A critical predictor of adult wellness is one's childhood experience, a period mythologized as happy but fraught with hazards. Unfortunately, America has a culture of child abuse - emotional, sexual, and physical. It creates generational illness by not addressing this problem. This investigation will review research on childhood sexual abuse and its impact on female victims.
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Nearly one in three women were sexually abused as minors, an incredible statistic indicating a sick society in need of fundamental reform.

Child sexual abuse is common, severe, is reported rarely, and the victims usually know their abuser. Preadolescent girls are at the most significant risk.

According to the American Psychological Association, sexual abuse is 'an undesired sexual activity, with perpetrators using force, making threats or taking advantage of victims not able to give consent.'

Sexual abuse takes different forms, such as fondling or sucking of sexual body parts, forced sexual intercourse, indecent exposure, and both oral sex and bodily penetration. Force includes coercion, manipulation, and threats where a person cannot consent.

Nearly one woman in three reported sexual abuse before the age of 16 years in the United States:

• A substantial number of these incidents (70%) involved genital contact or more severe abuse, and 12% of the victims were imperiled by sexual intercourse.
• The victims usually knew their abusers, with family members in 38% of cases and acquaintances in another 46%.
• Strangers accounted for 15% of all abuse experiences.
• Most of the abusers were young men.
•  Reporting of the abuse was infrequent, and only about 7% of all abuse was ever officially reported.

What the failure to report means is societal pressure using shame creates a perfect environment for serial predators,  thereby creating even more preventable injuries. 
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Major depressive disorders are affected by hereditary, environmental, and dispositional factors. For example, both routine life stressors and those linked plainly with abuse have long been considered leading contributors to the onset of depression, in which severe depression is strongly related to sexual, emotional, and physical abuse. 

Women tend to reveal more long-term changes in stress reactivity compared to males, which may be the reason for increased depression in females. Medical professionals diagnose women with depression twice as often as men, and are more likely to have suffered some form of abuse as a child. The proportion of women who faced depression during their lifespan was the highest among those who were victims of abuse.

Women who have experienced abuse or other types of trauma are more likely to develop a variety of different mental health illnesses. Males and females respond to sexual abuse differently.  Men tend to express their negatively charged sentiments, which can explain the high prevalence of hostility and outward-facing antisocial behavior. Women tend to turn their self-loathing inwards, with corrosive, life-altering results, anxious, distrusting, and carrying what they consider to be a shameful secret in their being.

Abuse revises how people identify themselves and the world around them, with prevalent adverse effects on self-esteem, physical and mental development, and social relationships.

Physical abuse occurs within a web of connected conducts, including authoritarian control, anxiety-provoking behavior, and bodily injuries or discomfort that is perpetrated by any person close to the victim. A meta-analysis with a total of over nine million participants found the global prevalence of childhood physical abuse to be 18%, with a material difference between studies based on the judgment of professionals relative to self-reported studies (0.3% vs. 22%, respectively). This points to the underdiagnosis of physical abuse, an immense problem.

Psychological abuse is behavior intended to undermine a person's well-being or self-esteem. The outcomes of psychological abuse differ depending on the circumstances and the age of the victim. In general, like other types of abuse, it is intentional behavior to convey to the victim that they have no merit (i.e., they are worthless or unwanted) or that something is wrong with them. Emotional abuse includes acts that disturb the emotional health of the individual. Such acts include restricting a person's movements, stigmatization, mockery, intimidation and bullying, prejudice, rejection, and other nonphysical forms of antagonistic action. Emotional abuse can represent an ongoing pattern of behavior occurring across many different situations or be limited to or triggered by a specific problem. It is the least registered type of abuse, and its occurrence is challenging to estimate. 

Studies that have examined the effects of multiple types of abuse have shown childhood emotional abuse to be more significantly linked to depression compared to sexual and physical abuse.

The anguished experiences of abuse can also affect mood regulation as the fundamental violations that live inside the person, often unreconciled and aching, can prompt uneven, difficult to understand, and unusual responses. Rumination and behavioral avoidance are both associated with emotional abuse during childhood and are strongly related to depression.

Experiences of early emotional abuse may be particularly damaging since primary attachment figures are often the source, lending credibility to irrational criticisms. These experiences increase attachment insecurity, avoidance, and isolation, which also play a significant role in the development of depression.

Victims of abuse often are unable to shake their anger, fear, shame, and guilt. Frequently, they attempt to cope by inhibiting all of these emotions. For example, a person who has difficulties revealing the concealed pain that resulted from abuse may also be unable to effectively understand and deal with their depression, concealing the history from therapists and resulting in poorer treatment and recovery outcomes.

