Sex Differences Research Articles

Sex differences of visceral fat with cardiac structure and function in type 2 diabetes: A cross-sectional study.

The aim of this study is to analyze the associations among fat distribution, left ventricular (LV) structure, and function in T2DM patients and further assess the sex differences among them. Two thousand and one hundred seven T2DM patients were enrolled to this study. Patients' height, weight, BMI, visceral fat area (VFA), baPWV, parameters of cardiac structure and function, and clinical biochemical indicators were measured and collected. There were significant differences between male and female T2DM patients in age, duration of diabetes, complication ratio of hypertension and dyslipidemia, smoking history, visceral fat, baPWV, and ventricular structure and function (p < 0.05). Compared with the Q1 group, female patients in the highest quartile (Q4) of VFA had a decreased LVEF and significantly increased baPWV (p < 0.05), whereas no such changes were found in males. The correlation analysis showed that LVEF in male patients was negatively correlated with hypertension history, using of CCBs, GLP-1RA, lipid-lowering medications, BMI, WC, WHR, FPG, FC-P, HbA1c, GA, HOMA-IR, Cr, and baPWV, while the LVEF in female patients was negatively correlated with VFA, VSR, VFA/BMI, VFA/H2, VFA/weight in females (p < 0.05). LVMI was positively associated with diabetes duration, age, hypertension history, WC, WHR, VFA, SFA, VFA/BMI, VFA/H2, VFA/weight, and baPWV in both males and females. Multivariable-adjusted linear regression analysis showed that VFA was independently associated with LVEF (β = - 0.096, p = 0.010), LVMI (β = 0.083, p = 0.038), and baPWV (β = 0.120, p = 0.003) in females. Values of VFA were independently associated with LVEF, LVMI, and baPWV in women, but not in men, in patients with T2DM.

The association of higher offspring early-childhood weight gain with prepregnancy metabolic and bariatric surgery.

The objective of this study was to assess maternal gestational outcomes and offspring growth trajectories following prepregnancy metabolic and bariatric surgery (MBS) compared with non-MBS controls. Single-center deliveries between January 2020 and March 2023 with prepregnancy Roux-en-Y gastric bypass (herein referred to as "bypass"), sleeve gastrectomy (herein referred to as "sleeve"), and non-MBS controls were included. Offspring growth trajectories were compared with the World Health Organization child growth standards. Linear mixed models assessed MBS-bypass and MBS-sleeve offspring weight, length, and BMI trajectories with a prepregnancy BMI 27 to 37 kg/m2 and propensity score-matched controls. The study included 440 participants with prepregnancy MBS (MBS-bypass, 185; MBS-sleeve, 225; 76% Hispanic/Latino) and 13,434 non-MBS controls. Gestational weight gain and gestational diabetes mellitus were similar, whereas hypertensive disorders of pregnancy were more common after MBS. The post-MBS offspring had lower birth weight but higher weight gain at 24 months (sleeve, +1.4 kg [95% CI: 1.0-1.9]; bypass, +0.5-0.7 kg [95% CI: 0.0-1.2]) compared with non-MBS groups. Male children had higher weight gain than females. The post-MBS-sleeve but not the post-MBS-bypass offspring had higher BMI z scores. The higher early-life weight gain and sex differences in the post-MBS-sleeve group compared with the post-MBS-bypass group provide a window toward elucidating pathways to mitigate intergenerational metabolic risk transfer.

