Articles

<b>Introduction:</b> Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line distance between two fixed points, provides a quantitative measure of arterial curvature. A CTI value of ≥1.2 indicates pathological tortuosity. Although noninvasive modalities such as CTA and MRA are frequently used, digital subtraction angiography (DSA) remains the gold standard for evaluating vessel geometry due to its higher spatial precision. This study aimed to determine the association of age, sex, and hypertension with CTI measured by DSA.<b> </b><b>Methods:</b> A cross-sectional study was conducted from November to December 2025 at the Neurointervention Clinic, RS Pelni Jakarta, Indonesia, involving 61 adult patients who underwent carotid DSA. CTI was measured bilaterally using digital imaging software and classified as <1.2 (non-tortuous) or ≥1.2 (tortuous). Clinical data, including age, sex, and hypertension status, were collected from medical records and analyzed using bivariate tests. <b>Results:</b> Older age (≥65 years), female sex, and hypertension were significantly associated with higher CTI values on both carotid sides. Tortuosity was more common among hypertensive patients and elderly females, indicating the influence of vascular remodeling and chronic hemodynamic stress. <b>Conclusion:</b> Carotid tortuosity increases with age, hypertension, and female sex. DSA-based CTI measurement provides a reliable and precise approach for evaluating vascular changes associated with cerebrovascular risk.

Background:</b> Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. <b>Aims:</b> This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high school students. <b>Methods:</b> A cross-sectional survey (CEASE Youth: School Survey) was conducted with 604 Baltimore high school students aged 14–20. Participants completed a questionnaire assessing perceptions of e-cigarette safety, as well as parental education, race/ethnicity, parental employment, household composition, and community tobacco use. <b>Results:</b> Higher parental education was associated with lower perceived e-cigarette safety among students. Students in higher grades also reported lower perceived e-cigarette safety. In contrast, male students—particularly those in upper grades—were more likely to perceive e-cigarettes as safe. Race/ethnicity, household composition, parental employment, and community tobacco exposure were not associated with perceived e-cigarette safety. <b>Conclusion:</b> Higher parental education, female gender, and being in higher grades were associated with perceiving e-cigarettes as unsafe. These findings highlight the need for targeted interventions to address vaping perceptions among youth in urban settings.

<b>Background:</b> Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. <b>Aims:</b> This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive disorder (MDD), nicotine use, and marijuana use. <b>Methods:</b> Participants were children from the Adolescent Brain Cognitive Development (ABCD) study. SGM identity was reported at baseline, while outcomes included past MDD and suicide attempts as well as future nicotine and marijuana use. Structural equation modeling (SEM) was used to test both direct and indirect pathways linking SGM identity to mental health and behavioral outcomes. <b>Results:</b> No significant mediation was found through family conflict, discrimination, or trauma. Instead, effects of SGM identity were primarily direct: SGM youth had higher odds of past suicide attempts and MDD, as well as future marijuana use, but not future nicotine use. Stressor variables, however, were independently associated with outcomes. Discrimination predicted all outcomes; trauma was positively associated with suicide, nicotine, and marijuana use but not MDD; and family conflict predicted all outcomes except MDD. <b>Conclusion:</b> Family conflict, discrimination, and trauma did not mediate SGM disparities in mental health and substance use, but each emerged as an independent predictor of risk. These findings highlight the complexity of mechanisms underlying SGM-related disparities and suggest the need for future research to explore additional pathways and contextual influences.

The anterior collateral ligament (ACL) is one of four ligaments in the knee, connecting the tibia and femur and acting as a key stabilizer. Factors influencing these injuries include playing surface, training programs, athlete strength, technique, and gender. Female athletes are at a higher risk of ACL injuries, being four to nine times more likely than males, often due to differences in biomechanics and training patterns. It ss important that rehab focuses on both legs, as overworking the injured leg increases the risk of injuries elsewhere. Prevention training, such as proprioceptive-balance and plyometric agility training, has been shown effectiveness in minimizing ACL injuries. Despite some limitations in research, these programs highlight the importance of improved training techniques. Kinesio taping might help reduce pain but lacks strong evidence for preventing ACL tears.

