (SMRspe = 1.21), Bretagne (1.18), Hauts-de-France (1.17) Normandie (1.15). After adjustment, significant PCa mortality excess was observed in Bretagne (HR = 1,29;95%IC[1.09–1.46]) and Hauts-de-France (HR = 1.19[1.03–1.34]). The other factors associated with death were an age ≥ 60years, an increasing comorbidity index, metastatic disease at onset (major weight in specific mortality with hazard ratio HR = 16.1[15.2–17.0]), precariousness, affiliation to the agricultural scheme, and the COVID period in all-cause mortality. Conclusion: This study updated incidence and mortality data in France. It showed differences in mortality between regions in France. The adjustment moderates regional findings based on raw mortality data. [ABSTRACT FROM AUTHOR]

Ageing has a protective impact on recidivism risk, including for those who offend sexually (Ambroziak, G., Kahn, R. E., Mundt, J. C., Keiser, K. L., & Thornton, D. (2020). Are civilly detained and committed sexually violent persons released after age 60 low risk? Criminal Justice and Behavior, 48(7), 981–998; Doren, D. M. (2006). What do we know about the effect of aging on recidivism risk for sexual offenders? Sexual Abuse: A Journal of Research and Treatment, 18; Harris, G. T., & Rice, M. E. (2007). Adjusting actuarial violence risk assessments based on aging or the passage of time. Criminal Justice and Behavior, 34(3), 297–313). Recent research of the Risk for Sexual Violence Protocol (RSVP) suggests increased age may affect the validity of this guideline, with good predictive performance in samples of men mostly aged under 50 (Davis, M. R., Woods, M., Raymond, B., Ogloff, J. R. P., & McEwan, T. E. (in submission). Does it work? Convergent and predictive validity of the Risk for Sexual Violence Protocol (RSVP) in an Australian Community Forensic Mental Health Setting. Manuscript submitted for publication; Vargen, L. M., Jackson, K. J., & Hart, S. D. (2020). Interrater reliability, concurrent validity, and predictive validity of the Risk for Sexual Violence Protocol. Law and Human Behavior, 44(1), 37–50), but poor predictive performance in a sample aged over 50 (Raymond, B. C., Davis, M. R., Ogloff, J. R. P., & McEwan, T. E. (in submission). Convergent and predictive validity of the sexual violence risk-20 and risk for sexual violence protocol with older sexual offenders. Manuscript submitted for publication). This study investigated possible reasons for these contrasting results by investigating age-related differences in risk factor endorsement and the relationships between risk factors. RSVP risk factors in two samples of men with prior sexual offending, older adults aged between 50 and 78 (n = 95) and adults aged between 18 and 46 (n = 139). Few differences were identified in risk factor endorsement or the relationship between risk factors. The younger adult sample were observed to have more risk factors present.PRACTICE IMPACT STATEMENTThis research adds to the literature regarding older men who offend sexually. It is anticipated that further research into factors that are associated with this age group, may encourage future research of gerontological literature in a forensic arena. Until more reliable evidence is available, the current risk assessment tools may require a level of caution when used with older men. [ABSTRACT FROM AUTHOR]

Age‐related loss of muscle mass and function is underpinned by changes at the myocellular level. However, our understanding of the aged muscle phenotype might be confounded by factors secondary to ageing per se, such as inactivity and adiposity. Here, using healthy, lean, recreationally active, older men, we investigated the impact of ageing on myocellular properties in skeletal muscle. Muscle biopsies were obtained from young men (22 ± 3 years, n = 10) and older men (69 ± 3 years, n = 11) matched for health status, activity level and body mass index. Immunofluorescence was used to assess myofibre composition, morphology (size and shape), capillarization, the content of satellite cells and myonuclei, the spatial relationship between satellite cells and capillaries, denervation and myofibre grouping. Compared with young muscle, aged muscle contained 53% more type I myofibres, in addition to smaller (−32%) and misshapen (3%) type II myofibres (P < 0.05). Aged muscle manifested fewer capillaries (−29%) and satellite cells (−38%) surrounding type II myofibres (P < 0.05); however, the spatial relationship between these two remained intact. The proportion of denervated myofibres was ∼2.6‐fold higher in old than young muscle (P < 0.05). Aged muscle had more grouped type I myofibres (∼18‐fold), primarily driven by increased size of existing groups rather than increased group frequency (P < 0.05). Aged muscle displayed selective deterioration of type II myofibres alongside increased denervation and myofibre grouping. These data are key to understanding the cellular basis of age‐related muscle decline and reveal a pressing need to fine‐tune strategies to preserve type II myofibres and innervation status in ageing populations. [ABSTRACT FROM AUTHOR]

Cardiovascular plaques result from atherosclerosis. Autopsy investigations of unnatural deaths provide atherosclerosis research. A Central European cohort was studied in a cross-sectional study to determine the origin of atherosclerosis and the link between arterial status and pathobiological variables. This study incorporated 3400 autopsy reports (n = 2318 men; aged 0─96 years; 1928─2010) of persons who died by unnatural causes (suicide, homicide, accident). Age, sex, BMI, abdominal fat thickness, and arterial status of six vascular areas were gathered. The arterial state was divided into five subgroups according to its status. BMI declined from 22.82 kg/m2 in 1931 to 18.43 kg/m2 in 1947, then increased to 27.88 kg/m2 in 2005. Atherosclerotic degeneration begins in the abdominal aorta, then the thoracic, coronary, carotid, ascending, and cerebral arteries. All blood arteries deteriorated faster in men than women until 55. Abdominal aorta damage was the fastest in both sexes. Age is the biggest predictor of atherosclerosis, followed by sex, overweight, and abdominal thickness, according to logistic regression. This is the largest Central European autopsy investigation of six vascular areas. Both sexes develop atherosclerosis in the abdominal aorta in the first decade of life. Being overweight increases the risk. The findings of this study aid healthcare providers in personalized therapy. [ABSTRACT FROM AUTHOR]

