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ONO YUKO, SHINOHARA KAZUAKI, SHIMADA JIRO, SUGIYAMA JUN, INOUE SHIGEAKI, KOTANI JOJI. Sex Disparities in Applied Force on Maxillary Incisors Among Novices During Laryngoscopy Using a High-Fidelity Simulator: A Prospective Observational Study. Kobe J Med Sci 2024; 69:E151-E158. [PMID: 38462525 PMCID: PMC11006240 DOI: 10.24546/0100486397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/12/2023] [Indexed: 03/12/2024]
Abstract
Endotracheal intubation (ETI) is a common and crucial intervention. Whether the performance of ETI differs according to the sex of the laryngoscopist remains unclear. The aim of this study was to assess sex disparities in markers of ETI performance among novices using a high-fidelity simulator. This prospective observational study was conducted from April 2017 to March 2019 in a public medical university. In total, 209 medical students (4th and 5th grade) without clinical ETI experience were recruited. Of the 209 students, 64 (30.6%) were female. The participants used either a Macintosh direct laryngoscope or C-MAC video laryngoscope in combination with a stylet or gum-elastic bougie to perform ETI on a high-fidelity simulator. The primary endpoint was the maximum force applied on the maxillary incisors during laryngoscopy. The secondary endpoint was the time to ETI. The implanted sensors in the simulator automatically quantified the force and time to ETI. The maximum force applied on the maxillary incisors was approximately 30% lower in the male than female group for all laryngoscopes and intubation aids examined (all P < 0.001). Similarly, the time to ETI was approximately 10% faster in the male than female group regardless of the types of laryngoscopes and intubation aids used (all P < 0.05). In this study, male sex was associated with a lower maximum force applied on the maxillary incisors during both direct and indirect laryngoscopy performed by novices. A clinical study focusing on sex differences in ETI performance is needed to validate our findings.
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Affiliation(s)
- YUKO ONO
- Department of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
- Emergency and Critical Care Medical Center, Fukushima Medical University, Fukushima, Japan
- Department of Anesthesiology, Ohta General Hospital Foundation, Ohta Nishinouchi Hospital, Koriyama, Japan
| | - KAZUAKI SHINOHARA
- Department of Anesthesiology, Ohta General Hospital Foundation, Ohta Nishinouchi Hospital, Koriyama, Japan
| | - JIRO SHIMADA
- Emergency and Critical Care Medical Center, Fukushima Medical University, Fukushima, Japan
| | - JUN SUGIYAMA
- Department of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - SHIGEAKI INOUE
- Department of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - JOJI KOTANI
- Department of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Flores-Umanzor E, Cepas-Guillén P, Freixa X, Regueiro A, Tizón-Marcos H, Brugaletta S, Ariza-Solé A, Calvo M, Forado I, Carrillo X, Cárdenas M, Rojas SG, Muñoz JF, García-Picart J, Lidón RM, Sabaté M, Masotti M, Roqué M. Clinical profile and prognosis of young patients with ST-elevation myocardial infarction managed by the emergency-intervention Codi IAM network. Rev Esp Cardiol (Engl Ed) 2023; 76:881-890. [PMID: 36958533 DOI: 10.1016/j.rec.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/09/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION AND OBJECTIVES Data on the clinical profile and outcomes of younger patients with ST-elevation myocardial infarction (STEMI) is scarce. This study compared clinical characteristics and outcomes between patients aged<45 years and those aged ≥ 45 years with STEMI managed by the acute myocardial infarction code (AMI Code) network. Sex-based differences in the younger cohort were also analyzed. METHODS This multicenter study collected individual data from the Catalonian AMI Code network. Between 2015 and 2020, we enrolled patients with an admission diagnosis of STEMI. Primary endpoints were all-cause mortality within 30 days, 1 year, and 2 years. RESULTS Overall, 18 933 patients (23% female) were enrolled. Of them, 1403 participants (7.4%) were aged<45 years. Younger patients with STEMI were more frequently smokers (P<.001) and presented with cardiac arrest and TIMI flow 0 before pPCI (P<.05), but the time from first medical contact to wire crossing was shorter than in the older group (P<.05). All-cause mortality rates were lower in patients aged<45 years (P<.001). Among younger patients, cardiogenic shock was most prevalent in women than in their male counterparts (P=.002), with the time from symptom onset to reperfusion being longer (P<.05). Compared with men aged<45 years, younger women were less likely to undergo pPCI (P=.004). CONCLUSIONS Despite showing high-risk features on admission, young patients exhibit better outcomes than older patients. Differences in ischemia times and treatment were observed between men and women.