<b>Background:</b> Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. <b>Aims:</b> This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. <b>Methods:</b> Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. <b>Results:</b> Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. <b>Conclusions:</b> Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.

<b>Background</b><b>:</b> Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). <b>Methods</b><b>:</b> This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. <b>Results</b><b>:</b> Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. <b>Conclusion</b><b>:</b> The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.

Intersectionality has significantly enhanced our understanding of how overlapping social identities—such as race, ethnicity, gender, sex, class, and sexual orientation—interact to shape individual experiences. However, despite its theoretical importance, much of the existing literature has relied on qualitative approaches to define and study intersectionality, limiting its application in predictive modeling, comparative analysis, and policy development. This paper introduces the concept of Quantitative Intersectionality Scoring System (QISS), a novel approach that assigns numerical scores to intersecting identities, thereby enabling a more systematic and data-driven analysis of intersectional effects. We argue that QISS can substantially enhance the utility and predictive validity of quantitative models by capturing the complexities of multiple, overlapping social determinants. By presenting concrete examples, such as the varying impacts of socioeconomic mobility on life expectancy among different intersectional groups, we demonstrate how QISS can yield more precise and reliable forecasts. Such a shift would allow policymakers and service providers to dynamically assess economic and health needs, as well as the uncertainties around them, as individuals move through different social and economic contexts. QISS-based models could be more responsive to the complexities of intersecting identities, allowing for a more quantified and nuanced evaluation of policy interventions. We conclude by discussing the challenges of implementing QISS and emphasizing the need for further research to validate these quantifications using robust quantitative methods. Ultimately, adopting QISS has the potential to improve the accuracy of predictive models and the effectiveness of policies aimed at promoting social justice and health equity.

<b>Background: </b>High parental education promotes various aspects of offspring well-being including reducing their risk of depression/anxiety, criminal justice involvement, and welfare reliance. However, according to minorities’ diminished returns, these benefits are not equal across racial groups, with Black families experiencing diminished returns of parental education compared to White families. This study explores the role of household income and offspring educational attainment as potential serial pathways that operate as mechanisms underlying diminished returns of parental education on offspring outcomes in Black families. Gender differences in these effects were also explored. <b>Methods: </b>Utilizing data from the Future of Families and Child Wellbeing Study (FFCWS) over a 22-year follow-up period (seven waves), we examined the serial mediation by household income and offspring educational attainment in explaining the relationship between parental education and offspring outcomes namely depression, anxiety, criminal justice involvement, and welfare reliance [Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)]. We used structural equation modeling (SEM) with household income as the first mediator and young adult education as the second mediator. Multi-group models were used to explore gender differences in these paths. <b>Results: </b>The study confirmed the role of our proposed serial mediators for Blacks’ weaker effects of parental education on offspring outcomes. We observed weaker effects of first affects household income, with this effect being for Black families compared to White families, which then impacted educational attainment of the offspring. The findings indicate that household income plays a crucial mediating role, but its effect is weaker in Black families. Additionally, the educational attainment of offspring from highly educated Black parents is less effective in improving outcomes compared to their White peers, further contributing to diminished returns. Some gender differences were observed for the effects of educational attainment on economic and health outcomes of young adults. <b>Conclusions: </b>The study underscores the need to reconsider traditional assumptions about the comparability of family conditions and outcomes across racial groups with similar levels of parental education. The findings highlight the importance of targeted policies and interventions aimed at enhancing the economic stability and educational outcomes of Black families to address these disparities. Policies should focus on promoting the economic well-being of highly educated Black parents and improving the educational outcomes of their children.