The new Marriage Act in Indonesia amended the minimum age for marriage for both women and men to 19 years old. Previous studies were dominated by factors that cause or result from Underage Marriage (UM). It is also important to know the perspective of the judges, who have an important role in the UM dispensation process. This study aims to explore the judges’ perspective when considering age changes in the Marriage Act and the ideal age for marriage. This study uses descriptive qualitative and deductive thematic analysis techniques. Data were collected through a purposive sampling technique and semi-structured interviews with 27 Islamic Court judges. There are five perspectives in responding to age limit changes; agreeing with 19 years old, returning to the old act, increasing the age limit to over 19 years old, giving different age limits for men and women, and considering that age does not affect readiness to marry. These perspectives also determine the ideal age for marriage based on several factors. The judges identified key factors indicating a person’s readiness to marry, including psychological maturity, physical and reproductive health, economic stability, educational attainment, and adherence to cultural and religious norms. Additionally, the persistence of underage marriage in Indonesia is attributed to poverty, lack of education, cultural practices like dowry, and societal pressure, particularly in rural areas. [ABSTRACT FROM AUTHOR]

Background: Reliable estimates of asthma prevalence are essential for developing effective public health policies. However, discrepancies in published results have posed challenges for public health planning in China. To address this issue, we conducted this study to provide a comprehensive assessment of the epidemiology of asthma prevalence in China. Methods: We conducted a thorough systematic review across multiple databases including PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Weipu database. The search was limited to studies published in either Chinese or English up to August 31, 2023, that reported on asthma prevalence in China. We extracted relevant study characteristics and performed meta-analyses. The study protocol was registered with PROSPERO (CRD42023397949). Results: A literature search yielded 192 studies that met the inclusion criteria out of 17,152 articles. The overall prevalence of asthma in Mainland China was found to be 2.20% (95% confidence interval, CI: 1.96-2.47%; I2 = 99.8%), with the prevalence of ever asthma at 2.21%, current asthma at 2.16%, ever asthma-like symptoms at 14.36%, and current asthma-like symptoms at 3.01%. Using a random-effects model, the prediction interval ranged from 0.44 to 10.27%. Meta-analysis subgroups indicated that men or children and the elderly generally have a higher prevalence of asthma. In addition, the prevalence of asthma is higher in urban areas and in the East China. The prevalence of asthma has been on the rise over the past three decades, from 0.69% in 1984 to 5.30% in 2021. Projections suggest that the prevalence could reach 9.76% by 2050 for the Chinese population. Conclusions: Asthma remains less prevalent in China than in western countries, however its prevalence has been gradually increasing over the past thirty years. The disease burden shows notable variations based on sex, age, and geographic regions, indicating significant demographic and regional disparities. To guide decision-making priorities and direct future research, conducting high-quality epidemiological studies on asthma is crucial. Key message: •The overall prevalence rate of asthma in China is 2.20%, and a higher rate observed in males compared to females. •The prevalence rate of asthma varied across different regions of China. •There has been an increasing trend in asthma prevalence in China over the past three decades. •The prevalence of asthma in China is projected to reach 9.76% by 2050. [ABSTRACT FROM AUTHOR]

The article discusses innovative housing models for older women, emphasizing affordability and community connections to combat poverty and loneliness. It highlights resident-coordinated housing options like co-living and enhanced Naturally Occurring Retirement Communities (NORCs) as effective solutions. These models, rooted in traditional concepts, offer older women opportunities to age comfortably while fostering social connections and empowerment. The commentary calls for further research and community support to develop and sustain these housing models effectively. [Extracted from the article]

ABSTRACT Introduction Aim Methods Results Conclusion In‐hospital falls represent significant health and economic concerns, but previous studies regarding the economic cost of falls do not account for other cofounders (comorbidities and clinical aspects) in this cost evaluation.The aim of this study is to analyse the cost of in‐hospital falls comparing those who had falls to nonfalls patients while accounting for several risk factors associated with falls.Data were collected from January 2020 to December 2022, in a private hospital in Brazil. The sample was divided into two groups: one with patients who fell and the other with nonfallers on a 1:2 ratio, and these groups were matched to avoid confounding variables.The median cost for patients who experienced falls was US$7520.26 compared to US$6144.24 for those without falls (p < 0.01). This trend was especially marked in men aged 20–40 who suffered falls and showed a significantly elevated median cost of US$29 722.02 distinguishing them from those without falls with a median cost of US$1179.48 (p < 0.01).Hospital falls significantly increase financial costs compared to nonfall cases, irrespective of comorbidities, length of stay or case‐mix variations. The findings recommend a universal precautions approach to fall prevention in hospitals, targeting all hospitalised patients to effectively minimise the economic burden associated with in‐hospital falls. [ABSTRACT FROM AUTHOR]

The current study examines registration data from the Dutch police pertaining to 2,757 individuals and 10 different crime categories, at the offense, individual, and network levels of analysis. Moreover, a novel estimate is introduced which identifies individuals’ tendency to operate as mentors or mentees in criminal networks. We find co-offending to be conditional on the type of crime and to typically involve groups of two to three offenders. Moreover, we find that men and those aged 18–25 are most likely to co-offend and that co-offenders typically do not show a preference for particular co-offenders. Individuals with central positions in the co-offending network were found to be older and to offend more frequently with a higher average of co-offenders per offense, than those less central. Lastly, we find the novel estimate to be a promising tool for identifying mentor and mentee roles in large quantitative network data. The results of the current study emphasize the importance of studying co-offending on different analytical levels, and to differentiate co-offending by different crime types, network positions, and individual roles, to better inform theory and policy. [ABSTRACT FROM AUTHOR]

