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Since the beginning of mass vaccination campaign for COVID-19 in Italy (December 2020) and following the rapidly increasing vaccine administration, sex differences have been emphasized. Nevertheless, incomplete and frequently incoherent sex-disaggregated data for COVID-19 vaccinations are currently available, and vaccines clinical studies generally do not include sex-specific analyses for safety and efficacy. We looked at sex variations in the COVID-19 vaccine’s effectiveness against infection and severe disease outcomes. We conducted a nationwide retrospective cohort study on Italian population, linking information on COVID-19 vaccine administrations obtained through the Italian National Vaccination Registry, with the COVID-19 integrated surveillance system, held by the Istituto Superiore di Sanità. The results showed that, in all age groups, vaccine effectiveness (VE) was higher in the time-interval ≤120 days post-vaccination. In terms of the sex difference in vaccination effectiveness, men and women were protected against serious illness by vaccination in a comparable way, while men were protected against infection to a somewhat greater extent than women. To fully understand the mechanisms underlying the sex difference in vaccine response and its consequences for vaccine effectiveness and development, further research is required. The sex-related analysis of vaccine response may contribute to adjust vaccination strategies, improving overall public health programmes.
In males, the relationship between pubertal timing and depression is understudied and less consistent than in females, likely for reasons of unmeasured confounding. To clarify this relationship, a combined epidemiological and genetic approach was chosen to exploit the methodological advantages of both approaches.
Methods
Data from 2026 males from a nationwide, representative study were used to investigate the non-/linear relationship between pubertal timing defined by the age at voice break and depression, considering a multitude of potential confounders and their interactions with pubertal timing. This analysis was complemented by Mendelian randomization (MR), which is robust to inferential problems inherent to epidemiological studies. We used 71 single nucleotide polymorphisms related to pubertal timing in males as instrumental variable to clarify its causal relationship with depression based on data from 807 553 individuals (246 363 cases and 561 190 controls) by univariable and multivariable MR, including BMI as pleiotropic phenotype.
Results
Univariable MR indicated a causal effect of pubertal timing on depression risk (inverse-variance weighted: OR 0.93, 95%-CI [0.87–0.99)], p = 0.03). However, this was not confirmed by multivariable MR (inverse-variance weighted: OR 0.95, 95%-CI [0.88–1.02)], p = 0.13), consistent with the epidemiological approach (OR 1.01, 95%-CI [0.81–1.26], p = 0.93). Instead, the multivariable MR study indicated a causal relationship of BMI with depression by two of three methods.
Conclusions
Pubertal timing is not related to MDD risk in males.
Male rectal and anal cancer patients demonstrate high rates of sexual dysfunction. This pilot randomized controlled trial tested a psychoeducational intervention designed to improve psychosexual adjustment.
Methods
Rectal or anal cancer patients were randomized to a Sexual Health Intervention for Men (intervention) or to a referral and information control (control). The intervention included control activities plus 4 sexual health intervention sessions every 4–6 weeks and 3 brief telephone calls timed between these sessions. Assessments were completed pre-intervention (baseline) and 3 months (follow-up 1) and 8 months (follow-up 2) post-intervention. Differences were assessed with statistical significance and Cohen’s d effect sizes (d = 0.2, small effect; d = 0.5, moderate effect; d = 0.8, large effect).
Results
Ninety subjects enrolled. Forty-three participants completed at least 1 follow-up assessment (intervention, n = 14; control n = 29). At follow-up 1, men in intervention, compared to control, improved on all domains of the International Index of Erectile Function (IIEF) (p < 0.001 to p < 0.05) and demonstrated large effects (d = 0.8 to d = 1.5). Similarly, at follow-up 2, changes in all domains of the IIEF except the orgasm domain were either statistically significant or marginally statistically significant (p = 0.01 to p = 0.08) and demonstrated moderate to large treatment effects for intervention versus control (d = 0.5 to d = 0.8). Men in the intervention, compared to control, demonstrated decreased sexual bother at follow-up 1 (p = 0.009, d = 1.1), while Self-Esteem and Relationship (SEAR) total scores and the SEAR sexual relationship subscale demonstrated moderate increases for intervention versus control (d = 0.4 to d = 0.6).
