Spatio-Temporal Trend and Geographic Disparity of Infertility Prevalence in Burkina Faso, 2011 to 2020

Background: Infertility affected 10% to 25% of couples globally, and about half of the infertility cases were reported in sub-Saharan Africa. Infertility poses significant social, cultural, and health challenges, particularly for women who often face stigmatization. However, comprehensive and nationally representative data, including prevalence, temporal trends, and risk factors, are lacking, prompting a study in Burkina Faso to address the need for informed policies and programs in infertility care and management. Objectives: This study aims to better understand the spatiotemporal trend of infertility prevalence in Burkina Faso. Methodology: This is a retrospective population-based study of women infertility from healthcare facilities in Burkina Faso, during January 2011 to December 2020. We calculated the prevalence rates of infertility and two disparity measures, and examined the spatiotemporal trend of infertility. Results: Over the 10-year period (2011 to 2020), 143,421 infertility cases were recorded in Burkina Faso healthcare facilities, resulting of a mean prevalence rate of 3.61‰ among childbearing age women and 17.87‰ among women who consulted healthcare facilities for reproductive issues (except contraception). The findings revealed a significant increase of infertility, with the prevalence rate varied from 2.75‰ in 2011 to 4.62‰ in 2020 among childbearing age women and from 13.38‰ in 2011 to 26.28‰ in 2020 among women who consulted healthcare facilities for reproductive issues, corresponding to an estimate annual percentage change of 8.31% and 9.80% respectively. There were significant temporal and geographic variations in the prevalence of infertility. While relative geographic disparity decreased, absolute geographic disparity showed an increasing trend over time. Conclusion: The study highlights an increasing trend of infertility prevalence and significant geographic variation in Burkina Faso, underscoring the urgent necessity for etiologic research on risk factors, psychosocial implications, and economic consequences to inform effective interventions and mitigate the socioeconomic impact of infertility.

Disparity estimation for multi-scale multi-sensor fusion

The perception module of advanced driver assistance systems plays a vital role.Perception schemes often use a single sensor for data processing and environmental perception or adopt the information processing results of various sensors for the fusion of the detection layer.This paper proposes a multi-scale and multi-sensor data fusion strategy in the front end of perception and accomplishes a multi-sensor function disparity map generation scheme.A binocular stereo vision sensor composed of two cameras and a light deterction and ranging(LiDAR)sensor is used to jointly perceive the environment,and a multi-scale fusion scheme is employed to improve the accuracy of the disparity map.This solution not only has the advantages of dense perception of binocular stereo vision sensors but also considers the perception accuracy of LiDAR sensors.Experiments demonstrate that the multi-scale multi-sensor scheme proposed in this paper significantly improves disparity map estimation.

Spatial Disparity in Availability of Tuberculosis Diagnostic Services Based on Sector and Level of Care in Nigeria

Background: Delay in Tuberculosis (TB) diagnosis can contribute to late presentation, severe disease, and continued transmission. KNCV TB Foundation Nigeria through the United States Agency for International Development (USAID) funded the TB Local Organization Network (LON) 1 and 2 projects that explored the availability of Tuberculosis services based on sector and levels of care. Methods: TB Patient Pathway Analysis was carried out in 14 states comprising 92 facilities. It involved primary, secondary, and tertiary levels of health care in both the public and private sectors. This was a cross-sectional study under program implementation. Proforma was used to collect data on the available TB diagnostic services. Results: In public health facilities, GeneXpert was available at 100% in tertiary facilities in 8 (57%) states;up to 82% in 4 (33%) states, 50% available at secondary facilities in 2 states, and There is none at the primary facilities. Smear microscopy was available at 100% in tertiary facilities in 9 (64%) states and 3 (25%) states have 50% to 82%;secondary -10 (71%) states have > 70% at facilities;primary 1 (7%) state has it in 61% of facilities. Loop-mediated isothermal amplification (TB-LAMP) in tertiary 2 (17%) states have 20% and 100% respectively;secondary 4 (<30%) states have in 1 or 2 facilities;none for primary facilities. In private health facilities, 79% of states have Smear microscopy at both primary and secondary facilities, and only 2 states (14%) at tertiary facilities. Only 1 (7%) state has GeneXpert in all tertiary facilities, 2 (14%) states have secondary facilities, and 4 states in about 1% of facilities. TB LAMP was not available in any tertiary facility, one (7%) state at secondary with coverage of 1%, and 2 (14%) states at primary both with 4% overall facility coverage. Conclusions: There is an inequitable distribution of TB diagnostic services in both sectors and levels of care in Nigeria. TB care and control will improve with enhanced equitable distribution of TB diagnostic services across the health system.