Introduction: Benign prostatic hyperplasia (BPH) is the enlargement of the prostate gland, primarily occurring in aging men, in which transforming growth factor-beta (TGF-ß) plays a critical role in prostate cell hyperproliferation and leads to uncomfortable urinary symptoms in BPH patients. Pterocarpus indicus Willd. is well known for its ethnopharmacological applications for treating ailments such as diuresis and bladder stones. Methods: This study aimed to examine the effect of P. indicus extract (PI extract) on TGF-ß-induced WPMY-1 cell proliferation, followed by bioassay-guided fractionation to isolate the active metabolites. Angolensin (Ang) and maackiain (Mac) were isolated from bioassay-guided fractionation. Network analysis was performed to investigate the potential mechanisms. Furthermore, network analysis of the Ang-Mac combination in BPH highlighted the potential top ten pathways, including PI3K/AKT signaling pathway. Accordingly, subsequent investigation focused on evaluating the effect of PI extract, Ang, Mac, and Ang-Mac combination on the expression of PCNA, p53, and PI3K/AKT protein localization and expression. Methods: This study aimed to examine the effect of P. indicus extract (PI extract) on TGF-ß-induced WPMY-1 cell proliferation, followed by bioassay-guided fractionation to isolate the active metabolites. Angolensin (Ang) and maackiain (Mac) were isolated from bioassay-guided fractionation. Network analysis was performed to investigate the potential mechanisms. Furthermore, network analysis of the Ang-Mac combination in BPH highlighted the potential top ten pathways, including PI3K/AKT signaling pathway. Accordingly, subsequent investigation focused on evaluating the effect of PI extract, Ang, Mac, and Ang-Mac combination on the expression of PCNA, p53, and PI3K/AKT protein localization and expression. cells. This study suggests that PI extract, Ang, and Mac are promising compounds for treating BPH, as evidenced by in silico and in vitro studies. Additionally, Ang and Mac could be used to standardize PI extract in future investigations. [ABSTRACT FROM AUTHOR]

Background: Fat infiltration in skeletal muscle is related to declining muscle strength, whereas excess subcutaneous fat is implicated in the development of metabolic diseases. Methods: Using multi-slice axial T2-weighted (T2w) MR images, this retrospective study characterized muscle fat infiltration (MFI) and fat distribution in the lower extremity of 107 subjects (64M/43F, age 11–79 years) with diverse ethnicities (including White, Black, Latino, and Asian subjects). Results: MRI data analysis shows that MFI, evaluated by the relative intensities of the pixel histogram profile in the calf muscle, tends to increase with both age and BMI. However, statistical significance was found only for the age correlation in women (p < 0.002), and the BMI correlation in men (p = 0.04). Sex disparities were also seen in the fat distribution, which was assessed according to subcutaneous fat thickness (SFT) and the fibula bone marrow cross-sectional area (BMA). SFT tends to decrease with age in men (p < 0.01), whereas SFT tends to increase with BMI only in women (p < 0.01). In contrast, BMA tends to increase with age in women (p < 0.01) and with BMI in men (p = 0.04). Additionally, MFI is positively correlated with BMA but not with SFT, suggesting that compromised bone structure may contribute to fat infiltration in the surrounding skeletal muscle. Conclusions: The findings of this study highlight a sex factor affecting MFI and fat distribution, which may offer valuable insights into effective strategies to prevent and treat MFI in women versus men. [ABSTRACT FROM AUTHOR]

Background: Osteomyelitis secondary to mandibular fracture surgery is rare and complete surgical debridement of necrotic infected tissues is an optimal treatment for it. Subsequent reconstruction is required for bone defect caused by operation. Autogenous, allograft and synthetic bone graft substitutes have become widespread in bone defect treatment. Distraction osteogenesis (DO) was also applied in bone defect reconstruction, even it wasn't conventional therapy in jaw. Case presentation: Here we report a case of a 40-year-old aged man who presented with chronic swelling and pain on the right mandibular masseteric region after mandibular angle and Le Fort II fracture surgery. In six weeks after surgery, CBCT images showed that the fracture ends hadn't heal and the fracture gap had widened significantly. The clinical diagnosis of the patient was right mandibular angle osteomyelitis. After controlling the symptoms of pain and infection with local rinses and systemic antibiotic therapy, the patient underwent segmental resection of the infected bone and DO reconstruction for bone defect simultaneously. Encouragingly, well bone healing and normal occlusion restoration was observed finally. Conclusions: DO could be a valuable alternative therapy to bone grafts for bone defect, even in the case of infection. [ABSTRACT FROM AUTHOR]

Background: Inter-generational interaction is a carrier of Chinese traditional culture, and it can exert important influence on the depressive symptoms on Chinese older adults. The study aims to analyze gender differences in the association between inter-generational interaction and depressive symptoms among Chinese older adults and explore factors contributing to the differences. Method: Data from China Family Panel Studies in 2020 were used. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. The latent class analysis was applied to identify patterns of inter-generational interaction of older adults (aged 60 and above). Before the comparison between older man and older woman, we used Coarsened Exact Matching to control confounding factors and improve causal inferences. Multiple linear regression was conducted to explore the association between inter-generational interaction and depression symptoms. Oaxaca-blinder decomposition method was used to analyze the gender difference and the sources. Result: Our study identified three types of inter-generational interaction: detached, nearby but discordant and two-way tight-knit. Analysis indicated that most of older man (54.39%) and older woman (49.78%) were in the type of nearby but discordant. Older man and older woman who in detached type had higher depression scores than other types, and the depression score of two-way tight-knit type accounted for 12.42 and 13.77 respectively. Our findings demonstrated that two-way tight-knit type (-11.89%) significantly decreased the gender differences in the depression symptoms. Other major contributors also included living without spouse (20.56%), primary school and junior middle school (15.95%), higher middle school and above (9.50%) and no illness for two weeks (47.70%). Conclusion: Our study highlighted three patterns of inter-generational interaction, and most of older man and older woman were in the pattern of nearby but discordant. In addition, the two-way tight-knit pattern significantly can decrease gender differences in depression symptoms. The contributors should be taken into account in more targeted intervention strategies for narrowing gender differences in the depression symptoms, which could achieve a gender dividend in the era of China's aging population. [ABSTRACT FROM AUTHOR]