Significance of results
This study provides initial evidence for combining a psychoeducational intervention with medical interventions to address sexual dysfunction following rectal and anal cancer. Trials register number: NCT00712751 (date of registration: 7/10/2008).
To map Greek academic otolaryngologists, and assess gender, age and location-related differences in their rank and academic productivity.
Methods
A pre-established database of local and diaspora scientists was used, after adjustment and updating for otolaryngology. The following data were recorded: age, gender, academic rank, country of work, total citations and h-index of December 2022.
Results
A total of 276 Greek academic otolaryngologists were identified in the Scopus database. Of Greek otolaryngologists, 15.9 per cent are women. Of all academic otolaryngologists, 27.1 per cent have a university post, but only 4 per cent of them are women. There is an almost linear correlation between university post ranking and citations. Otolaryngologists based in Greece accounted for 3 out of the 10 most cited Greek otolaryngologists.
Conclusion
There are significant age, gender and location-related differences in academic output. The representation of women and the full use of their potential in medicine require proactive measures, to lift the burdens limiting their participation.
The office evaluation of the infertile male involves a comprehensive history and physical structured to uncover all potential causes including congenital, medical, surgical, environmental, genetic, and psychosocial etiologies. The physical exam begins with the patient’s general appearance, body habitus, and progresses to the genital exam in which the testicles are examined for size, consistency, and location. Prior surgical scars, absence of the vas deferens, or the presence of varicoceles may be identifiable causes of infertility. The semen analysis is the cornerstone laboratory evaluation of the male undergoing an infertility workup. The semen is evaluated for several key parameters including volume as well as sperm concentration, number, motility, and form. An endocrine evaluation is indicated in men with oligospermia, azoospermia, or a history of physical examination findings suggestive of hormonal abnormalities including sexual dysfunction, decreased libido, or physical evidence of impair androgenization. Pending the initial workup genetic testing may be indicated.
This review discusses epigenetic mechanisms and the relationship of infertility in men and women in relation to parameters pertaining to nutrition. The prevalence of infertility worldwide is 8–12 %, and one out of every eight couples receives medical treatment. Epigenetic mechanisms, aging, environmental factors, dietary energy and nutrients and non-nutrient compounds; more or less energy intake, and methionine come into play in the occurrence of infertility. It also interacts with vitamins B12, D and B6, biotin, choline, selenium, zinc, folic acid, resveratrol, quercetin and similar factors. To understand the molecular mechanisms regulating the expression of genes that affect infertility, the environment, the role of genotype, age, health, nutrition and changes in the individual's epigenotype must first be considered. This will pave the way for the identification of the unknown causes of infertility. Insufficient or excessive intake of energy and certain macro and micronutrients may contribute to the occurrence of infertility as well. In addition, it is reported that 5–10 % of body weight loss, moderate physical activity and nutritional interventions for improvement in insulin sensitivity contribute to the development of fertility. Processes that pertain to epigenetics carry alterations which are inherited yet not encoded via the DNA sequence. Nutrition is believed to have an impact over the epigenetic mechanisms which are effective in the pathogenesis of several diseases like infertility. Epigenetic mechanisms of individuals with infertility are different from healthy individuals. Infertility is associated with epigenetic mechanisms, nutrients, bioactive components and numerous other factors.
Infertility is a reproductive health condition that is often not openly discussed. By not discussing this condition, many stigmas and stereotypes may be ascribed. For example, many think that infertility pertains only to women, although men may also receive an infertility diagnosis. Race and ethnicity can impact how male factor infertility is understood, communicated, and managed. The aim of this chapter is to synthesize available research regarding biopsychosocial variables of male factor infertility with African American men while offering support considerations.