Finite Difference Schemes for Time-Space Fractional Diffusion Equations in One-and Two-Dimensions

In this paper,finite difference schemes for solving time-space fractional diffusion equations in one dimension and two dimensions are proposed.The temporal derivative is in the Caputo-Hadamard sense for both cases.The spatial derivative for the one-dimensional equation is of Riesz definition and the two-dimensional spatial derivative is given by the fractional Laplacian.The schemes are proved to be unconditionally stable and convergent.The numerical results are in line with the theoretical analysis.

Sex and racial disparities in non-alcoholic fatty liver disease-related cardiovascular events: National inpatient sample analysis (2019)

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To investigate the relationship between NAFLD and major cardiovascular and cerebrovascular events(MACCE)in subgroups using a nationally representative United States inpatient sample.METHODS We examined National Inpatient Sample(2019)to identify adult hospitalizations with NAFLD by age,sex,and race using ICD-10-CM codes.Clinical and demographic characteristics,comorbidities,and MACCE-related mortality,acute myocardial infarction(AMI),cardiac arrest,and stroke were compared in NAFLD cohorts by sex and race.Multivariable regression analyses were adjusted for sociodemographic characteristics,hospitalization features,and comorbidities.RESULTS We examined 409130 hospitalizations[median 55(IQR 43-66)years]with NFALD.NAFLD was more common in females(1.2%),Hispanics(2%),and Native Americans(1.9%)than whites.Females often reported non-elective admissions,Medicare enrolment,the median age of 55(IQR 42-67),and poor income.Females had higher obesity and uncomplicated diabetes but lower hypertension,hyperlipidemia,and complicated diabetes than males.Hispanics had a median age of 48(IQR 37-60),were Medicaid enrollees,and had non-elective admissions.Hispanics had greater diabetes and obesity rates than whites but lower hypertension and hyperlipidemia.MACCE,all-cause mortality,AMI,cardiac arrest,and stroke were all greater in elderly individuals(P<0.001).MACCE,AMI,and cardiac arrest were more common in men(P<0.001).Native Americans(aOR 1.64)and Asian Pacific Islanders(aOR 1.18)had higher all-cause death risks than whites.CONCLUSION Increasing age and male sex link NAFLD with adverse MACCE outcomes;Native Americans and Asian Pacific Islanders face higher mortality,highlighting a need for tailored interventions and care.

Are there sex-based disparities in cataract surgery?

AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery.METHODS:This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine.Data collected included the patient’s health history,ocular comorbidities,operative and post-operative complications,and the post-operative best corrected visual acuity(BCVA).The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study.RESULTS:A total of 11977 eyes from 7253 patients were included in the study.Ocular comorbidities differed by sex,with males having significantly higher percentages of traumatic cataracts(males 0.7%vs females 0.1%),prior ocular surgery(6.7%vs 5.5%),and mature cataracts(2.8%vs 1.9%).Conversely,females had significantly higher rates of pseudoexfoliation(2.0%vs 3.2%).In unadjusted analysis,males had higher rates of posterior capsular rupture(0.8%vs 0.4%)and vitreous loss(1.0%vs 0.6%),but this difference was not significant after adjustment for confounders.Males had a significantly increased risk of post-operative retinal detachment,but in multivariable analysis this was no longer significant.Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy for posterior capsule opacification(OR=0.8,95%CI=0.7-0.9,P=0.0005).The BCVA was slightly worse for males pre-operatively;but post-operatively,both sexes exhibited similar visual acuity of Snellen equivalent 20/25.CONCLUSION:The study finds that in a cohort of patients presenting for cataract surgery,sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males.However,observed surgical complication rates exhibit almost no difference by sex after adjusting for pre-operative differences and post-operative BCVA is similar between sexes.