Intimacy and relationships are important to sexual minority men, yet traditional sex and relationship education from sources such as schools and families may lack perceived usefulness. Consequently, sexual minority men may seek information from alternative sources, but little research has explored the usefulness of these alternatives. A national survey of sexual minority men in Australia (n = 936, Mage = 38.9) evaluated the usefulness of seven sources of information: school programmes, family, peers and friends, social media and the Internet, popular culture, pornography, and official information sources. Five topics were examined for each source: sexual and reproductive physiology, HIV/STI prevention, relationship skills, consent and needs negotiation, and sexual and intimate behaviours. Participants rated the sources as minimally to moderately useful. Official information sources were rated most useful, followed by peers and friends, social media and the Internet, popular culture, pornography, school, and family. Older men found most sources less useful than younger participants. Perceived usefulness varied across topics (e.g. popular culture and peers and friends rated most useful for relationship skills). These findings underscore the limited relevance of conventional sex and relationship education for sexual minority men and highlight the need for enhanced education programmes. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results and conclusion With the increasing trend ofpopulation aging, erectile dysfunction (ED) among elderly men has emerged as apressing health concern. Despite extensive research on the relationship betweenED and aging, ongoing discoveries and evidence continue to arise.Through this comprehensiveanalysis, we aim to provide a more nuanced theoretical framework for thedevelopment of preventive and therapeutic strategies for senile ED, ultimatelyenhancing the quality of life for elderly men.This review delves deeper into thecore mechanisms underlying ED in the context of aging and offers acomprehensive overview of published meta‐analyses and systematic reviewspertinent to these conditions.Our findings revealthat local structural damage to the penis, vascular dysfunction, neuronalinjury, hormonal alterations, other physiological changes, and psychologicalbarriers all play pivotal roles in the pathogenesis of aging‐related ED.Furthermore, more than 20 diseases closely associated with aging have beenimplicated in the occurrence of ED, further compounding the complexity of thisissue. [ABSTRACT FROM AUTHOR]

Introduction: Benign prostatic hyperplasia (BPH) is a common urological condition, particularly among middle-aged and elderly men. Trans urethral resection of prostate (TURP) has some drawbacks, particularly concerning ejaculatory function. Ejaculation preserving TURP (Ep-TURP) is one such technique that aims at preserving the tissues that are primarily responsible for antegrade ejaculation. Methods and material: In this prospective study, patients with bothersome LUTS were randomized into Ep-TURP and standard TURP groups. Supramontal tissue was preserved in Ep-TURP while standard TURP group had resection of the entire prostatic tissue up to the verumontanum. The outcomes with regard to IPSS, Qmax, IIEF(Q9), Ejaculation and PVR were studied. Ejaculation projection score was separately calculated and assessed. Results: About 60 patients were studied, with 30 in each group. At 6 months' follow-up, complication rates were the same in both groups. The IPSS, Qmax, IIEF were similar and comparable. There was no change in erection in all patients (P = 0.559). The ejaculation was well preserved in Ep-TURP (p<0.001). Ejaculation projection score was maintained at 3.77 in the Ep-TURP group while in the standard group it was 0 (P<0.001). Conclusions: Ep-TURP is a safe and a cost-effective method of preserving ejaculation in patients undergoing TURP. This procedure adds a better quality of life that greatly aids in enhancing the improving his psychological outlook towards life. Ep-TURP has now emerged as the standard procedure of choice in sexually active young males needing TURP, as the degree of ejaculation is largely well preserved in patients undergoing this procedure. [ABSTRACT FROM AUTHOR]

The relationship between smoking and testosterone levels in adult males remains a topic of ongoing debate. Serum cotinine is considered a reliable marker of both smoking intensity and exposure to tobacco smoke. Therefore, we aim to examine the association between serum cotinine levels and total testosterone concentrations in adult males using data from the U.S. National Health and Nutrition Examination Survey (NHANES) database. Our study assessed the relationship between serum cotinine and total testosterone using weighted linear regression models and subgroup analysis. A fully adjusted model with smooth curve fitting was employed to investigate the potential nonlinear association between serum cotinine and total testosterone. Threshold effects were analyzed to identify the inflection point between serum cotinine and total testosterone. Indeed, a total of 7797 participants were included in our study. After adjusting for potential confounding variables, the findings indicate a positive association between serum cotinine levels and total testosterone levels (β: 0.05, 95%CI: 0.02, 0.09). Furthermore, applying smoothed curve fitting analysis and threshold effects, an inflection point was detected at a serum cotinine level of 487 ng/ml. Above this threshold, total testosterone levels declined with increasing serum cotinine levels. In conclusion, the findings of our study suggest a positive association between elevated serum cotinine levels and total testosterone levels in adult men. However, it is essential to note that this association may be reversed at excessively high serum cotinine concentrations. [ABSTRACT FROM AUTHOR]