Smoking has dangerous and sometimes irreversible effects on various body tissues, including the reproductive system. We conducted this research to determine the in vivo effects of cigarette smoke condensate (CSC) on reproduction in mice. In this experimental in vivo study, 32 male and female NMRI mice were divided into four groups. The mice were injected with CSC (CSC-1R3F) for 28 days. The mice were mated 1 day after the last injection and observed daily for 1 week for the presence of a vaginal plug to track mating. We evaluated mating success rate, and sperm and oocyte quality, pregnancy outcome, childbearing status, and in vitro fertilization (IVF). The results showed a decrease in successful mating in female mice that received the CSC injections. CSC significantly influenced the number of offspring born to males. When the CSC was injected into male mice, there was a significant increase in the number of offspring compared with the group in which only the females received CSC injections. According to the results, there was a negative effect of CSC on morphological parameters in male and female mice. Also, successful IVF after exposure to CSC was significantly decreased in the female mice treated group. The results indicated that CSC significantly affected the number of offspring and fecundity success in females.
Coronavirus disease, one of the most disastrous epidemics, has caused a worldwide crisis, and the containment measures applied to decelerate the progression of the pandemic can increase the risk of obsessive-compulsive disorder (OCD). Identifying vulnerable groups in this area can lead us to better resource expenditure, and therefore, this systematic review aims to make a comparison between males and females to determine which of the two groups was most affected by the COVID-19 pandemic regarding OCD. Also, a meta-analysis was designed to investigate the prevalence of OCD during the COVID-19 pandemic. A comprehensive search was conducted among three databases (Medline, Scopus, Web of Science) until August 2021 which resulted in 197 articles, and 24 articles met our inclusion criteria. Overall, more than half of the articles stated the role of gender in OCD during the COVID-19 pandemic. Several articles emphasized the role of the female gender, and some others the role of the male gender. The meta-analysis revealed a 41.2% overall prevalence of OCD during the COVID pandemic and 47.1% and 39.1% OCD prevalence for female and male genders respectively. However, the difference between the two genders was not statistically significant. Generally, it seems that females are at greater risk of OCD during the COVID-19 pandemic. In the following groups, the female gender may have acted as a risk factor: under-18 years students, hospital staff, and the studies in the Middle East. In none of the categories, male gender was clearly identified as a risk factor.
The main purpose of this chapter is to review the recent literature on male sexual fantasies. Topics that are analysed include sexual fantasies’ definitions and functions; methodological issues related to the disparate measures used across studies; the distinction between fantasies, interests/desires, and experiences; how general and unusual fantasies are developed; prevalence rates and the multidimensional content of fantasies, with highlights on gender, sexual orientation, and personality differences; and, finally, fantasies’ role in sexual offending. Overall, sexual fantasies are pervasive across the general population and, for the most part, they reflect evolutionary perspectives on psychology. As sexual fantasies can be used to increase sexual arousal in people that suffer from dysfunctions and to foster more positive romantic feelings towards a partner, they are important in clinical treatment and marital therapy settings. Moreover, they constitute a central component in the treatment of people convicted of sexual offenses that are at a high risk of recidivism. Therefore, it is essential to understand fantasies’ role in human sexuality and behaviour.
In species with internal female fertilization, males face the problem of paternity uncertainty, which refers to the risk of investing in unrelated offspring. As such, a partner’s sexual infidelity may be particularly damaging for males given that it may result in allocating resources to genetically unrelated offspring, reducing a male’s inclusive fitness. As such, males invest considerable time and effort to retain their mates. Mate retention tactics involve cost-inflicting strategies that operate by reducing the partner’s self-perceived value to prevent the partner from leaving the partnership, and benefit-provisioning strategies that operate by boosting a partner’s self-esteem and improving relationship satisfaction. In this chapter, first, we discuss the benefits that men gain from long-term relationships, which include increased probability of paternity, prolonged proximity and sexual access to a partner, and increased probability of attracting a high-quality partner. Second, we discuss the main costs of infidelity for males, including the risk of investing in an unrelated child as well as costs to his reputation and future mating opportunities. Third, we define and discuss a taxonomy of mate retention tactics and explain that a male’s mate retention tactics are expected to respond to his female’s partner preferences, at least partly. Indeed, males have been found to engage in tactics such as resource display given that females value mates that are able and willing to provision them and their offspring with resources. Empirical evidence has also, surprisingly, found that men, more than women, engage in strategies such as submission and debasement. Empirical evidence also suggests that men also use threats and violence directed to rivals more than women do. Our review also demonstrates that males engage in both benefit-provisioning and cost-inflicting mate-retention strategies, and that the type of strategy chosen as well as its intensity is partly dependent on a man’s mate value and his ability to acquire resources. Finally, we discuss some of the main environmental factors that may influence the mate retention tactics displayed by males, including partner mate value and perceived infidelity threat.