The purpose of this study was to examine indicators of forgiving behaviour and intervention among adolescent students in Junior High School in Bimbilla in the Nanumba North Municipality of Ghana<b>. </b>This study adopted the Pragmatist philosophy. The mixed methods experimental design was used for the study. The study population comprised all adolescents in Junior High Schools in the Nanumba North Municipality of the Northern Region, Ghana. Purposive, random sampling techniques Krejcie and Morgan's table of determination of sample size were used for the schools and respondents for the study. Two major instruments were used for this study: a questionnaire and an interview guide. The interview schedule was used to gather the qualitative data whereas the quantitative data was gathered using the questionnaire. The study indicated that both the REACH model and Process model are efficacious in reducing the level of depression among adolescent students when their levels of forgiveness are increased through forgiveness counselling regardless of gender and age. The findings also revealed that both REACH and Process models were good interventions for the adolescents in showing greater emotional regulation (increased forgiveness, reduced anger and reduced depression, enhanced sense of well-being, positive feelings and positive thoughts towards the offender). It is recommended that counsellors organise training programmes with parents in conjunction with Non-governmental organisations on using the Process and REACH models. This will bring awareness of the interventions and encourage parents to seek assistance anytime their adolescents need assistance. It is once again recommended that teachers and school administrators consider forgiveness interventions (the Process model and REACH model) as a very effective strategy for treating unforgiveness to improve students' psychological well-being.

There is an ongoing debate regarding how to feed Sub-Saharan Africa's fast rising population in the long run, as well as the implications for food security. To maintain food security, various strategies have been recommended, including a focus on the significance of diversifying and improving people's diets. Proposals have been tabled elsewhere with a primary focus on enhancing agricultural inputs and technology adoption in order to increase agricultural production and productivity, hence strengthening food security. The current opinion piece attempts to contribute to this debate by examining smallholder agriculture and its role to African food security. This discussion proposes a future paradigm shift toward a gendered climate-smart smallholder agriculture and food production and security conceptual framework based on the promotion and development of smallholder agriculture and food production and security. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For Africa, today’s predicament is to ensure food security for the anticipated rapid population expansion, while on the other hand handling an overall net adverse effect of worldwide global climate change, and increased socio-economic ills associated with gender inequality in smallholder agriculture and ensuring long-term agriculture sustainable development. The failure to address gender inequality in smallholder agriculture and food production and pontificate of global climate change effect has thrown Sub-Saharan Africa into a state of perpetual food scarcity and insecurity because of low agricultural productivity and food supply, and by force of circumstances exposing the agricultural communities and its people to extreme poverty and nutrition and food insecurity. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For this purpose, this discussion proposes a future paradigm shift towards a gendered climate-smart smallholder agriculture and food production and security conceptual framework hinged on the promotion and development of the micro-livestock and/or unconventional animal species sub-sector to strengthen food security on the continent. Overall, the discussion emphasizes the importance of taking immediate action to alleviate the negative effects of climate change and address gender inequality through promotion of micro livestock to assist in the development of long-term adaptation measures to maintain smallholder agricultural productivity.