The article presents the results of assessing the dynamics of the age at marriage of the reproductive part of the population of the south of Central Russia, which acts as one of the factors in the dynamics of the genetic structure of subsequent generations. Over 130 years (from 1890–1910 to 2016–2018), there was an increase in the age of marriage for men (+5.11 years, from 24.05 to 29.16 years) and women (+5.78 years, from 20.39 to 26.17 years), and the average difference in the age of spouses decreased by 0.66 (3.66 to 3.00 years). At the end of the 19th century, the marriage age of the urban population of the reproductive part of the population was higher than that of the rural population (especially among men). By the middle of the 20th century, the average age of marriage among the rural population increased, exceeding the city indicators, and this trend continued in subsequent generations until 2016–2018. There was a decrease in the average age difference between spouses, especially in the urban part of the population. At the end of the 19th century, the average difference in the age of spouses among urban residents was 1.4 times higher than for rural residents, and by the beginning of the 21st century, on the contrary, it was 1.4 times lower. Positive marital assortativity by age of spouses increased over the 130-year period (1.2 times), both in the city and in the village, but was more significant for residents of rural areas (except for the period 1991–1993). Changes in the average marriage age of spouses that have been occurring in recent decades are of particular significance from a medical-genetic point of view (especially the age at which women marry), since this indicator is potentially significant for determining the prevalence of a number of hereditary diseases among the population. Studying the age at marriage allows us to identify unfavorable trends and risks of potential negative changes in the structure of gene pools (and accordingly, the level of health) of subsequent generations. [ABSTRACT FROM AUTHOR]

Lactate, a product of glycolysis, is formed under aerobic conditions. Extensive work has shown lactate flux in young and exercising humans; however, the effect of age is not known. We tested the hypothesis that postprandial lactate shuttling (PLS) would be diminished in older adults. We used [3-13C]lactate and [6,6-2H]glucose tracers, an oral glucose tolerance test (OGTT), and arterialized blood sampling to determine postprandial lactate rates of appearance (Ra), disappearance (Rd), and oxidation (Rox) in 15 young (28.1 ± 1.4 yr) and 13 older (70.6 ± 2.4 yr) healthy men and women. In young participants, fasting blood [lactate] (≈0.5 mM) rose after the glucose challenge, peaked at 15 min, dipped to a nadir at 30 min, and rose again peaking at 60 min (≈1.0 mM). Initial responses in lactate Ra of older participants were delayed and diminished until 90 min rising by 0.83 mg·kg−1·min−1. Lactate Rox was higher throughout the entire trial in young participants by a difference of ∼0.5 mg·kg−1·min−1. Initial peaks in lactate Ra and concentration in all volunteers demonstrated the presence of an enteric PLS following an OGTT. Notably, in the systemic, but not enteric, PLS phase, lactate Ra correlated highly with glucose Rd (r2 = 0.92). Correspondence of second peaks in lactate Ra and concentration and glucose Rd shows dependence of lactate Ra on glucose Rd. Although results show both enteric and systemic PLS phases in young and older study cohorts, metabolic responses were delayed and diminished in healthy older individuals. NEW & NOTEWORTHY: We used isotope tracers, an oral glucose tolerance test, and arterialized blood sampling to determine postprandial lactate flux rates in healthy young and older men and women. Lactate rates of appearance and oxidation and the lactate‐pyruvate exchange were delayed and diminished in both enteric and systemic postprandial lactate shuttle phases in older participants. [ABSTRACT FROM AUTHOR]

Objective: To examine changes in trends of hospital-presenting suicide-related ideation in older adults living in Ireland, during the first 24 months of the COVID-19 pandemic and 2018–2019. Methods: Data on presentations of patients aged 60 and older from participating hospitals of the National Clinical Programme for Self-Harm and Suicide-related Ideation were used to compare trends during the first two years of the COVID-19 pandemic (2020–2021) with the preceding period (2018–2019). Poisson regression models were used to estimate trends in the pre-pandemic and pandemic periods. Results: There were 1531 presentations for suicide-related ideation to hospital emergency departments in older adults between January 1, 2018–December 31, 2021, with most presentations involving males (57.2%, n = 876). There was a 27% increase in suicide-related ideation presentations during the pandemic years (2020–2021) when compared to 2018–2019 (RR: 1.27, p =.001, 95%CI: 1.14–1.40), with females showing a 29% increase (RR: 1.29, p =.001, 95%CI: 1.11–1.51) and males a 23% increase (RR: 1.23, p =.002, 95%CI: 1.08–1.40). When examining these trends by years, there were only significant increases in 2021, and no significant increases were observed in 2020. Conclusions: The study findings show that in the second year following the start of the pandemic, significant increases were observed in suicide-related ideation hospital-presentations in older adults. While immediate changes in trends were not observed in the first year of the pandemic, it is important to consider the pandemic's medium and long-term impact on older adults' mental health, to provide adequate support and reduce suicide risk among those presenting with suicide-related ideation. HIGHLIGHTS: Hospital-presenting suicide-related ideation increased by 27% in the first two years of the COVID-19 pandemic, with more accentuated increases in 2021. Older men had increased suicide-related ideation presentations in 2021. In the aftermath of the COVID-19 pandemic, it is important to consider the medium and long-term effects on older adults' mental health. [ABSTRACT FROM AUTHOR]

A radiographic gold standard to distinguish osteoporotic vertebral fractures (VFs) from nonosteoporotic VFs does not exist. Radiographic fracture-shaped vertebral deformity (FSVD) is common among young populations with normal bone strength. FSVD in an older population is called osteoporotic-like vertebral fracture (OLVF) when the FSVD is likely associated with compromised bone strength. For more severe grade deformities or when a vertebra is collapsed, experienced readers can make an osteoporotic VF diagnosis with a high degree of certainty. In milder cases, radiographic osteoporotic VF is often diagnosed based on a high probability rather than an absolute diagnosis. For older women, three nonadjacent minimal grade OLVFs (< 20% height loss), one minimal grade OLVF and one mild OLVF (≥ 20∼25% height loss), or one OLVF with ≥ 25% height loss meets the diagnosis of osteoporosis. For older men, a single OLVF with ≥ 33 to 40% height loss is insufficient to suggest the patient has osteoporosis. [ABSTRACT FROM AUTHOR]