The spectrum of adverse mental health trajectories caused by sexual abuse, broadly defined as exposure to rape and unwanted physical sexual contact, is well-known. Few studies have systematically appraised the epidemiology and impact of sexual abuse among boys and men. New meta-analytic insights (k = 44; n = 45 172) reported by Zarchev and colleagues challenge assumptions that men experiencing mental ill health rarely report sexual abuse exposure. Adult-onset sexual abuse rates of 1–7% are observed in the general population, but for men experiencing mental ill health, adult lifetime prevalence was 14.1% (95% CI 7.3–22.4%), with past-year exposure 5.3% (95% CI 1.6–12.8%). We note that these rates are certainly underestimates, as childhood sexual abuse exposures were excluded. Boys and men with a sexual abuse history experience substantial disclosure and treatment barriers. We draw attention to population health gains that could be achieved via implementation of gender-sensitive assessment and intervention approaches for this at-risk population.
Addressing sexual health and sexual problems of patients, needs and education, and training in patient-centered, non-judgmental communication to help patients talk about intimate issues in an open way, thus providing emotional relief, feelings of acceptance and helping patients to understand the factors which contribute to problems, and the possible solutions
Cognitive impairment is consistently reported in bipolar disorder (BD), but few studies have characterised which memory component processes are affected. Further, it is unknown whether the component processes underlying memory impairment are moderated by sex. The present study examined diagnosis and sex differences in both verbal and visual memory/learning domains in patients with BD and psychiatrically healthy controls.
Method:
Verbal and visual memory/learning were measured using the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R). 114 patients with BD (n = 50 males, n = 64 females), were compared to 105 psychiatrically healthy controls (n = 42 males, n = 63 females).
Results:
Patients with BD had worse performance in verbal and visual immediate and total recall, verbal and visual delayed free recall, and verbal recognition discrimination scores, but there were no group differences in learning slopes and cumulative learning index scores. There were trends for BD females to outperform BD males in visual memory/learning free recall and cumulative learning, but these results did not survive multiple testing correction. These findings did not change in a secondary sensitivity analysis comparing only strictly euthymic BD patients to controls (n = 64).
Conclusion:
The present study found trait-like verbal and visual memory/learning impairment in BD that was attributable to deficient encoding and/or consolidation processes rather than deficits in learning. We did not find marked sex differences in either visual or verbal memory/learning measures, although some trend level effects were apparent and deserve exploration in future studies.
The COVID-19 pandemic exacerbated gender disparities in some academic disciplines. This study examined the association of the pandemic with gender authorship disparities in clinical neuropsychology (CN) journals.
Method:
Author bylines of 1,018 initial manuscript submissions to four major CN journals from March 15 through September 15 of both 2019 and 2020 were coded for binary gender. Additionally, authorship of 40 articles published on pandemic-related topics (COVID-19, teleneuropsychology) across nine CN journals were coded for binary gender.
Results:
Initial submissions to these four CN journals increased during the pandemic (+27.2%), with comparable increases in total number of authors coded as either women (+23.0%) or men (+25.4%). Neither the average percentage of women on manuscript bylines nor the proportion of women who were lead and/or corresponding authors differed significantly across time. Moreover, the representation of women as authors of pandemic-related articles did not differ from expected frequencies in the field.
Conclusions:
Findings suggest that representation of women as authors of peer-reviewed manuscript submissions to some CN journals did not change during the initial months of the COVID-19 pandemic. Future studies might examine how risk and protective factors may have influenced individual differences in scientific productivity during the pandemic.
Total rhinectomy is an invasive procedure that significantly impairs the intranasal turbulence, humidification and heating of inspired air. The use of uvulopalatopharyngoplasty for the treatment of sleep-disordered breathing disorders such as primary snoring and obstructive sleep apnoea has diminished over the past years because of the emergence of less invasive procedures and alternative therapeutic options. This clinical record presents the treatment of a long-term side effect of total rhinectomy using uvulopalatopharyngoplasty.