Multiple recommended health behaviors among medical students in Western Canada: a descriptive study of self-reported knowledge, adherence, barriers, and time use

BackgroundGeneral medical practitioners are responsible for promoting and prescribing lifestyle modification and serve as role models for healthy behaviors. We aimed to assess self-reported knowledge, adherence, barriers and time spent on all recommended health behaviors among medical students.MethodsA cross-sectional online survey of eight behavioral domains among undergraduate medical students in The University of British Columbia, Canada, was analysed using descriptive statistics and visual display.ResultsBetween March and April 2023, 137 medical students participated in the survey (74% female). Over 80% had knowledge of five health behavior recommendations, but lacked knowledge of specific dietary recommendations in particular. Over 60% reported meeting guideline-recommended levels for tobacco, weekly alcohol, daily alcohol (females only), and physical activity (males only). Large gaps existed between knowledge and adherence for physical activity, sleep, sedentariness, screen time, and dietary recommendations. Sex differences in knowledge and adherence to recommended health behaviors were identified. Time spent on wellness focused on sleep (47–49 h/week), diet (9.6 h/week), exercise (5.8 h/week), and hobbies (6.1 h/week). Forgetting recommendations (69% of females, 71% of males), and lack of time (72% of females, 52% of males) were principal barriers to knowledge and adherence.ConclusionMost medical students in Western Canada reported not meeting multiple recommended health behaviors. Time was the largest barrier to adherence and free time was spent on sleep. Medical education may require protected time and dedicated content for health behaviors to ensure future physicians can be role models of health promotion for patients.

Sex difference in the relationship between environmental unpredictability and depressive symptom in Chinese adolescents: The chain mediating role of sense of control and fast life history strategies.

Adolescents are at a high risk of depressive symptom. A substantial body of literature indicates that early environmental unpredictability (EU) significantly affects the likelihood of developing depressive symptom. However, only a few studies have focused on the mediating mechanisms underlying this relationship. Based on life history (LH) theory and the adaptive calibration model, this study constructed a chain-mediating model to examine whether the association between EU and depressive symptom among Chinese adolescents is mediated by sense of control and fast life history strategies. In total, 1838 Chinese adolescents (47.8% women, mean age=13.17±0.99years) participated in this study and responded to self-report measures of EU, fast LH strategies, sense of control, and depressive symptom. (1) There were significant correlations between EU, sense of control, fast LH strategies, and depressive symptom. (2) After controlling for the effects of sex, age and socioeconomic status, EU still had a significant positive effect on depressive symptom. (3) Adolescent depressive symptom was partly influenced by EU through three different pathways: the mediating role of sense of control, the mediating role of fast LH strategies, and the chain-mediating role of both sense of control and fast LH strategies. (4) There are significant gender differences in the above chain mediation models. The analysis is cross-sectional, which limits causal inference. These findings contribute to a more comprehensive understanding of risk factors for adolescent depressive symptom. The chain-mediating effect of a sense of control and fast LH strategies plays an important role in the occurrence of depressive symptom.

Genetic associations of metabolic factors and therapeutic drug targets with polycystic ovary syndrome

IntroductionPolycystic ovary syndrome (PCOS) is frequently accompanied with metabolic dysfunctions, yet the causal relationships between metabolic factors and PCOS remain to be conclusively established and etiology-based therapies are lacking. ObjectivesTo comprehensively identify the metabolic causal factors and potential drug targets for PCOS. MethodsThis genetic association study was conducted using bidirectional two-sample Mendelian Randomization (MR), multivariable MR (MVMR) and drug-target MR. Considering metabolic sexual dimorphism, female-specific genome-wide association studies (GWASs) for metabolic factors were obtained. To ensure the robustness of the findings, an additional independent PCOS GWAS dataset was utilized for replication. ResultsThe PCOS cohort included 10,074 PCOS cases (mean age 28 to 45 years) and 103,164 controls (mean age 27 to 60 years) of European ancestry. All participants were female. Employing two-sample MR analysis, we found that genetically proxied body mass index (BMI) (OR = 3.40 [95 % CI, 2.65–4.36]), triglyceride (TG) (OR = 1.54 [95 % CI, 1.17–2.04]), low-density lipoprotein cholesterol (LDL-c) (OR = 1.37 [95 % CI, 1.07–1.76]), and type 2 diabetes (T2D) (OR = 1.24 [95 % CI, 1.09–1.41]) were significantly associated with an increased risk of PCOS, whereas genetically predicted high-density lipoprotein cholesterol (HDL-c) (OR = 0.61 [95 % CI, 0.47–0.80]) decreased the odds of PCOS. Stepwise MVMR established a hierarchy of interactions among these metabolic factors, identifying BMI and HDL-c as the most prominent causal factors. Notably, drug-target MR analysis identified incretin-based therapeutics, PCSK9 inhibitors, LPL gene therapy, sulfonylureas, and thiazolidinediones as potential therapeutics for PCOS. All these findings were validated in an independent dataset. ConclusionThis study offered insights into the roles of obesity, diabetes, and dyslipidemia in PCOS etiology and therapeutics, underscoring the necessity for managing metabolic health in women and paving the way for tailored therapeutic strategies for PCOS based on its metabolic underpinnings.