Gastric Cancer Disparities in the United States: Overcoming the Barriers

In this narrative review, we highlight the disparities in the incidence and mortality of gastric cancer across various racial and ethnic populations in the United States (US). Despite the low and decreasing trend in the incidence of gastric cancer in the US, the incidence remains significantly high among Asian and Hispanic Americans, showing a striking racial and ethnic disparity. The low survival rate of gastric cancer further accentuates the magnitude of this disparity. In addition, there is a marked funding disparity among different cancers in the US, reflecting the significantly lower level of support for cancers, such as gastric cancer, which are more prevalent in minority populations, compared to the cancers more prevalent among non-Hispanic Whites (NHW). Moreover, the economic burden from health disparities remains high. Although studies from the US and Asia suggest that screening for stomach cancer may be cost-effective, there is no currently available guideline for scree-ning high-risk populations in the US. A multidimensional framework involving the community, physicians, and policymakers is proposed to tackle these gastric cancer disparities and to develop population-based screening and surveillance programs to reduce the burden of gastric cancer.

Disparities in Prevalence and Determinants of Hypertension amongst Bamiléké Adults Residing in Two Different Agroecological Zones of Cameroon

Background: Cardiovascular diseases such as hypertension (HTN) are one of the main causes of death in Cameroon. This study aimed at assessing prevalence disparities and determinants of hypertension amongst Bamiléké adults residing in two different agroecological zones of Cameroon. Methods: A cross-sectional and descriptive survey was conducted among Bamiléké population living in the Highlands zone (Western region) and in the Monomodal Rainforest zone (Littoral region) of Cameroon from August 2016 to August 2017. Participants (962) were aged at least 20 years old. Data on sociodemographic, hemodynamic, anthropometric, and biochemical parameters and lifestyle of the participants were collected. Results: Results obtained revealed that 34.2% were hypertensive and those residing in the highland zone were more affected than those living in the monomodal rainforest zone (44.5% vs 22.9%). The different subtypes of HTN (Isolated systolic hypertension (14.1%), isolated diastolic hypertension (7.2%) and Systo-diastolic hypertension (23.3%)) were also more prevalent in the Highlands Zone. The most prevalent stage of HTN was pre-HTN (31.5%). However, people living in the monomodal rainforest zone were more affected by pre-HTN compared to Bamiléké living in the highland zone (33.6% vs. 29.6%). Results also showed that high consumption (≥ 3 times/week) of carbohydrate- and fat-rich foods, ageing, obesity, and marital status were associated with high blood pressure in both agroecological zones. Besides, secondary education (OR = 0.68;95% CI: 0.42 - 0.99) in the Highlands Zone and high (≥3 times/week) vegetable consumption (OR = 0.66;95% CI: 0.44 - 0.98) in the Monomodal Rainforest Zone had a protective effect on elevated blood pressure of population. Conclusion: There is a disparity in the prevalence of hypertension and some of its determinants among Bamiléké adults residing in different agroecological zones. This work highlights the need to advocate for local and ethno-cultural health policies to prevent, diagnose and manage hypertension.

Disparities in the impact of economic well-being on self-esteem in adulthood:Race and ethnicity

BACKGROUND Most studies have defined economic well-being as socioeconomic status,with little attention given to whether other indicators influence self-esteem.Little is known about racial/ethnic disparities in the relationship between economic wellbeing and self-esteem during adulthood.AIM To explore the impact of economic well-being on self-esteem in adulthood and differences in the association across race/ethnicity.METHODS The current study used data from the National Longitudinal Survey of Youth 1979.The final sample consisted of 2267 African Americans,1425 Hispanics,and 3678 non-Hispanic Whites.Ordinary linear regression analyses and logistic regression analyses were conducted.RESULTS African Americans and Hispanics were more likely to be in poverty in comparison with non-Hispanic Whites.More African Americans were unemployed than Whites.Those who received fringe benefits,were more satisfied with jobs,and were employed were more likely to have higher levels of self-esteem.Poverty was negatively associated with self-esteem.Interaction effects were found between African Americans and job satisfaction predicting self-esteem.CONCLUSION The role of employers is important in cultivating employees’self-esteem.Satisfactory outcomes or feelings of happiness from the workplace may be more important to non-Hispanic Whites compared to African Americans and Hispanics.