The fracture that childhood abuse causes distances the victims from all of humanity, often condemning them to a tortured and lonely life.  The injury is more than a temporal injury, never forgotten, often simply buried, creeping out in inappropriate ways that further distance the victim from other people, and a joyful life.

Is there an answer to helping these victims? Visibility would help as often these people feel they are alone, and somehow they encouraged or caused the abuse. They were actually raped and had no guilt in the foul crime perpetrated on them. If they understood the frequency of this horror, perhaps they would feel more comfortable seeking treatment and opening up about their predicament.
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Creating a more open societal concept about the frequency of abuse could encourage victims to come forward, and aggressive enforcement of existing laws could help jail predators, interrupting serial abuse and reducing harm. Enforcement, interdiction, jail time, and treatment all would help change the story arc associated with this societal illness.

​Since the dawn of consciousness, humans have been searching for magical compounds and techniques to extend what can never be replaced - a person’s time on this planet. Many techniques, such as extended fasting, vitamin supplementation, exercise, and now pharmaceutical compounds, are tools to extend life, both lifespan and quality of life. One of these, rapamycin, has hit the mainstream, and doctors routinely prescribe it as a longevity drug despite incomplete evidence of its efficacy.

Human life expectancy constantly rises, and the median lifespan increases, but the maximum lifespan does not. Although the number of centenarians (100 or older) doubles every ten years, maximum longevity remains the same. The longest-living person died in 1997 at 122; this record has not been beaten.
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Researchers first isolated rapamycin from soil samples collected from Easter Island in the 1960s. This exciting find contained streptomyces hygroscopicus, a bacteria native to the island. Realizing that streptomyces hygroscopicus produced a compound that could kill fungi, they named it rapamycin after the island, Rapa Nui. 

When scientists discovered rapamycin inhibited the growth of eukaryote cells, research on rapamycin turned to rapamycin’s immunosuppressive and anticancer properties. A eukaryote is any cell or organism that possesses a clearly defined nucleus. 

The United States Food and Drug Administration (FDA) approved rapamycin in 1994 to help prevent organ rejection in liver transplant patients, marking a significant milestone in organ transplantation. Rapamycin is also used to avoid restenosis after coronary angioplasty, and it is being tested in many clinical trials as an antitumor agent. That research paid off when the FDA approved the use of rapamycin for treating pancreatic cancer patients in 2011.

In 1994, several scientists independently discovered several aspects of rapamycin’s mechanism of action. When rapamycin crosses a cell membrane and enters a cell, it binds with an enzyme named mTOR, the mechanistic target of rapamycin. In doing so, rapamycin partially inhibits mTOR activity, which enables the activation of autophagy. Rebalancing the mTOR/autophagy ratio may result in extraordinary vigor upgrades and pause aging initiation.
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In 2009, researchers found rapamycin could increase the lifespan of mice when administered later in life. This was the first evidence that a pharmacologic agent could lengthen life. Since then, there has been a surge in research investigating the effects of rapamycin on various diseases, biological functions, and organic processes in mice. However, the importance of further human studies to validate these effects cannot be overstated, underscoring the urgency and importance of our continued exploration in this promising field.   

Popular theory considers pharmaceuticals as the primary means of delaying aging. Over the past decades, various anti-aging drugs, such as the mTOR inhibitor rapamycin; antioxidants such as resveratrol, melatonin, and coenzyme Q10 (CoQ10); and especially senolytics such as dasatinib and quercetin (D + Q) or fisetin, have shown promising effects on longevity by targeting mTOR, mitochondrial and oxidative stress, and cellular senescence.  

When nutrients are available to a cell, mTOR initiates signals that activate cell metabolism, telling the cell to use the available nutrients to build new proteins, enzymes, and other cell components. mTOR is a crucial sensor of nutrient availability. When nutrients are available, mTOR activates cell anabolic (building) growth and proliferation processes.

Autophagy is a process within all cells that counterbalances mTOR’s activities. It occurs when the body breaks down damaged proteins, enzymes, and other cell components for reuse or elimination.

Most cells contain hundreds of mTOR sites. When a person takes rapamycin, it enters cells and binds to some mTOR sites. This results in partial inhibition of mTOR and the activation of autophagy, which promotes a wide range of health benefits in people constantly over-activating mTOR (most people).