The largest to the south? Assessment of the latitudinal variation in Mustelus schmitti (Chondrichthyes: Carcharhiniforms: Triakidae), an endemic coastal shark of the Southwest Atlantic Ocean

Abstract Relative growth and life history traits along latitudinal gradients have been widely examined in bony fishes, but chondrichthyans have received less attention. The present work focuses on testing whether southern distributed individuals of Mustelus schmitti sharks are larger and will mature at larger sizes than northern distributed individuals. We also show that intraspecific variation follows the latitudinal pattern and that body shape proportions are not altered by latitudinal distribution. The specimens come from two areas 1200 km apart [Puerto Quequén (PQ) and Ria Deseado (Deseado estuary) (PD)], which implies 9 degrees of latitudinal difference. For PQ, four allometric variables related to the trunk of the body showed secondary sexual dimorphism, while for PD this dimorphism was observed in a single variable. The females of PQ presented with a higher relative growth of the trunk than the females of PD. Males, by contrast, did not present a characteristic growth pattern that could differentiate specimens between the two areas. Specimens of both sexes in PD reached a larger average total length at first maturity (P &amp;lt; .05) than those in PQ.

Evaluations of Morphometric Traits and Body Conformation Indices of Horse Ecotypes Reared in the Highlands of Bale Eco-Region, Ethiopia.

Morphometric traits discrepancies are associated with production, reproduction, adaptation and behaviours in horses. It also determines the design of harnessing implements, physical injury level and working performance of the native horses. Thus, the study was conducted to evaluate morphometric traits and body conformation indices of horse ecotypes reared across four districts of Bale Zone, Ethiopia. Data of croup height, croup length, hip height, mid-back height, wither height, hip width, thoracic depth, chest width, body length, sternum height, thorax perimeter and cannon perimeter were measured in 500 horses (294 male and 206 female). Using those traits, 17 body conformation indices were calculated to define the horses for multi-faceted performances. The study revealed that croup height, hip height, wither height, hip width, croup length, body length, thorax perimeter and sternum height were significantly (p < 0.0001) different among the studied districts. The district effect was also significant at p < 0.05 for mid-back height, thoracic depth, chest width and cannon perimeter. The sexual dimorphism effect was statistically significant for all measured traits; however, females were inferior to males except for cannon perimeter. Body conformation indices of pelvic index, body index, transversal pelvic index and weight were highly significant (p < 0.0001) among the studied districts. The sex dimorphism effect was significant (p < 0.001) for dactyl-costal index, pelvic index, longitudinal pelvic index, transversal pelvic index, weight, tare index 1 (trot or gallop), tare index 2 (walk) and riding comfort degree, while non-significant (p > 0.05) for the remaining indices. The studied horses were classified as mediline, elipometric, light, small and suitable riding ecotypes with a medium-conforming body structure and good capacity for carrying loads on carts and backs for functional effectiveness. The correlations of body conformation indices ranged from very high to low, with positive and negative associations for functional capabilities. Therefore, selection for improvement needs to rank morphometric traits and body conformation indices in correlation to developing racing and modern sport horses in the highlands of the Bale eco-regions. Further, molecular studies will be essential to determine whether the predominated phenotypic multiplicity is genetic or environmentally progressed.