Bridging the gap: Addressing disparities in hepatitis C screening, access to care, and treatment outcomes

Hepatitis C virus(HCV)is a significant public health challenge globally,with substantial morbidity and mortality due to chronic liver disease.Despite the availability of highly effective and well-tolerated direct-acting antiviral therapies,widespread disparities remain in hepatitis C screening,access to treatment,linkage to care,and therapeutic outcomes.This review article synthesizes evi-dence from various studies to highlight the multifactorial nature of these dispari-ties,which affects ethnic minorities,people with lower socioeconomic status,in-dividuals with substance use disorders,and those within correctional facilities.The review also discusses policy implications and targeted strategies needed to overcome barriers and ensure equitable care for all individuals with HCV.Recom-mendations for future research to address gaps in knowledge and evaluation of the effectiveness of interventions designed to reduce disparities are provided.

How Does E-Commerce Policy Affect Consumption Disparities of Rural Households?-Evidence from China

In the context of China’s ongoing efforts to promote countryside revitalization and facilitate domestic economic circulation,it is of great significance to reduce the consumption disparity among rural households and unleash the consumption potential in the countryside.Based on data from China Family Panel Studies,this paper adopts a staggered difference-in-differences method to assess the impact of the e-commerce to enter rural areas on the consumption disparity among rural households.Findings:the comprehensive demonstration work of promoting e-commerce to enter rural areas has reduced the consumption disparity among rural households through the following mechanisms.Firstly,this policy initiative has mitigated the consumption-inhibiting effect on rural household consumption due to the local market size and external market accessibility by promoting the distribution of consumer goods to villages.Secondly,this policy initiative has also increased the agricultural income of rural households and reduced their consumption disparity by distributing farm produce to cities and enhancing the agricultural income of rural households.Moreover,the work is characterized by inclusive growth and is not susceptible to the“elite capture”phenomenon.

Digital Disparities:How Artificial Intelligence Can Facilitate Anti-Black Racism in the U.S.Healthcare Sector

This paper delves into the intricate interplay between artificial intelligence(AI)systems and the perpetuation of Anti-Black racism within the United States medical industry.Despite the promising potential of AI to enhance healthcare outcomes and reduce disparities,there is a growing concern that these technologies may inadvertently/advertently exacerbate existing racial inequalities.Focusing specifically on the experiences of Black patients,this research investigates how the following AI components:medical algorithms,machine learning,and natural learning processes are contributing to the unequal distribution of medical resources,diagnosis,and health care treatment of those classified as Black.Furthermore,this review employs a multidisciplinary approach,combining insights from computer science,medical ethics,and social justice theory to analyze the mechanisms through which AI systems may encode and reinforce racial biases.By dissecting the three primary components of AI,this paper aims to present a clear understanding of how these technologies work,how they intersect,and how they may inherently perpetuate harmful stereotypes resulting in negligent outcomes for Black patients.Furthermore,this paper explores the ethical implications of deploying AI in healthcare settings and calls for increased transparency,accountability,and diversity in the development and implementation of these technologies.Finally,it is important that I prefer the following paper with a clear and concise definition of what I refer to as Anti-Black racism throughout the text.Therefore,I assert the following:Anti-Black racism refers to prejudice,discrimination,or antagonism directed against individuals or communities of African descent based on their race.It involves the belief in the inherent superiority of one race over another and the systemic and institutional practices that perpetuate inequality and disadvantage for Black people.Furthermore,I proclaim that this form of racism can be manifested in various ways,such as unequal access to opportunities,resources,education,employment,and fair treatment within social,economic,and political systems.It is also pertinent to acknowledge that Anti-Black racism is deeply rooted in historical and societal structures throughout the U.S.borders and beyond,leading to systemic disadvantages and disparities that impact the well-being and life chances of Black individuals and communities.Addressing Anti-Black racism involves recognizing and challenging both individual attitudes and systemic structures that contribute to discrimination and inequality.Efforts to combat Anti-Black racism include promoting awareness,education,advocacy for policy changes,and fostering a culture of inclusivity and equality.