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Affiliation(s)
- Eduardo Flores-Umanzor
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain. https://twitter.com/@ejfu0209
| | - Pedro Cepas-Guillén
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain. https://twitter.com/@pedro_cepas
| | - Xavier Freixa
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain
| | - Ander Regueiro
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain
| | - Helena Tizón-Marcos
- Servicio de Cardiología, Consorci Mar Parc de Salut de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Salvatore Brugaletta
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain
| | - Albert Ariza-Solé
- Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Margarita Calvo
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain
| | - Ilana Forado
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain
| | - Xavier Carrillo
- Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Mérida Cárdenas
- Servicio de Cardiología, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Sergio Giovanny Rojas
- Servicio de Cardiología, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain
| | - Juan Francisco Muñoz
- Servicio de Cardiología, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Joan García-Picart
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Rosa María Lidón
- Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Manel Sabaté
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain
| | - Mónica Masotti
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain
| | - Mercè Roqué
- Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic, Universidad de Barcelona, Spain.
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Foster-Witassek F, Rickli H, Roffi M, Pedrazzini G, Eberli F, Fassa A, Jeger R, Fournier S, Erne P, Radovanovic D. Reducing gap in pre-hospital delay between women and men presenting with ST-elevation myocardial infarction. Eur J Prev Cardiol 2023; 30:1056-1062. [PMID: 36511951 DOI: 10.1093/eurjpc/zwac294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/20/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Abstract
AIMS This study aimed to analyse changes in pre-hospital delay over time in women and men presenting with ST-elevation myocardial infarction (STEMI) in Switzerland. METHODS AND RESULTS AMIS Plus registry data of patients admitted for STEMI between 2002 and 2019 were analysed using multivariable quantile regression including the following covariates: interaction between sex and admission year, age, diabetes, pain at presentation, myocardial infarction (MI) history, heart failure history, hypertension, and renal disease. Among the 15,350 patients included (74.5% men), the median (interquartile range) delay between 2002 and 2019 was 150 (84; 345) min for men and 180 (100; 414) min for women. The unadjusted median pre-hospital delay significantly decreased over time for both sexes but the decreasing trend was stronger for women. Specifically, the unadjusted sex differences in delay decreased from 60 min in 2002 (P = 0.0042) to 40.5 min in 2019 (P = 0.165). The multivariable model revealed a significant interaction between sex and admission year (P = 0.038) indicating that the decrease in delay was stronger for women (-3.3 min per year) than for men (-1.6 min per year) even after adjustment. The adjusted difference between men and women decreased from 26.93 min in 2002 to -1.97 min for women in 2019. CONCLUSION Over two decades, delay between symptom onset and hospital admission in STEMI decreased significantly for men and women. The decline was more pronounced in women, leading to the sex gap disappearing in the adjusted analysis for 2019.
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Affiliation(s)
- Fabienne Foster-Witassek
- AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Hans Rickli
- Department of Cardiology, Kantonsspital St. Gallen, Rorschacher Str. 95, 9000 St. Gallen, Switzerland
| | - Marco Roffi
- Department of Cardiology, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Giovanni Pedrazzini
- Department of Cardiology, Cardiocentro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Franz Eberli
- Department of Cardiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zurich, Switzerland
| | - Amir Fassa
- Department of Cardiology, Hôpital de La Tour, Av. J.-D.-Maillard 3, 1217 Meyrin, Switzerland
| | - Raban Jeger
- Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland
- Department of Cardiology, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zurich, Switzerland
| | - Stéphane Fournier
- Department of Cardiology, University Hospital of Lausanne (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Paul Erne
- AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Dragana Radovanovic
- AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
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Bayati M, Kiadaliri A. Contributions of avoidable mortality to the sex gap in life expectancy and life disparity in Iran. Arch Public Health 2023; 81:126. [PMID: 37420294 DOI: 10.1186/s13690-023-01141-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/23/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Public health policies and healthcare quality play a pivotal role on the health outcome level and disparities across sociodemographic groups. However, there is little evidence on their role on disparities in life expectancy (LE) and life disparity (LD) in low and middle income countries. The present study aimed to assess the contributions of avoidable mortality, as a measure of inter-sectoral public health policies and healthcare quality, into the sex gap in LE (SGLE) and LD (SGLD) in Iran. METHODS Latest available data of death causes, according to the ICD codes, for Iran was obtained from the WHO mortality database for the period 2015-2016. An upper age limit of 75 years was applied to define avoidable causes of death. LD was measured as the average years of life lost at birth. The SGLE and SGLD (both females minus males) were decomposed by age and cause of death using a continuous-change model. RESULTS Females, on average, outlived males for 3.8 years (80.0 vs. 76.2 years) with 1.9 lower life years lost (12.6 vs. 14.4 years). Avoidable causes accounted for 2.5 (67%) and 1.5 (79%) years of the SGLE and SGLD, respectively. Among avoidable causes, injury-related deaths followed by ischaemic heart disease had the greatest contributions to both SGLE and SGLD. Across age groups, the age groups 55-59 and 60-64 accounted for the greatest contributions of avoidable causes to SGLE (0.3 years each), while age groups 20-24 and 55-59 had the greatest contributions to SGLD (0.15 years each). Lower mortality rates for females than males in age groups 50-74 years accounted for about half of the SGLE, while age groups 20-29 and 50-64 years accounted for around half of SGLD. CONCLUSION More than two third of the SGLE and SGLD in Iran were attributed to the avoidable mortality, particularly preventable causes. Our results suggest the need for public health policies targeting injuries in young males as well as lifestyle risk factors including smoking in middle aged males in Iran.