Heart Rate and Its Variability Are Associated With Resting Metabolic Rate and Substrate Oxidation in Young Women but Not in Men.

This study aims to examine the relationship between resting vagal-related heart rate variability (HRV) parameters and heart rate (HR) with resting metabolic rate (RMR) and respiratory exchange ratio (RER) in young adults. A total of 74 young adults (22 ± 2 years old, 51 women) were included in this cross-sectional study. HRV was assessed using a HR monitor, whereas RMR and RER were determined by indirect calorimetry. Linear regression analyses showed a positive association between HR and RER in women (standardized β = 0.384, p = 0.008), while negative associations were observed between vagal-related HRV parameters and RER in women (β ranged from -0.262 to -0.254, all p ≤ 0.042). No significant association was found between the abovementioned physiological parameters in men. Here, we show that HR is positively associated with RER in young women but not in men, while vagal-related HRV parameters are inversely related to RMR, therefore suggesting a potential sexual dimorphism between cardiac rhythm and its relationship with markers of cardiometabolic health status. ClinicalTrials.gov identifier: NCT02365129.

Longitudinal Associations Between Physical Health Conditions in Childhood and Attention-Deficit/Hyperactivity Disorder Symptoms at Age 17

ADHD is associated with lower birth weight, but also with obesity in childhood. Findings on the direction of this association are mixed. This study investigated the relationship between weight and ADHD from birth across development. We used data from the Millennium Cohort Study (MCS), collected at seven time points between 9 months and 17 years. ADHD diagnosis status and scores on the Strength and Difficulties Questionnaire (SDQ) were used to create an ADHD group and a control group. Random intercept cross-lagged panel models were conducted in females (N=4051) and males (N=3857) to examine bidirectional associations between BMI z-scores and SDQ scores between ages three and 17. Analyses were adjusted for common risk factors for ADHD and obesity, such as sex assigned at birth, multiple births, and ADHD medication status. Children in the ADHD group were significantly lighter at birth than the control group (t(5674)=2.65, 95% CI [0.02, 0.14] p=.008) and significantly more likely to have obesity at age five onwards (OR range 1.57-2.46, RR range 0.98-2.29). Path analyses conducted separately for males and females showed that higher ADHD symptoms in females at ages 7, 11 and 14 significantly predicted higher BMI z-score at ages 11, 14 and 17 respectively. In males, this association was only seen between age 11 and 14 (β= 0.07; 95% CI, 0.04-0.10, p < .001). Results suggest that interventions for children with ADHD, and their parents, should begin as soon as possible, prenatally if possible. Developmental sex differences should be considered.

Cerebellar functional connectivity relates to lower urinary tract function: A 7 Tesla study.

The objective of this study is to explore the functional connectivity (FC) of the cerebellum during the storage phase of micturition, through detecting spontaneous blood-oxygen-level dependent signal between the cerebellum and different brain regions using a high-resolution 7 Tesla magnetic resonance imaging (MRI) scanner. We recruited healthy individuals with no reported history of neurological disease or lower urinary tract (LUT) symptoms. Participants were asked to drink 500 mL of water and then empty their bladders before entering the MRI scanner. They underwent a T1-weighted anatomical scan, followed by an initial (8 min) empty bladder resting state functional MRI (rs-fMRI) acquisition. Once subjects felt the desire to void, a second rs-fMRI scan was obtained, this time with a full bladder state. We established a priori cerebellar regions of interest from the literature to perform seed-to-voxel analysis using nonparametric statistics based on the Threshold Free Cluster Enhancement method and utilized a voxel threshold of p < 0.05. Twenty individuals (10 male and 10 female) with a median age of 25 years (IQR [3.5]) participated in the study. We placed 31 different 4-mm spherical seeds throughout the cerebellum and assessed their FC with the remainder of the brain. Three of these (left cerebellar tonsil, right posterolateral lobe, right posterior lobe) showed significant differences in connectivity when comparing scans conducted with a full bladder to those with an empty bladder. Additionally, we observed sex differences in FC, with connectivity being higher in women during the empty bladder condition. Our initial findings reveal, for the first time, that the connectivity of the cerebellar network is modulated by bladder filling and is associated with LUT function. Unraveling the cerebellum's role in bladder function lays the foundation for a more comprehensive understanding of urinary pathologies affecting this area.