This review assesses the evidence of the physiological effects of testosterone on cardiovascular health, the association between male hypogonadism and cardiovascular health, and the effects of testosterone therapy on cardiovascular health in male hypogonadism. Preclinical studies suggest complex effects of testosterone on cardiovascular risk by acting on skeletal muscle, cardiomyocytes, vasculature, adipocytes, insulin action, and erythropoiesis. Furthermore, low testosterone has a bi‐directional association with cardiometabolic risk. Observational studies have reported worse metabolic profiles in men with organic hypogonadism. However, a consistent association between major cardiovascular events and male hypogonadism has not been established. Hematocrit increases with testosterone therapy; however, most studies do not report an increase in venous thromboembolism risk. Although some observational studies and a small randomized controlled study reported an increased risk of cardiovascular disease, recent data confirm the medium‐term cardiovascular safety of testosterone therapy in middle‐aged and older men with low testosterone. [ABSTRACT FROM AUTHOR]

Purpose: Prolonged work in the heat increases the risk of acute kidney injury (AKI) in young men. Whether aging and age-associated chronic disease may exacerbate the risk of AKI remains unclear. Methods: We evaluated plasma neutrophil gelatinase-associated lipocalin (NGAL) and serum kidney injury molecule-1 (KIM1) before and after 180 min of moderate-intensity work (200 W/m2) in temperate (wet-bulb globe temperature [WBGT] 16 °C) and hot (32 °C) environments in healthy young (n = 13, 22 years) and older men (n = 12, 59 years), and older men with type 2 diabetes (T2D; n = 9, 60 years) or hypertension (HTN; n = 9, 60 years). Results: There were no changes in NGAL or KIM1 concentrations following prolonged work in temperate conditions in any group. Despite a similar work tolerance, the relative change in NGAL was greater in the older group when compared to the young group following exercise in the hot condition (mean difference + 82 ng/mL; p < 0.001). Baseline concentrations of KIM1 were ~ 22 pg/mL higher in the older relative to young group, increasing by ~ 10 pg/mL in each group after exercise in the heat (both p ≤ 0.03). Despite a reduced work tolerance in the heat in older men with T2D (120 ± 40 min) and HTN (108 ± 42 min), elevations in NGAL and KIM1 were similar to their healthy counterparts. Conclusion: Age may be associated with greater renal stress following prolonged work in the heat. The similar biomarker responses in T2D and HTN compared to healthy older men, alongside reduced exercise tolerance in the heat, suggest these individuals may exhibit greater vulnerability to heat-induced AKI if work is prolonged. [ABSTRACT FROM AUTHOR]

Neuroendocrine neoplasms (NENs) are rare in the head and neck region, with the larynx being the most common site. To date, nearly 700 cases of laryngeal neuroendocrine carcinoma (NEC) have been reported in the literature, with an estimated incidence as low as 0.23%. This type of cancer is more prevalent among men aged 50–83 who are heavy smokers. NENs encompass paragangliomas and epithelial neoplasms. The latter categories include neuroendocrine tumors, or typical carcinoids, and NECs, or atypical carcinoids. Due to their nonspecific and often misleading presentation, and given the rarity of this condition, optimal management lacks standardization. Treatment typically involves a combination of surgery, chemotherapy, and radiotherapy. We present a case of supraglottic laryngeal NEC in a 61‐year‐old female nonsmoker. The patient underwent endoscopic excision followed by adjuvant radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Hypertension, a major non-communicable disease, is responsible for a significant number of global deaths, including approximately 17.9 million yearly. The Global Burden of Disease 2019 (GBD 2019) estimates that 19% of global deaths are attributed to elevated blood pressure. India, with a population of over 1.4 billion, is facing a serious challenge in combating this silent killer. This study aims to analyze the gender-based prevalence of hypertension in India and explore its associated risk factors using data from the fifth National Family Health Survey (NFHS-5). Methods: NFHS-5 collected data from 636,699 households across all states and union territories. The study includes standardized blood pressure measurements for 17,08,241 individuals aged 15 and above. The data were analyzed using Stata, employing descriptive statistics for the assessment of the prevalence and binary logistic regression to identify predictors of hypertension. Results: The study found the overall prevalence of hypertension in India to be 22.6%, with men (24.1%) having a higher prevalence than women (21.2%). Prevalence increased with age, reaching 48.4% in individuals aged 60 and above. Urban residents had a slightly higher prevalence (25%) than rural residents (21.4%), indicating the rapid spread of hypertension across all populations. Regional variations were observed, with the highest prevalence in Sikkim (37.9%) and the lowest in Rajasthan (16.5%). Increasing age, urban residence, belonging to certain religions (Muslim and other than Hindu or Muslim), and being classified as Scheduled Tribes (ST) were associated with a higher likelihood of hypertension. Conversely, belonging to Scheduled Castes (SC) or Other Backward Classes (OBC), being currently unmarried, and having higher education were associated with a lower likelihood of hypertension. Wealth index analysis revealed that those in the richest quintile were more likely to have hypertension. Behavioural risk factors, such as alcohol consumption, overweight, obesity, increased waist circumference, and high blood glucose levels, are positively associated with hypertension. Conclusion: Hypertension is a significant health burden in India, affecting both men and women. Age is the strongest non-modifiable predictor for both men and women. However, ageing women have higher odds of hypertension than ageing men, and this distinction becomes much more evident in their older ages. Obese women, based on BMI, have higher odds of hypertension than men. However, hypertension prevalence is slightly higher among men who are overweight or obese compared to women. BMI, waist circumference, random glucose level, alcohol use, and education level emerged as major predictors. Health education and awareness campaigns are critical to control the growing burden of hypertension in India. Policymakers must focus on preventive measures, targeting lifestyle changes and improved healthcare access for both men and women. By addressing these risk factors, India can make significant progress in controlling hypertension and reducing its impact on public health. [ABSTRACT FROM AUTHOR]

