BACKGROUND: Lynch syndrome (LS) is the most frequent hereditary tumor syndrome and is associated with an increased risk of colorectal cancer (CRC). While gene-specific and age-specific differences are considered in patient surveillance, gender-specific risks in the development of CRC have been reported in many studies but are not consistently documented.
OBJECTIVE: This systematic review aims to investigate gender-specific differences in CRC development among LS patients.
METHODS: A systematic literature search following PRISMA 2020 guidelines was conducted in the PubMed, Ovid, The Cochrane Library and Web of Science databases. A total of 688 studies were screened, and 41 met the inclusion criteria.
RESULTS: Men have a higher risk of CRC and develop CRC earlier compared to women.
CONCLUSIONS: These findings indicate gender-specific differences in the risk of CRC among LS patients, although they do not currently justify separate surveillance strategies.
UNASSIGNED: HINTERGRUND: Das Lynch-Syndrom (LS) ist das häufigste erbliche Tumorsyndrom und mit einem erhöhten Risiko für kolorektale Karzinome (KRK) verbunden. Gen- und altersspezifische Unterschiede werden bei der Überwachung berücksichtigt, während geschlechtsspezifische Risiken in der Entwicklung eines KRK in vielen Studien berichtet, aber nicht einheitlich dokumentiert sind.
UNASSIGNED: Ziel dieser systematischen Übersichtsarbeit ist es, geschlechtsspezifische Unterschiede in der Entwicklung eines KRK bei LS-Betroffenen zu untersuchen.
METHODS: Eine systematische Literatursuche nach PRISMA 2020 wurde in den Datenbanken PubMed, Ovid, The Cochrane Library und Web of Science durchgeführt. 688 Studien wurden gesichtet, 41 erfüllten die Einschlusskriterien.
UNASSIGNED: Männer mit einem LS-Syndrom haben ein höheres Risiko für ein KRK und erkranken früher an einem KRK als Frauen.
UNASSIGNED: Die Ergebnisse weisen auf geschlechtsspezifische Unterschiede beim KRK-Risiko bei LS-Betroffenen hin, aus denen sich aber derzeit keine gesonderten Überwachungsstrategien ableiten lassen.

Protecting populations contending with co-occurring stressors requires a better understanding of how multiple early-life stressors affect the fitness of natural systems. However, the complexity of such research has limited its advancement and prevented us from answering new questions. In human studies, cumulative risk models predict adult health risk based on early adversity exposure. We apply a similar framework in wild yellow-bellied marmots (Marmota flaviventer). We tested cumulative adversity indices (CAIs) across different adversity types and time windows. All CAIs were associated with decreased pup survival and were well supported. Moderate and acute, but not standardized CAIs were associated with decreased lifespan, supporting the cumulative stress hypothesis and the endurance of early adversity. Multivariate models showed that differences in lifespan were driven by weaning date, precipitation, and maternal loss, but they performed poorly compared with CAI models. We highlight the development, utility, and insights of CAI approaches for ecology and conservation.

UNASSIGNED: Health-promoting behaviors carry substantial significance for miners\' overall health and well-being. This study aimed to examine the association between cumulative risk (CR) and miners\' health-promoting behaviors and test the mediating role of health beliefs in this relationship.
UNASSIGNED: Data were collected from a sequential survey conducted among 712 frontline miners (Mage=41.7 ± 10.1 years) in China. The survey entailed online questionnaire measurements at three distinct time points, each spaced two weeks apart. This study utilized the conceptual model of health-promoting behaviors, the CR model, and structural equation modeling in the analysis of relationships.
UNASSIGNED: CR was negatively related to health-promoting behaviors, with a negative acceleration effect. CR was positively associated with perceived threat in a gradient effect, while negatively associated with perceived benefits in a gradient effect. Furthermore, CR was negatively related to self-efficacy, following a negative acceleration effect. Perceived threat, perceived benefits, and self-efficacy emerged as significant mediators in the relationship between CR and health-promoting behaviors.
UNASSIGNED: This study highlights the critical role of considering both CR and health beliefs in shaping miners\' health-promoting behaviors. Understanding these dynamics is pivotal for developing interventions to enhance miners\' health and well-being.

UNASSIGNED: Lymph node metastasis is the major cause of increased recurrence and death in patients with papillary thyroid carcinoma (PTC). We evaluate the clinicopathologic factors affecting excellent response (ER) in patients with PTC with lymph node metastasis following operation and 131I ablation therapy.
UNASSIGNED: A total of 423 patients with PTC with lymph node metastasis who underwent thyroidectomy and postoperative 131I ablation therapy were enrolled. The relationship between clinicopathological factors affecting ER achievement was analyzed.
UNASSIGNED: Multivariate analysis showed that the foci diameter (≤1 cm), unifocal, combination with Hashimoto\'s thyroiditis (HT), lymph node metastases rate (LR) (≤40%), no postoperative lymph node metastasis, low preablative stimulated thyroglobulin (ps-Tg) level (≤3.87 ng/mL), and the time of 131I ablation therapy (one time) were positively correlated with the ER achievement [odds ratio (OR): 1.744, 3.114, 3.920, 4.018, 2.074, 9.767, and 49.491, respectively; all p < 0.05]. The receiver operating characteristic (ROC) curves showed that the cutoff values of ps-Tg and LR were 4.625 ng/mL and 50.50%, respectively. The AUC of ROC of ps-Tg and LR for predicting ER achievement was 0.821 and 0.746, respectively. The Tg and the cumulative risk of non-ER elevated with the increase of LR, especially for the high-level ps-Tg (>4.625 ng/mL) group.
UNASSIGNED: The foci diameter and number, combination with HT, LR, and ps-Tg level are independent factors for ER. Ps-Tg level and LR are valid predictive factors for the efficacy of 131I therapy in patients with PTC. The predictive value of the cumulative risk of non-ER can be improved by the combination of ps-Tg and LR.