Large-scale characterization of cocaine addiction-like behaviors reveals that escalation of intake, aversion-resistant responding, and breaking-points are highly correlated measures of the same construct.

Addiction is commonly characterized by escalation of drug intake, compulsive drug seeking, and continued use despite harmful consequences. However, the factors contributing to the transition from moderate drug use to these problematic patterns remain unclear, particularly regarding the role of sex. Many preclinical studies have been limited by small sample sizes, low genetic diversity, and restricted drug access, making it challenging to model significant levels of intoxication or dependence and translate findings to humans. To address these limitations, we characterized addiction-like behaviors in a large sample of >500 outbred heterogeneous stock (HS) rats using an extended cocaine self-administration paradigm (6 hr/daily). We analyzed individual differences in escalation of intake, progressive ratio (PR) responding, continued use despite adverse consequences (contingent foot shocks), and irritability-like behavior during withdrawal. Principal component analysis showed that escalation of intake, progressive ratio responding, and continued use despite adverse consequences loaded onto a single factor that was distinct from irritability-like behaviors. Categorizing rats into resilient, mild, moderate, and severe addiction-like phenotypes showed that females exhibited higher addiction-like behaviors, with a lower proportion of resilient individuals compared to males. These findings suggest that, in genetically diverse rats with extended drug access, escalation of intake, continued use despite adverse consequences, and PR responding are highly correlated measures of a shared underlying construct. Furthermore, our results highlight sex differences in resilience to addiction-like behaviors.

Association Between Pre-Hip Fracture Antidepressant Use and Post-Hip Fracture Length of Hospital Stay in Medicare Beneficiaries and Assessing Sex Differences

Association Between Pre-Hip Fracture Antidepressant Use and Post-Hip Fracture Length of Hospital Stay in Medicare Beneficiaries and Assessing Sex Differences

Early vascular aging in chronic kidney disease: focus on microvascular maintenance, senescence signature and potential therapeutics

Chronic kidney disease (CKD) is a strong risk factor for cardiovascular mortality and morbidity. We hypothesized that a senescent phenotype instigated by uremic toxins could account for early vascular aging (EVA) and vascular dysfunctions of microvasculature in end stage kidney disease (ESKD) patients which ultimately lead to increased cardiovascular complication. To test this hypothesis, we utilized both in vivo, and ex vivo approaches to study endothelial and smooth muscle function and structure, and characterized markers related to EVA in 82 ESKD patients (eGFR <15 ml/min) and 70 non-CKD controls. In vivo measurement revealed no major difference in endothelial function between ESKD and control group, aside from higher stiffness detected in the microcirculation of ESKD participants. In contrast, ex vivo measurements revealed a notable change in the contribution of endothelium-derived factors and increased stiffness in ESKD patients vs. controls. In support, we demonstrated that ex vivo exposure of arteries to uremic toxins such as Trimethylamine N-oxide, Phenylacetyl glutamine, or extracellular vesicles from CKD patients impaired endothelial function via diminishing the contribution of endothelium-derived relaxing factors such as nitric oxide and endothelium derived hyperpolarizing factor. Uremic arteries displayed elevated expression of senescence markers (p21CIP1, p16INK4a, and SA-β-gal), calcification marker (RUNX2), and reduced expression of Ki67, sirtuin1, Nrf2, and MHY11 markers, indicating the accumulation of senescent cells and EVA phenotype. Correspondingly, treating uremic vessel rings ex vivo with senolytic agents (Dasatinib + Quercetin) effectively reduced the senescence-associated secretory phenotype and changed the origin of extracellular vesicles. Notably, sex differences exist for certain abnormalities suggesting the importance of biological sex in the pathogenesis of vascular complications. In conclusion, the uremic microvasculature is characterized by a “senescence signature”, which may contribute to EVA and cardiovascular complications in ESKD patients and could be alleviated by treatment with senolytic agents.