Inhibiting mTOR and activating autophagy allows all cells in the body to detoxify more effectively and undergo regeneration and restoration. Results from animal models suggest that partially inhibiting mTOR with rapamycin might improve symptoms of continuing progressive diseases. This category includes metabolic syndrome and Type 2 diabetes, inflammatory conditions like arthritis and lupus, nerve ailments such as Parkinson’s and multiple sclerosis, macular degeneration, glaucoma, obesity, hearing loss, periodontal disease, cognitive decline, and Alzheimer’s disease.

Obesity is an escalating global health crisis with direct links to metabolic syndrome and cardiovascular disease. Because rapamycin inhibits mTOR, it mimics calorie restriction. In animal studies, rapamycin therapy decreases appetite and reduces body weight and fat mass.  Based on these results, rapamycin might be a potential tool for obesity treatment.
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Proponents point to rapamycin's benign side effect profile, which includes a variety of conditions like many other drugs. As physicians use the drug for various situations, including mitigating transplant rejection, scientists have closely defined these side effects, providing a risk profile for examination by physicians and potential users of the drug.  

It is almost certain that the FDA will never approve rapamycin for longevity. The agency doesn’t categorize aging as a disease, plus rapamycin’s generic status means there’s little financial incentive to run expensive clinical trials for aging or similar ailments.

Living a healthy and long life is achievable, provided genetic medical conditions are manageable and lifestyle conditions are healthy and supportive of such ambitions. The mix includes emotional wellness, sleep, exercise, diet, and environmental factors. Pills alone may support this endeavor, but they are in no way a magic bullet. Instead, they could help boost health and longevity.
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Unfortunately, the science about the efficacy and risks of longevity compounds, including rapamycin, is murky and unlikely to be resolved soon. Still, the temptation exists, particularly for older people who don’t wish to wait and choose to be their laboratory rat.  

Alcoholism, sometimes denoted as Alcohol Use Disorder, has been a curse on humanity since they created refined alcohol.  Alcoholism provides a binary choice: abstinence or a progressive march to death due to systemic poisoning and the resultant destruction of critical organs.   Alcoholism has ineffective treatments, and the syndrome affects as much as 11.2 % of the adult American populace. 
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Likely, alcoholism is a complex mix of genetic factors and trauma.  While alcoholics and other addicts do severe damage to families and friends, they are still human beings and deserve treatment and respect as such.  

The first step significant clinical consequence of alcoholism is cirrhosis. Cirrhosis is permanent scarring and damage to the liver, trading healthy tissue with scar tissue that prevents the liver from acting conventionally. The scar tissue can also partially block blood flow through the liver, and cirrhosis worsens, causing a condition known as portal hypertension.

Cirrhosis and portal hypertension are the commanding origins of ascites, accounting for about 80% of cases in Western countries.    That's when long-term alcohol abuse causes scarring of the liver tissues, which obstructs blood flow through the portal vein running through the liver.
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Clinical outlooks for liver cirrhosis have two phases: the symptomless stage, also named 'compensated cirrhosis,' and the phase of problems due to the advance of portal hypertension and liver dysfunction, also called 'decompensated cirrhosis,' where patients may develop ascites, the most frequent complication from liver cirrhosis.

When fluid from these enlarged veins leaks into the abdomen, it builds up inside the peritoneal cavity, causing ascites. Ascites cause uncomfortable swelling in the abdomen and can affect appetite and digestion. In severe cases, it extends into the chest cavity and interferes with breathing. It's also a risk factor for infection in the peritoneal cavity, resulting in peritonitis.
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The march towards ascites is straightforward.  A heavy drinker damages their liver through years of heavy drinking; scar tissue stiffens the organ, and then they develop uncomplicated ascites. Hepatic decompensation, defined by ascites, hepatic encephalopathy, and portal hypertensive gastrointestinal bleeding, is an essential landmark in the natural history of cirrhosis. 

Even patients who are ambulatory and have cirrhotic ascites have a 3-year mortality rate of 50%. Patients with refractory ascites have a 1-year survival of less than 50%. 
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A silent path characterizes the natural history of cirrhosis until decompensation when the progressive deterioration of liver function causes a rapid decline in life expectancy. The disease's early stage is 'compensated cirrhosis.' At the same time, the late one, defined by the appearance of ascites, bleeding, brain disease, or jaundice, is 'decompensated cirrhosis.' Due to the strikingly different survival rates, compensated and decompensated cirrhosis are considered two distinct clinical entities.

Management of Uncomplicated Ascites:

• Reducing dietary salt intake and increasing renal sodium excretion are the initial cornerstones of ascites management.
• Diuretics are used as symptomatic treatments, not affecting the general course of the disease, since they act downstream in the pathophysiological cascade.
• Large volume paracentesis (LVP) is the treatment of choice due to its effectiveness and low rate of complications.  LVP requires inserting a needle in the patient's abdomen and drawing excess fluid from the cavity, alleviating the pressure on the patient's body.
• All patients with cirrhosis should be evaluated for liver transplantation, as that is the only cure.