Background: Adenocarcinoma of the esophagogastric junction (AEGJ) is most common in men and the elderly, but the disease is becoming more common in female and young adult persons. We have investigated the clinicoepidemiological characteristics of female and young adult patients with AEGJ and the 12-year trends in the Kurashiki area for young adult patients with AEGJ. Methods: Patients diagnosed with AEGJ in 12 hospitals between January 2008 and December 2019 were included in this study. Patients were divided into three groups by age (young adult [≤50 years], middle-aged [51 to 70 years], and elderly [>70 years]). Factors associated with AEGJ such as obesity, smoking, hiatal hernia and male, which were reported in our previous study, were identified. Results: One hundred and eighty-eight AEGJ patients, including 36 females and 20 young adults, were characterized. There was no significant change in the annual incidence of AEGJ among female (p=0.078) and young adult patients (p=0.89). Female patients without any associated factors, accounting for 53% (19/36) of the female patients and young adult patients, had significantly more histologically undifferentiated cancers than patients with at least one associated factor (58% [11/19] vs. 30% [50/169], p=0.025) and middle-aged and elderly patients (60% [12/20] vs. 30% [25/83] vs. 28% [24/85], p =0.026). Smoking was significantly less common in women than in men (8% [3/36] vs. 57% [87/152], p < 0.01). There were no significant differences between ages in the proportions of these associated factors. Conclusions: Histologically undifferentiated AEGJ cancers were more frequent in female patients without any associated factors and in young adult patients. Factors associated with AEGJ may differ between women and men, but they are similar in young adults and older adults. No increase in young adult patients with AEGJ was observed in the 12-year study. [ABSTRACT FROM AUTHOR]

This study explored the demand for improved farm animal welfare (FAW) legislation in the BRIC countries and the USA. Results are discussed in comparison to Europe. Interviewees ranked their willingness to support or oppose introduction of more FAW-friendly laws in their country. A multinomial logistic regression was fit to the data (p < 0.001), with the parameters "country × gender" (p < 0.001) and "country × age" (p < 0.001) found significant. Americans, Russian women, and older Brazilian men are very supportive. The age effect is also felt in India, where older people are more supportive. Chinese, American men, and younger Indians are less supportive. Russian males are the group that oppose the most, followed by younger Brazilians and Indians. The law and its application vary a lot between countries. Nevertheless, the societal willingness to improve FAW legislation is high in all countries. The willingness is higher in Europe. The different cultural backgrounds, the socio-economic factors, and the social, economic, and environmental sustainability are enough reasons to create barriers to policy harmonization in the global trade of farm animal products. [ABSTRACT FROM AUTHOR]

To examine population-level scrotal cancer incidence rates and trends among adult men in the United States. Data from the United States Cancer Statistics, covering approximately 96% of the United States population, were analyzed to calculate age-standardized incidence rates of scrotal cancer among men aged 18 years and older from 1999 to 2020. Trends in incidence rates were evaluated by age, race and ethnicity, Census region, and histology using joinpoint regression. Overall, 4669 men were diagnosed with scrotal cancer (0.20 per 100,000). Incidence rates were highest among men aged 70 years and older (0.82 per 100,000). Rates were higher among non-Hispanic Asian or Pacific Islander men (0.31 per 100,000) compared to other race and ethnicity groups. The most common histologic subtypes were squamous cell carcinoma (35.9%), extramammary Paget disease (20.8%), and sarcoma (20.5%). Incidence rates decreased by 2.9% per year from 1999 to 2019 for non-Hispanic Asian or Pacific Islander men, decreased by 8.1% per year from 1999 to 2006 for basal cell carcinomas, and increased by 1.8% per year from 1999 to 2019 for extramammary Paget disease; otherwise, rates remained stable for all other variables examined. While scrotal cancer incidence rates were higher than previously reported, rates were still low and stable over time. [ABSTRACT FROM AUTHOR]

To compare the risk of intentional self-harm (ISH) and suicide in older men using 5-α reductase inhibitors (5-ARIs) and alpha-blockers for benign prostatic hyperplasia (BPH). Observational research of older men with BPH suggested an increase in ISH with 5-ARI use compared with nonuse; we aimed to address potential confounding by indication with an active comparator reference group. Using Medicare data linked to the National Death Index (NDI) from 2007-2016, we implemented a retrospective cohort design in males aged ≥65 years who initiated 5-ARI or alpha-blocker use for BPH. ISH was identified using ICD-9-CM and ICD-10-CM diagnosis codes. Suicides were identified through cause-of-death information from the NDI. We used inverse probability of treatment weighted Cox proportional hazards regression to compare time-to-event between treatment groups, with robust variance estimation. The event rates for ISH and suicide, respectively, were 0.314 and 0.308 per 1000 person-years (PY) among 5-ARI users (n = 181,675), and 0.364 and 0.382 per 1000PY among alpha-blocker users (n = 850,476). For 5-ARI use relative to alpha-blocker use, hazard ratios (HRs) for ISH and suicide, respectively, were 0.88 (95% CI:0.62-1.25) and 0.82 (95% CI:0.54-1.24); for the composite outcome (non-fatal ISH or suicide), the HR was 0.88 (95% CI:0.66-1.16). Subgroup and sensitivity analyses supported these results. 5-ARI use was not associated with an increased risk for ISH or suicide compared to alpha-blocker use in older men with BPH. Study limitations included low event rates and potentially low sensitivity for ISH events. [ABSTRACT FROM AUTHOR]