DENSE DISPARITY MAP ESTIMATION USING GENETIC ALGORITHMS

An approach to addressing the stereo correspondence problem is presented using genetic algorithms (GAs) to obtain a dense disparity map. Different from previous methods, this approach casts the stereo matching as a multi-extrema optimization problem such that finding the fittest solution from a set of potential disparity maps. Among a wide variety of optimization techniques, GAs are proven to be potentially effective methods for the global optimization problems with large search space. With this idea, each disparity map is viewed as an individual and the disparity values are encoded as chromosomes, so each individual has lots of chromosomes in the approach. Then, several matching constraints are formulated into an objective function, and GAs are used to search the global optimal solution for the problem. Furthermore, the coarse-to-fine strategy has been embedded in the approach so as to reduce the matching ambiguity and the time consumption. Finally, experimental results on synthetic and real images show the performance of the work.

Pattern Change and Regional Disparity Tendency of Cultivated Land Use in Jiangsu Province

The study has examined the tempo-spatial patterns of cultivated land use change in Jiangsu province. A principal component analysis （PCA） of 18 selected indicators of cultivated land use during the period 1970-2010 identified 2 main pat- terns of change in planting productivity and economic efficiency. A major shift from production-centered pattern to profit-oriented one occurred in 1984, the time of grain yield surplus and the mitigation of population pressure. In response to the impending Opened Market System, there was a notable tendency of higher efficiency and less productivity since 1997, as well as remarkable regional disparity of cultivated land use change spatially. It revealed a relative decrease in grain cropping share, crop- ping scale and cultivation intensity in South Jiangsu, especially in Tai-Lake region, and the reverse in North Jiangsu. Some suggestions for the future were finally dis- cussed from the above findings.

Regional disparity in the changes of agricultural land use intensity in China during 1980-2002

Based on the cost-benefit data （1980-2002） of farm products and China Agriculture Yearbooks, this paper studies the regional disparity in the changes of the agricultural land use in China during the period 1980-2002 from three aspects such as the degree of intensity, the sown area and the abandoned farmland. The results show that： （1） The degree of intensity of land use in the westena region during 1980-2000 has a strong uptrend, but in the eastern and central regions the degree of intensity descends obviously and has shown a continuous downtrend since 1997. （2） The total sown area shrinks notably in the eastern region, while it enlarges constantly in the western region. （3） The sown area in the eastern, central and western regions has gone through a similar cyclic process： down （1980-1985）-up （1985-1991）-down （1991-1994）-up （1994-1999）-down （1999-2002）. However, there are obvious differences in amplitude variation and tendency among them. The sown area has shrunk in the eastern region and expanded in the central and western regions especially before 1999. （4） The most cases of abandoned farmland are reported in the central region, the second in the eastern region and the least in the western region. The abandonment phenomena chiefly occurred during 1992-1995 in the eastern region, and during 1998-2002 in the central region.

Gastric cancer in Alaska Native people: A cancer health disparity

AIM To evaluate recent trends in gastric cancer incidence, response to treatment, and overall survival among Alaska Native(AN) people. METHODS A retrospective analysis of the Alaska Native Medical Center patient database was performed. Patient history, clinical, pathological, response to treatment and patient outcomes were collected from one-hundred and thirty-two AN gastric cancer patients. The Surveillance, Epidemiology and End Result database 18 was used to collect comparison United States non-Hispanic White(NHW) and AN gastric cancer patient data between 2006-2014.RESULTS AN gastric cancer patients have a higher incidence rate, a poorer overall survival, and are diagnosed at a significantly younger age compared to NHW patients. AN patients differ from NHW patients in greater prevalence of non-cardia, diffuse subtype, and signet ring cell carcinomas. AN females were more likely to be diagnosed with later stage cancer, stage IV, compared to AN males. Diminished overall survival was observed among AN patients with increasing stage, O+ blood type, < 15 lymph nodes examined at resection, and no treatment. This study is the first report detailing the clinicopathologic features of gastric cancer in AN people with outcome data.CONCLUSION Our findings confirm the importance of early detection, treatment, and surgical resection for optimizing AN patient outcomes. Further research on early detection markers are warranted.