One of the current issues facing humanity is ensuring sustained global food security in the face of devastating effects of climate change; this challenge is particularly pressing on the African continent. Here, I present an opinion piece identifying local animal genetic resources as "African leverage point" that provide the highest chances to cushion rural fork to climate change, enhance environmental sustainability and food security in Africa. When it comes to boosting food production, coping with climate change, or bolstering the delivery of a wide range of ecosystem services, I believe that African animal genetic resources are essential alternatives for the sustainable growth of the livestock industry and its contribution to food security. Africa needs to address the support and development of indigenous animal genetic resources in order to meet the basic food needs of more than 1 billion people, address numerous environmental issues with continental implications, and focus on more effective and resilient food systems with the greatest impact on food security. The indigenous animal resources diversity and support actions to this unique group could provide a boost in protein that is lacking to constitute healthy diets in Africa. The priorities of nonprofit organizations, foundations, governments, citizens' groups, and companies can be influenced by this leverage point in the African food system. Due to continuous food insecurity, which appears to be becoming worse with climate change and makes it even harder to accomplish the SDGs on the continent, Africa has paid a hefty price for being misled about the worth of its own animal genetic resources. To the contrary, it is highly improbable that a strategy to improve food security and rural livelihoods that undermines the utilization of indigenous animal genetic resources will be viable in long-term. If Africa makes an effort, is committed, and fully commits resources to putting indigenous animal genetic resources at the forefront of combating food insecurity and accelerating the achievement of SDGs, it can achieve more under the adverse prevailing climate change induce environmental conditions. Our personal opinion is that we would not have had the ongoing food problems, even in the face of climate change, if Africa had over the years implemented the necessary mechanisms to develop and promote local animal genetic resources. What lies ahead in terms of climate change effect on food security in Africa is anyone's guess – but whatever it is, promoting continental adapted indigenous animal genetic resources portfolio is ready to handle it. Development and promotion of African animal genetic resources should be part of a continental strategy to transform smallholder animal production by 2050, in line with the goals of achieving the SGDs, to improve rural household food security, and bringing rural economy prosperity, resilience, sustainability, and all other desired animal related food outcomes for rural healthy diets. African animal genetic resources are the most important but underutilized resource to address the issue of ongoing food insecurity. The responsible use of local animal genetic resources through climate smart animal husbandry practices also contributes to food security, rural development and increased employment opportunities. African genetic improvement programs involving indigenous animal genetic resources must be considered as regards to local agriculture and livestock development aspirations, appropriateness to local reality and livelihood security, as well as environmental friendliness. Animal agriculture will fill in the enormous gaps in the continent's food supply if this animal group receives adequate attention and is used integrated properly in crop and livestock systems which characterize smallholder farming sector in Africa. Because they have evolved over time to accommodate the various climatic conditions and environmental pressures on the continent, Africa's native animal genetic resources are particularly resilient. Indirectly, the impact of climate change offers a chance to use native animal genetics from Africa. The use of local animal genetic diversity has the potential to substantially improve Africa's food security landscape hence should be given special consideration for sociocultural, environmental, and economic aspects, and with regard for smallholder farmer-specific factors of interest. African animal genetic resources have contributed significantly to the food and nutrition security aspects of the millions of people in their communities of origin and custody in Africa. The purpose of the perception piece is to educate the reader about the fundamental mechanisms that control the use of continental animal genetic resources and how the outlook for these mechanisms can be manipulated in the future for the benefit of improving food security in Africa. The discussion provides in-depth insight into the pertinent literature in understanding the significance of local animal genetic resources in terms of their contribution to food security in Africa.

This paper brings to light efforts of male institutional leaders in the University of Education, Winneba in promoting the gender equality agenda and effects of their efforts in bridging the gender gaps in staff and students’ levels. It sheds further light on involving men in the gender mainstreaming efforts. Both primary and secondary data on gender equality and equity measures were used in this study. The study found that male Vice-Chancellors have over the years been devoted to promoting gender equality agenda in the University. The effects of their efforts are largely seen in the increase in the number of females that have benefited from the institutional mentorship and scholarship programmes, which has impacted positively on addressing the gender gaps in the University. It is recommended that new strategies be adopted in promoting gender equality agenda. These strategies include revision in gender policies to involve men as agents of change in gender mainstreaming activities; gender training for male staff and students of all levels and categories for effective gender work, offering specific trainings and interactive discussions on gender issues for men as volunteers for gender mainstreaming. The study further suggests among other things, the need to engage the university community in entertaining activities like cycling for the equality agenda to be made more real to men and court their interest to promote men’s involvement in gender work.

The purpose of the study was to investigate the factors contributing to domestic violence in Koforidua in the New Juaben Municipality of Ghana. The population of the study consisted of 340 men selected from four communities in Koforidua. Purposive sampling technique 4 communities. Using the Krejcie and Morgan table, a sample size of 340 men were selected which is appropriate for a population of 3428 with an alpha level of 5 percent in a quantitative study. The selection was based on the fact that these communities registered the highest cases of domestic violence in the Municipality. The main instrument used for the study was structured questionnaire. Data analysed using SPSS (Statistical Product for Service Solution, version 20). Statistical tools such as frequency distribution tables, percentages, charts and cross tabulation was used. The frequency tables were used to give the summary of the data for easy understanding and comparison. The study revealed that men perceive that factors like show of power, exposure to domestic violence, poor communication in marriage, unemployment and poverty, control of women through discipline and women’s low academic achievement are the triggers of domestic violence in a marital relationship. The study recommended that effort ought to be put in place to unravel the mystery surrounding male supremacy over women at both institutional and community levels by DOVVSU, Gender Advocacy Groups and other institutions to benefit humanity and society at large.