Refractory ascites (RA) is the term for a patient's progressive lack of response to diuretic therapy (diuretic-resistant RA).
Management of Refractory Ascites

• RA dramatically worsens patients' prognosis, reducing the median survival to about six months.
• Periodic execution of LVPs is agreed to be the treatment of choice for patients with RA.
• In a meta-analysis of randomized controlled trials, human albumin solution (HAS) was shown to reduce the risk of mortality compared to other strategies in patients undergoing LVP.
• Diuretic therapy is either reduced or withdrawn due to the high risk of diuretic-related complications.
• Trans-jugular intra-hepatic portosystemic shunts (TIPS) can address portal hypertension, a critical factor in decompensated cirrhosis. TIPS consists of creating an artificial shunt between the portal and hepatic vein, thus decreasing portal hypertension.
• A dreaded complication of advanced liver disease is hepatorenal syndrome (HRS). In its most lethal form (type I), there is a relentless deterioration of renal function, reflected in soaring creatinine and BUN, resulting in death. This syndrome always occurs with ascites.
• Liver replacement is the best treatment option because it is associated with 2-year survival rates of almost 85%.

Abdominal wall and inguinal hernias are common in patients with cirrhosis and ascites because of the incredible abdominal pressure from fluid buildup. Umbilical hernias grow in about 20% of patients with cirrhosis.  Increased abdominal pressure from ascites, weakened abdominal muscles, and poor nutrition can rapidly enlarge hernias.

​Bacterial infections are present in approximately one-third of patients with cirrhosis who are hospitalized, a much higher prevalence than in those without cirrhosis.   A familiar yet unique type of infection in this setting is infections that occur without an obvious source of infection. Bacterial translocation, the migration of bacteria from the gut to the bloodstream and other extraintestinal sites, and decreased host defenses have been implicated in the pathogenesis of these spontaneous infections.  Other common infections in cirrhosis are urinary tract infections, pneumonia, and soft tissue.

Liver replacement is the best treatment for cirrhosis and cirrhotic ascites. Experts have different opinions about the referral timing, but physicians should contemplate it when a cirrhotic patient first presents with difficulty from cirrhosis, such as ascites. Because refractory ascites portends imminent death, time is critical.
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Alcoholism offers a mortal choice to those afflicted – quit drinking or die a miserable death at a young age.  As it results from a complicated array of factors and is incredibly difficult to treat, it seems sad for humanity.  Despite that, formal education about the consequences and other public health measures are essential to implement and would result in significant positive outcomes.

Ultra-processed foods (UPFs), deceptively designed to be hyper-palatable, pose a significant threat to our health. Many of these products, due to their cunningly addictive potential, can hijack our neuronal mechanisms, making them difficult to resist.
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One can find UPFs in the center aisles of grocery stores, which charge vendors fees for shelf space. Crowding on those shelves are thousands of different concoctions fraudulently presenting themselves as food stuffed with chemicals and sugars, the stuff of slow suicide, and the path toward obesity and its sister ailments.

Over 60 percent of caloric intake in the United States is from UPFs, a staggering statistic that should raise concern. These products are industrially processed substances (oils, fats, sugars, starch, and protein isolates) extracted or refined from whole foods. They contain little or no whole food and typically include flavorings, colorings, emulsifiers, and other cosmetic additives.

This extreme processing creates foods so effortlessly absorbed by the body that they’re effectively predigested. Specialists claim food companies design these to overcome our satiety mechanisms, which pilot people to overindulge and gain weight.

Ultra-processing degrades the internal structure or ‘food matrix,’ the intricate core structures that not only hold the raw materials together but influence the bioavailability of the nutrients, how our bodies use the food, and whether we feel full after eating it.
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Most ultra-processed products are poor in protein and micronutrients and can potentially supersede nutrient-dense, unprocessed, or minimally processed foods. This displacement could lead to a low protein and micronutrient intake during critical periods of growth and development. 