OBJECTIVE: We report the chances of 14-year-old males becoming victims of firearm injury or death before age 25 in Philadelphia, Pennsylvania.
METHODS: Using life table methods, we followed 4,501 Black males aged 14 years, and a comparison group of 1,751 White males, over 11 years.
RESULTS: Among 14-year-old Black males, the risk of a nonfatal firearm injury before age 25 was 10.1% (95% confidence interval, 9.2%-11.0%), the risk of death from firearms was 2.5% (1.7%-3.2%), and the combined risk was 12.5% (11.0%-14.1%). Among White males, the risk of nonfatal firearm injury was 0.8% (0.3%-1.2%), the risk of death was 0.3% (0.02%-0.5%), and the combined risk was 1.0% (0.5%-1.5%).
CONCLUSIONS: Risk estimates reveal the dire likelihood of firearm injury or death among Black adolescent males in Philadelphia. Immediate interventions are needed to de-escalate conflicts, provide supports, and address the upstream causes of violence like poverty and structural racism.

BACKGROUND: North American studies find that geographic indicators of disadvantage, such as concentrated poverty, significantly increase the risk of child protection involvement. Despite having one of the most extensive family support systems and progressive income redistribution policies in North America, the Canadian province of Québec still faces geographic variations in socioeconomic conditions that remain a major risk factor for child protection involvement.
OBJECTIVE: This study asks how child protection involvement is distributed across socioeconomically distinct geographic areas of the province. Drawing from prior literature, we hypothesize that the highest level of child protection involvement across childhood (age 0-17) is found in the lowest socioeconomic areas.
METHODS: This is a population-based prevalence study using administrative child protection data spanning the years 2000 to 2017 across Québec.
METHODS: We constructed cumulative risk life tables of first instances of child protection events (report confirmation, compromised security or development, and out-of-home placement). Prevalence rates were mapped onto 10,650 Census dissemination areas divided into three tiers according to a validated socioeconomic status (SES) index.
RESULTS: The highest childhood prevalence of confirmed child protection reports, finding of compromised security or development, and out-of-home placement was found in the lowest SES areas. Rates in low SES areas can be over twice the rates in high SES areas.
CONCLUSIONS: Area-level socioeconomic vulnerability remains a robust predictor of child protection involvement even in a socially progressive context. Our findings underscore that without targeted pediatric and family services, as well as poverty-alleviation programs for high-need families in high-need areas, even well-intentioned systems may fall short of reaching the families most in need.

Left-behind children, as a large-scale disadvantaged group, encounter an array of risk factors that impede their academic development because of parental migration. The current study aimed at investigating the roles of left-behind cumulative risk and growth mindset on academic adjustment and exploring whether growth mindset moderated the association between left-behind cumulative risk and academic adjustment in left-behind middle school students. A total of 1184 left-behind middle school students (615 males; 12-16 years) participated in the study. Results indicated that left-behind cumulative risk is negatively associated with academic adjustment in middle school students (β = -.199, t(1183) = -7.229, p < .001). Besides, growth mindset has a protective effect on left-behind middle school students\' academic adjustment (β = .386, t(1183) = 14.070, p < .001) and a moderating effect on the relationship between left-behind cumulative risk and academic adjustment (β = .394, t(1182) = 4.057, p < .001, ΔR2 = .012). These findings suggest that family risk factors related to left-behind status affect the academic adjustment of left-behind middle school students in a superposition way, while the positive individual factor of growth mindset could protect the negative impact caused by parental migration.

The practice of exposing honeybees to pesticides by bee-keepers or via agricultural crops, is one of the ways in which honey becomes contaminated with pesticides. Though honey has many health advantages, however, human exposure to pesticides via consumption of honey has generated public health concerns due to their endocrine-disruptive abilities. Thus, this study evaluated human exposure to endocrine-disrupting pesticides in honey from Nigeria to establish the safety of honey consumed in Nigeria. Honey were analyzed for pesticides using a gas chromatograph combined with an electron capture detector. The concentrations of ∑20 OCPs and ∑14 OPPs in the honey ranged from 0.45-1045 ng/g and 1.13-632 ng/g respectively. The values of both individual and cumulative non-carcinogenic and carcinogenic risks for humans were <1 and 1 × 10-4 respectively suggesting that there are no potential health risks via the honey consumption. The source analysis showed that pesticides in these honey originated from historical and recent/fresh use.

Previous studies have determined that exposure to risk and adversities may impair children\'s cognitive abilities. In particular, children engaged with Child Protective Services (CPS) seem to be at greater risk for enhanced detrimental effects resulting from the cumulative risk factors to which they are exposed. However, little is known about children\'s future thinking when they face adverse circumstances, and it is not clear how the associations among episodic foresight abilities, episodic memory, and executive functions work with children under such circumstances. The current study describes the episodic foresight abilities of CPS-involved school-aged children, its association with other cognitive abilities, and how this association is affected by the exposure to cumulative risk and adversity factors. Episodic foresight, episodic memory, executive functions, and a composite of cumulative risk factors were analyzed in a sample of 95 school-aged children engaged with CPS in Portugal. Results suggest the detrimental effect of cumulative risk on the episodic foresight abilities of CPS-involved children. Episodic memory and cognitive flexibility were significant predictors of episodic foresight abilities, and cumulative risk exposure moderated the relation between episodic memory and episodic foresight. The current study provides a better understanding of the influences of multiple adversities on CPS-involved children\'s episodic foresight abilities and related cognitive outcomes.

BACKGROUND: The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS).
METHODS: This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI).
RESULTS: The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be.
CONCLUSIONS: The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.