Background. Lung carcinoma with p40/TTF1 coexpression (LC-PTC) is a very rare tumor with poor prognosis, and few cases have been reported to date. Objectives. To better understand biological behavior and prognosis of LC-PTC. Methods. We collected 9 examples of LC-PTC and compared them with 36 lung adenosquamous carcinomas during the same period in clinicopathologic characteristics, biologic behaviour, and prognosis. Results. Lung carcinoma with p40/TTF1 coexpression mainly occurred in middle-aged and elderly men; 8 tumors belonged to the peripheral type, and 1 belonged to the central type. The rates of lymph node and distant metastasis were 88% (7/8) and 50% (4/8), respectively; 2 patients died during follow-up. Histologically, the LC-PTC showed nest-like growth pattern without glandular growth pattern; the surface of 2 tumors was covered with ciliated columnar epithelium and tumor cells grew under the columnar epithelium. In all patients, tumor cells diffusely coexpressed p40 and TTF1. Although there was no significant difference in the maximum diameter of tumor with lymph node metastasis or with distant metastasis between LC-PTC and lung adenosquamous carcinoma, LC-PTC had a higher rate of lymph node metastasis and distant metastasis. There was no significant difference in overall survival of patients between LC-PTC and lung adenosquamous carcinoma. Additional histologic evaluation of normal pulmonary structures revealed that p40/TTF1 coexpression cells existed in bronchial mucosa and the number of cells coexpressing p40/TTF1 increased gradually from proximal bronchus to distal bronchus. Conclusions. Lung carcinoma with p40/TTF1 coexpression is a rare tumor with high metastatic potential and may originate from p40/TTF1 coexpression cells in distal bronchial mucosa. [ABSTRACT FROM AUTHOR]

The present research investigated whether and (if so) how one's perception of gender discrimination would vary as a function of age and gender in Korea. Since gender-related conflicts have escalated in Korea especially among younger adults, we predicted that (1) there would be gender differences in one's perception of gender discrimination in Korea and (2) such differences would be particularly large among younger adults. Consistent with the predictions, we found that Korean men underestimated discrimination against women and overestimated discrimination against men, relative to Korean women. Also, such tendency was more pronounced among younger men than among older men without significant differences in sexism between them. Moreover, young men claimed that men were at least as discriminated against as women in Korea unlike other groups who believed that discrimination against women was larger than discrimination against men. Our data also suggest that such perception of gender discrimination among younger Korean men is possibly due to their beliefs that social atmosphere in Korea is disadvantageous to their gender. We further showed that gender differences in perception of gender discrimination were associated with corresponding differences in emotional reactions (i.e., anger) to gender discrimination. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusion We have previously shown that exposure to famine in early gestation was associated with poorer adult health and, in women, with reduced survival up to age 64.Here, we explore the association between prenatal famine exposure and mortality up to age 76 for men and women separately.We studied adult mortality (>18 years) in men (n = 989) and women (n = 1002) born as term singletons around the time of the 1944–1945 Dutch famine. We compared overall and cause‐specific mortality among men and women exposed to famine in late, mid, or early gestation to that among unexposed persons (born before or conceived after the famine) using Cox regression.In total, 500 persons (25.1%) had died after age 18. Women exposed to famine in early gestation had higher overall (HR 1.49, 95% CI 1.00, 2.23), cancer (HR 2.17, 95% CI 1.32,3.58) and cardiovascular mortality (HR 2.33, 95% CI 0.91, 5.95) compared to unexposed women. Mortality rates among men were not different between exposure groups.This study showed that women, but not men, exposed to famine in early gestation had increased overall, cardiovascular and cancer mortality up to age 76. Although prenatal famine exposure affects adult health of both men and women, it seems to only lead to increased mortality among women. [ABSTRACT FROM AUTHOR]

Purpose: The authors experienced several cases of extra-articular calcaneal fracture accompanied by joint depression involving the entire posterior facet without joint involvement. This type of fracture and its characteristics and treatment outcomes have not been previously reported. The study was performed to analyze the characteristics of extra-articular calcaneal fractures of the joint depression type and their postoperative clinical and radiographic results and complications. Methods: Between February 2013 and March 2021, 23 extra-articular calcaneal fractures of the joint depression type were consecutively treated by a single surgeon. Relationships between fracture characteristics and patient demographics were assessed. Clinical results were quantified using visual analog scale, American Orthopaedic Foot and Ankle Society ankle-hindfoot scale, and Foot Function Index, radiographic results were evaluated using Böhler's angles, and calcaneal widths were determined using calcaneal axial and lateral radiographs obtained preoperatively and at last follow-up. Results: Twenty (87%) of the 23 cases occurred in women, and the mean age of all patients was 65.8 years (43–90). The three men were older than 65. Five (21.7%) patients had osteopenia, and 12 (52.2%) had osteoporosis. Bone mineral density testing could not be performed in the other six patients. Clinical and radiographic results were significantly improved after surgery. Conclusion: Extra-articular calcaneal fractures of the joint depression type are much more common in women and occur at an older age than calcaneal fractures commonly occur. These fractures are also more common in patients with a low bone mineral density. Level of evidence: Level IV. Case series. [ABSTRACT FROM AUTHOR]

Non‐surgical (reversible) male contraception methods, when approved for general clinical application, should be made available to all interested men aged 18 50 years in good general health regardless of their semen parameters. In the preliminary workup, a complete personal and family history aimed at identifying specific conditions that may potentially increase the risks for adverse effects (associated with testosterone replacement) is advisable but a general or andrological examination is not required, unless indicated by the history. Baseline body weight, blood pressure and haemoglobin should be recorded for the purpose of future monitoring. While risks and benefits of vasectomy have been well established, appropriately nuanced patient counselling and assessment are essential for ensuring a satisfactory outcome of vasectomy. [ABSTRACT FROM AUTHOR]