Regional Disparity and Convergence of China's Inbound Tourism Economy

Comprehending regional characteristics and influencing factors of China＇s inbound tourism economy is im- portant to make effective policies that will help inbound tourism develop harmoniously and shrink regional disparity. This paper studied the regional disparity and convergence of China＇s inbound tourism economy during 1996-2008 with the methods of a-convergence, club convergence and r-convergence. The results indicate that 1） inbound tourism receipts per capita （ITRPC） of the whole country, the eastern, central and western regions presented the rapid increasing trend; 2） ITRPC of the whole country was characterized by convergence; 3） the eastern region presented club con- vergence, but the central and western regions did not show this trend; 4） the star-hotel levels and investment in fixed assets for the tourism industry per capita had a same trend to growth rates of ITRPC, promoting inbound tourism de- velopment, and there was no difference among the 31 provinces （municipalities） in the mainland of China; 5） but the proportion of employed persons in the tourism industry accounting for total population and the proportion of the terti- ary industry accounting for GDP had a reversal trend to growth rates of ITRPC, shrinking the provincial disparity in inbound tourism economy, and there were differences between the developed provinces and the developing provinces. Based on these analyses, we put forward some suggestions for the developing provinces to speed up inbound tourism economy.

Analyzing Population Density Disparity in China with GIS-automated Regionalization: The Hu Line Revisited

The famous ’Hu Line’, proposed by Hu Huanyong in 1935, divided China into two regions(southeast and northwest) of comparable area size but drastically different in population. However, the classic Hu Line was derived manually in absence of reliable census data and computational technologies of modern days. It has been subject to criticism of lack of scientific rigor and accuracy. This research uses a GIS-automated regionalization method, termed REDCAP(Regionalization with Dynamically Constrained Agglomerative Clustering and Partitioning), to reconstruct the demarcation line based on the 2010 county-level census data in China. The results show that the logarithmic transformation of population density is a better measure of attributive homogeneity in derived regions than density itself, and produces two regions of nearly identical area size and greater contrast in population. Specifically, the revised Hu Line by Hu Huanyong in 1990 had the southeast region with 94.4% of total population and 42.9% of total land, and our delineation line yields a southeast region with 97.4% population and 50.8% land. Therefore, the population density ratio of the two regions is 27.1 by our line, much higher than the ratio of 22.4 by the Hu Line, and thus outperforms the Hu Line in deriving regions of maximum density contrast with comparable area size. Furthermore, more regions are delineated to further advance our understanding of population distribution disparity in China.

PHYSICAL STRUCTURE OF GEOGRAPHICAL ENVIRONMENT-INTEGRITY AND DISPARITY,GENERALITY AND INDIVIDUALITY

Integrity and disparity are two of the basic characteristics implied in the scientific connotation of the physical environment as a material system. From a dialectical materialistic point of view the physical character of geographical environment of the earth surface is the unity in diversity. It is on such grounds that the two basic characteristics were put forth by the author in his monograph 'Physical Structure of South American Geographical Environment' as the underlying theme. This holds true for the hierarchy of physical regions. For instance, the physical environment of the earth surface in unity behaves as a huge whole, yet, in differentiation into continents, it displays disparity; each continent differs from others and becomes an integrity in its own right. The same is true of regions of lower levels. In the case of generality and individuality of regional types and their constituent distributive areas in different continents, the same relationship exists among them. Owing to similar origin

Molecular mechanisms of gender disparity in hepatitis B virus-associated hepatocellular carcinoma

Chronic hepatitis B virus(HBV)infection is one of the most common causes of hepatocellular carcinoma(HCC),a malignant tumor with high mortality worldwide.One remarkable clinical feature of HBVrelated HCC is that its incidence is higher in males and postmenopausal females compared to other females.Increasing evidence indicates that HBV-associated HCC may involve gender disparity and that it may be a type of hormone-responsive malignant tumor.Sex hormones,such as androgen and estrogen,have been shown to play very different roles in the progression of an HBV infection and in the development of HBVrelated HCC.Through binding to their specific cellular receptors and affecting the corresponding signaling pathways,sex hormones can regulate the transactivation of HBx,cause the chronic release of inflammatory cytokines in the hepatocellular microenvironment,and participate in epigenetic and genetic alternations in hepatocytes.All of these functions may be related to the initiation and progression of HBV-associated HCC.A thorough investigation of the molecular mechanisms underlying the gender-related disparity in HBV-related HCC should provide a new perspective for better understanding its pathogenesis and exploring more effective methods for the prevention and treatment of this disease.