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Affiliation(s)
- Mohsen Bayati
- Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Kiadaliri
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopaedics, Skåne University Hospital, Lund University, Remissgatan 4, Lund, SE-221 85, Sweden.
- Centre for Economic Demography, Lund University, Lund, Sweden.
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Dai N, Li J, Ren L. Trends in women's representation as lead authors in high impact journals of lung cancer. Transl Lung Cancer Res 2023; 12:962-970. [PMID: 37323176 PMCID: PMC10261852 DOI: 10.21037/tlcr-22-770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/12/2023] [Indexed: 06/17/2023]
Abstract
Background Women's participation in the clinical oncology practice has increased over the past decade. There is a need to investigate whether women's participation in academia, as reflected by publication activity, increased over the time. This study aimed to investigate trends in female authorship in top journals of lung cancer in the past ten years. Methods In this cross-sectional study of all original research and review articles published in lung cancer journals including New England Journal of Medicine, Lancet journals, JAMA journals, Journal of Clinical Oncology, Annals of Oncology, Cancer Discovery, Journal of Thoracic Oncology, and Translational Lung Cancer Research (TLCR) between 2012 and 2021, the sex composition of lead authors were analyzed. The sex of the author was confirmed by internet searching for photographs, biographies, and gender-specific pronouns from journal or personal websites. The time-trend of female authorship was determined using Join-Point Regression (JPR) analysis. Results A total of 3,625 first authors and 3,612 corresponding authors were identified in the journals during the years studied. The sex of the author was revealed for 98.5%. Among 3,625 first authors with the sex being revealed, 1,224 (33.7%) were women. The proportion of female first authors increased remarkably from 29.4% in 2012 to 39.8% in 2021. The annual percentage change (APC) in female first authorship took place in 2019 [APC for 2019-2021, 37.03, 95% confidence interval (CI): 18.0-59.1, P=0.003]. The proportion of first authors in TLCR increased from 25.9% in 2012 to 42.8% in 2021 and showed the greatest rise in female first authorship. There were significant discrepancies in the female first authorship across the journals and regions. Among the 3,612 corresponding authors whose sex were determined, 884 (24.5%) were female. There is no significant increasing trend in female corresponding authorship. Conclusions The sex gap in the first authorship of lung cancer research articles has improved markedly in the recent years, however, sex imparities persist especially in corresponding authorship. There is an urgent need to proactively support and promote women in taking the leadership roles, thereby increasing their contributions to and influence on the development or advancement for future healthcare policies and practices.
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Affiliation(s)
- Ni Dai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China
- Editorial Department of Chinese Journal of Cancer Research, Peking University Cancer Hospital & Institute, Beijing, China
| | - Junqiang Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China
- Editorial Department of Chinese Journal of Cancer Research, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lixia Ren
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China
- Editorial Department of Chinese Journal of Cancer Research, Peking University Cancer Hospital & Institute, Beijing, China
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Abstract
The relationship between differential mortality rates and differences in life expectancy is well understood, but how changing differential rates translate into changing differences in life expectancy has not been fully explained. To elucidate the mechanism involved, this study extends existing decomposition methods. The extended method decomposes change in the sex gap in life expectancy at birth into three components capturing the effects of the sex difference in mortality improvement (ρ-effect), life table deaths density by age (f-effect), and remaining life expectancy by age (e-effect). These three effects oppose and augment each other, depending on relative change in sex-differential mortality rates. The new method is applied to period data for 35 countries and cohort data for 25 countries. The results demonstrate how the mechanism, involving the three effects, operates to determine change in the sex difference in life expectancy. We observe the pivotal importance of the f-effect, which is predominantly negative because of lower female mortality, in favoring narrowing rather than widening of the sex gap, in shifting the overall effect to younger ages, and in exaggerating fluctuations due to crisis mortality. The new decomposition provides a more detailed basis for substantive analyses examining change in differences in life expectancy.
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Affiliation(s)
- Qi Cui
- School of Demography, Australian National University, Canberra, Australia.
| | | | - Heather Booth
- School of Demography, Australian National University, Canberra, Australia
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