​Studies confirm the harmful health effects of UPFs:

• High consumption of ultra-processed foods is associated with cardiovascular and heart disease mortality risks. Evidence suggests these harmful associations may be more pronounced in women. 
• UPF consumption appears to cause changes in the gut microbiota composition related to the development of neurodegenerative diseases.
• There appear to be risk associations between the consumption of ultra-processed foods and the development of Alzheimer’s disease.
• Overall, the proportion of calories in youths’ diets from ultra-processed foods rose between 1999 and 2018, from about 61% to 67%. However, with the right interventions, the proportion of whole, unprocessed foods could be increased, potentially reversing this trend and bringing about a healthier future.
• In this large cross-sectional study, researchers positively associated UPF consumption with high fasting plasma glucose levels, elevated BMI, waist circumference, and fat mass index and inversely associated with HDL cholesterol concentration. 
• These findings suggest that high UPF consumption in young children is associated with obesity and other cardiometabolic risk factors, highlighting the need for public health initiatives to promote the replacement of UPFs with unprocessed or minimally processed foods.
• Consumption of UPFs was associated with increased risk of overweight, obesity, abdominal obesity, all-cause mortality, metabolic syndrome, and depression in adults, as well as wheezing but not asthma in adolescents.
• In addition, consumption of ultra-processed food was associated with cardiometabolic diseases, frailty, irritable bowel syndrome, functional dyspepsia, and cancer (breast and overall) in adults while also being associated with metabolic syndrome in adolescents and dyslipidemia in children. 
• Findings suggest that frequent UPF intake during early childhood may be linked to stunted growth, indicating that the displacement of whole food results in malnutrition.
• Greater ultra-processed food consumption was cross-sectionally associated with increased odds of depressive and anxiety symptoms.
• Furthermore, a meta-analysis of prospective studies demonstrated that greater ultra-processed food intake was associated with an increased risk of subsequent depression.
• Ultra-processed food consumption was associated with increased body fat from childhood to early adolescence, and this association was not just because of ultra-processed food on calorie content.
• Maternal consumption of ultra-processed food during the child-rearing period not only increases the risk of overweight or obesity in offspring but also does so independently of other lifestyle risk factors. This underscores the severe and long-term health implications of these dietary choices, urging us to act and make healthier food choices. 

UPFs are manufactured via industrial processes, requiring large plants that cost a lot of money and are exclusively owned and run by large corporations. There’s gold in those center aisles, and these enormous corporations present calorie-dense, sweet, and salty foods that are impossible to resist.
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As the feedstocks for these ersatz foods are cheap and vendors sell many units of each, large corporations accrue huge profits and can sell their products at a lower price point than whole foods, thereby capturing the low-income market. Additionally, these food surrogates have exceptionally long shelf lives, as they only resemble food and are resistant to spoiling and decay.

One of the most significant issues with UPFs is their ubiquitous added sugar, which manufacturers use as a flavor enhancer, flavor, and browning agent. Sugars turn brown with heat, providing a desirable visual hue to baked goods like bread and buns. Epidemiological data imply that the prevalence of metabolic conditions, such as obesity, nonalcoholic fatty liver disease, cardiovascular disease, and diabetes, has heightened due to the excess consumption of these sugars.

High fructose corn syrup (HFCS) is cheaper than other types of sugar and is made in America. Corn is the biggest crop in the United States; we grow it far more than any other country. In 2021, American farmers produced 15.1 billion bushels, and the process is mechanized and efficient. Since the middle of the 20th century, mechanization, advances in agrichemicals (both fertilizers and pesticides), and genetic modification of crops have increased yields dramatically.
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The United States government is complicit in the UPF boom, as it encourages farmers to grow immense amounts of corn through subsidies, helping ensure that prices stay low and production stays high, making HFCS artificially cheap. In addition to annual crop insurance coverage, farmers can obtain commodity payments for growing corn (and other crops like soybeans, wheat, and cotton). In 2019, the federal government dispersed more than $2.7 billion in free funding to corn growers. This influences a system that creates a load of cheap corn ready for processing. 
 
The United States uses about one-third of its corn grown for animal feed, with another one-third to produce ethanol. The rest enters the food supply, much of it in the form of HFCS, which is more sugar for an already sick and overfed population.
 
American adults now consume an average of almost twenty teaspoons of sugar daily, about sixty pounds of added sugar per year. Humans never encountered significant amounts of sugar in the natural world during their evolution, and thus, we couldn’t adapt to process them, so the sugar load shows in the health effects of this extreme consumption.
 
Are there solutions? Of course, there are, but aside from education, much more is hopeless in the current business-friendly American political environment. One can envision an American population continuing to struggle, with public health continuing to deteriorate.
 
Pursuing a similar approach to a contemporary public health problem, smoking, would likely work. Sin taxes to raise the costs of these phony foods would raise the prices higher than whole foods, which would steer consumers to whole foods. Requiring warning labels on these products, like warnings on cigarette packs, would be prudent.