Case report
In 1997, a 62-year-old male underwent total rhinectomy for a nasal schwannoma, followed by rehabilitation with a nasal prosthesis. Twenty-one years later, he presented with severe complaints of nasal blockage and breathing difficulties during both daytime and night-time. Clinical examination revealed no major anomalies besides significant velopharyngeal narrowing. Thus, in 2019, uvulopalatopharyngoplasty was performed to re-establish velopharyngeal patency. Hereafter, the symptoms of nasal blockage disappeared, resulting in an improved quality of life.
Conclusion
Uvulopalatopharyngoplasty may prove useful to treat selected patients with daytime breathing difficulties due to velopharyngeal narrowing.
A delusion of pregnancy in men has been rarely reported in psychiatric disorders. The literature on this delusion in male schizophrenia is limited. It was reported especially in medical conditions. In psychiatric disorders, it has been explained for a long time by psychodynamic theories.
Objectives
To present a case of a pregnancy delusion in man associated temporally to neuroleptic-induced hyperprolactinemia and a review of literature of medical and psychological etiologies of this symptom
Methods
We presented a case of a pregnancy delusion in man associated temporally to neuroleptic-induced hyperprolactinemia and we elucidated through a review of literature of medical and psychological etiologies of this symptom.
Results
Case report A 46-year-old man, unmarried, who had a mild intellectual disability and a 22-year history of schizophrenia. He was admitted to our hospital for psychotic relapse due to the interruption of his medication. This patient had been treated for years with long action injection medication. On admission he was disorganized, verbalizing a poorly-systematized fuzzy delirium. And he believed he was pregnant. Serum prolactin levels was 38 ng/ml (3-25ng/ml). He was put on Haldol decanoate 150mg/month, chlorpromazine 150mg/day, and diazepam 15mg/day.
Conclusions
The presentation of a delusion of pregnancy in man is rather infrequent. The delusion may have many social, psychological, and biological determinants to its genesis. This case highlights the importance of medical investigations notably the assay of prolactin in the assessment of patients who present with delusions of pregnancy.
Whilst loneliness and social isolation amongst older care-givers are becoming increasingly recognised, little is known about how these concepts impact on specific sub-groups of care-givers, such as older males. In the current study, we aimed to gain a better understanding of the experiences of loneliness and social isolation amongst older spousal male care-givers. Semi-structured interviews were undertaken with 24 participants, caring for a spouse/partner with a long-term chronic condition. After thematic analysis of the data, three themes were identified: dwindling social interactions, loneliness in the spousal relationship, and living with loneliness and social isolation. Study findings suggest that opportunities for social interactions gradually ‘dwindled’ due to a reluctance by older male care-givers to leave their spouse/partner at home alone, to accept offers of help or respite, or to attend social events without their spouse/partner. Consequently, social isolation increased. Feelings of physical and emotional loneliness were evident, and the loss of spousal companionship (such as loss of conversation and shared interests) increased loneliness. Individualised coping strategies were adopted including focusing on moments of positivity, talking to others and using prescribed medication. Findings provide insight into the experience of loneliness and social isolation for many older male spousal care-givers. This may facilitate a better understanding of older male care-givers’ support needs in addressing loneliness and social isolation, and should help to inform the development of targeted support services for this population.
This chapter provides an overview of the theories of generation and hereditary resemblance found in Aristotle’s work On the Generation of Animals. This treatise completes the project of explaining the development of the perfected living being, which the epigenetic process of embryological development aims for. Aristotle’s explanation of how a new animal comes into being fits to his four-causal scheme, by adding in the more specific principles, male and female. The opponent, thinks Aristotle, is wrong to think that the generative contributions of the parents (seed, sperma) derive from all parts of the body. Instead, what male and female contribute is the most refined nourishment that their bodies produce, which is ready to become all the parts of the body. Male and female roles are then differentiated: the female provides this blood-derived product to serve as that material body (material cause) while the male’s seed is further refined so as to initiate and direct that development as the efficient cause. Aristotle also explains how it is that particular animals end up as male or female and come to resemble their blood relatives. The chapter ends by reflecting on Aristotle’s sexism in his theory of generation.