Exercise Improves Self-Reported Sexual Function Among Physically Active Adults

BackgroundSexual dysfunction is common among adults and takes a toll on quality of life for both men and women.AimTo determine whether higher levels of weekly cardiovascular exercise are protective against self-reported sexual dysfunction among men and women.MethodsWe conducted an international online, cross-sectional survey of physically active men and women between April and December 2016, assessing exercise activity categorized into sextiles of weekly metabolic equivalent-hours. Odds ratios (ORs) of sexual dysfunction for each activity sextile compared with the lowest sextile were calculated using multivariable logistic regression, controlling for age, body mass index, diabetes mellitus, tobacco/alcohol use, sport, and marital status.Main Outcome MeasuresFemale sexual dysfunction was defined as a score ≤26.55 on the Female Sexual Function Inventory and erectile dysfunction (ED) was defined as a score ≤21 on the Sexual Health Inventory for Men.Results3,906 men and 2,264 women (median age 41–45 and 31–35 years, respectively) met the inclusion criteria for the study. Men in sextiles 2–6 had reduced odds of ED compared with the reference sextile in adjusted analysis (P_trend = .03), with an OR of 0.77 (95% CI = 0.61–0.97) for sextile 4 and 0.78 (95% CI = 0.62–0.99) for sextile 6, both statistically significant. Women in higher sextiles had a reduced adjusted OR of female sexual dysfunction (P_trend = .02), which was significant in sextile 4 (OR = 0.70; 95% CI = 0.51–0.96). A similar pattern held true for orgasm dissatisfaction (P_trend < .01) and arousal difficulty (P_trend < .01) among women, with sextiles 4–6 reaching statistical significance in both.Clinical ImplicationsMen and women at risk for sexual dysfunction regardless of physical activity level may benefit by exercising more rigorously.Strengths & LimitationsStrengths include using a large international sample of participants with a wide range of physical activity levels. Limitations include the cross-sectional design, and results should be interpreted in context of the study population of physically active adults.ConclusionHigher cardiovascular exercise levels in physically active adults are inversely associated with ED by self-report in men and protective against female sexual dysfunction in women.Fergus KB, Gaither TW, Baradaran N, et al. Exercise Improves Self-Reported Sexual Function Among Physically Active Adults. J Sex Med 2019;16:1236–1245.     

Youth Beverage Intake and Reported Prediabetes: Choice and Frequency Matter

IntroductionSugar sweetened beverage (SSB) consumption among U.S. adolescents exceeds current recommendations. This study examines relationships between SSB intake and reported prediabetes.MethodData are from the 2019 Minnesota Student Survey (N = 125,375). Logistic regression was used to examine relationships between frequencies for SSB intake and youth reported prediabetes in analytic models adjusting for demographic and other cardiometabolic indicators. Additional analyses examined relationships between consumption of fruit juice, milk, and water, and prediabetes.ResultsOne in four youth reported consumption of at least one SSB daily. In fully adjusted models, a range of SSB intake frequencies were significantly associated with increased odds of reported prediabetes. All intake frequencies for water were associated with reduced odds of prediabetes.DiscussionEfforts to reduce SSB intake among adolescents are warranted to support cardiometabolic health. Study findings are consistent with current guidance identifying water as the preferred drink for adolescents’ hydration needs.     

一种预测子宫内膜病变患者内膜病理类型的临床模型＊

目的 开发并评估一种用于预测子宫内膜病变患者内膜病理类型的临床模型；方法 选取2019年11月至2021年11月因妇科B超发现子宫内膜病变并于山东中医药大学附属医院行宫腔镜下内膜活检的患者，结合其病史与最小绝对收缩和选择算子法（Least absolute shrinkage and selection operator，LASSO）筛选影响内膜病变的独立危险因素，列线图（nomogram）函数建立列线图模型，采用ROC曲线下方的面积大小（Area Under Curve， AUC）、C指数（C-index）、拟合优度（Hosmer-Lemeshow）检验、自举法（bootstrap）评估及验证模型，依据列线图对纳入患者进行风险赋分，绘制ROC曲线获取风险评分的截断值，从而划分高低风险的人群；结果 阴道流血、绝经、无流产史、并发高血压、B超内膜厚度增厚、内膜回声不正常，中医证型为虚实夹杂证是发生子宫内膜癌及癌前病变的独立危险因素，评估模型所得AUC值与C-index均>0.9，Hosmer-Lemeshow检验显示P>0.05，bootstrap内部验证法所得C-index亦高于0.9，均说明模型准确度、区分度及可信度良好，当患者的风险评分总和≥177分时，属于高风险人群；结论 本模型可以预测B超提示子宫内膜病变患者的内膜病理类型为癌前或恶变型的概率并识别高风险人群。     

Germline gain-of-function MMP11 variant results in an aggressive form of colorectal cancer

Matrix metalloproteinase-11 (MMP11) is an enzyme with proteolytic activity against matrix and nonmatrix proteins. Although most MMPs are secreted as inactive proenzymes and are later activated extracellularly, MMP11 is activated intracellularly by furin within the constitutive secretory pathway. It is a key factor in physiological tissue remodeling and its alteration may play an important role in the progression of epithelial malignancies and other diseases. TCGA colon and colorectal adenocarcinoma data showed that upregulation of MMP11 expression correlates with tumorigenesis and malignancy. Here, we provide evidence that a germline variant in the MMP11 gene (NM_005940: c.232C>T; p.(Pro78Ser)), identified by whole exome sequencing, can increase the tumorigenic properties of colorectal cancer (CRC) cells. P78S is located in the prodomain region, which is responsible for blocking MMP11's protease activity. This variant was detected in the proband and all the cancer-affected family members analyzed, while it was not detected in healthy relatives. In silico analyses predict that P78S could have an impact on the activation of the enzyme. Furthermore, our in vitro analyses show that the expression of P78S in HCT116 cells increases tumor cell invasion and proliferation. In summary, our results show that this variant could modify the structure of the MMP11 prodomain, producing a premature or uncontrolled activation of the enzyme that may contribute to an early CRC onset in these patients. The study of this gene in other CRC cases will provide further information about its role in CRC development, which might improve patient treatment in the future.     

Incorporating respondent-driven sampling into web-based discrete choice experiments: preferences for COVID-19 mitigation measures

Health Services and Outcomes Research Methodology - To slow the spread of COVID-19, most countries implemented stay-at-home orders, social distancing, and other nonpharmaceutical mitigation...