Serum growth differentiation factor-15, glial fibrillary acidic protein, and neurofilament light chain: Their link and role in Creutzfeldt-Jakob disease

BackgroundCreutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative disorder characterized by neuronal damage. Emerging biomarkers, such as serum neurofilament light chain (sNfL), glial fibrillary acidic protein (sGFAP), and growth differentiation factor-15 (sGDF-15), are currently being studied for their potential use in this disease. ObjectivesThis study analyzes the levels of sNfL, sGFAP, and sGDF-15, as well as their relationships, in patients with CJD compared to healthy controls (HC). MethodsA total of 19 CJD patients and 81 age- and sex-matched HCs were enrolled. Serum levels of sNfL and sGFAP were measured using ultrasensitive immunoassays, while sGDF-15 levels were assessed via ELISA. Statistical analyses included correlation analysis and analysis of covariance (ANCOVA) models. ResultsCJD patients showed significantly higher serum levels of sNfL and sGFAP compared to HCs (p 〈0,001). sNfL levels were positively correlated with both sGFAP (Rho = 0,70; p < 0,001) and sGDF-15 (Rho = 0,60; p = 0,004). Interestingly, sGFAP levels were higher in female CJD patients compared to males (p = 0,001), while no significant difference in sNfL levels was observed between sexes. ConclusionsIn conclusion, this study explores the potential of sNfL, sGDF-15, and sGFAP as biomarkers in CJD patients. The higher levels of sNfL and sGFAP in CJD patients compared to healthy controls, along with the observed sex differences in sGFAP, highlight the need for further research into the interaction between astroglia and neurons in CJD, with a focus on sex as a key variable.

The effects of family, culture and sex on linguistic development across 20 languages.

Languages vary in their complexity; caregivers vary in the way they structure their communicative interactions with children; and boys and girls can differ in their language skills. Using a multilevel modelling approach, we explored how these factors influence the path of language acquisition for young children growing up around the world (mean age 2-years 9-months; 56 girls). Across 43 different sites, we analysed 103 mother-child pairs who spoke 3,170,633 utterances, 16,209,659 morphemes, divided across 20 different languages: Afrikaans, Catalan, Cantonese, Danish, Dutch, English, Farsi, French, German, Hebrew, Icelandic, Irish, Italian, Japanese, Mandarin, Norwegian, Portuguese, Spanish, Swedish and Turkish. Using mean length of utterance (MLU) as a measure of language complexity and developmental skill, we found that variation in children's MLU was significantly explained by (a) between-language differences; namely the rate of child MLU growth was attuned to the complexity of their mother tongue, and (b) between-mother differences; namely mothers who used higher MLUs tended to have children with higher MLUs, regardless of which language they were learning and especially in the very young (<2.5 years-old). Controlling for family and language environment, we found no evidence of MLU sex differences in child speech nor in the speech addressed to boys and girls. By modelling language as a multilevel structure with cross-cultural variation, we were able to disentangle those factors that make children's pathway to language different and those that make it alike. RESEARCH HIGHLIGHTS: The speech of 103 mother-child pairs from 20 different languages showed large variation in the path of early language development. Language, family, but not the sex of the child, accounted for a significant proportion of individual differences in child speech, especially in the very young. The rate at which children learned language was attuned to the complexity of their mother tongue, with steeper trajectories for more complex language. Results demonstrate the relative influence of culture, family, and sex in shaping the path of language acquisition for different children.

Sex dimorphism and tissue specificity of gene expression changes in aging mice

BackgroundAging is a complex process that involves all tissues in an organism and shows sex dimorphism. While transcriptional changes in aging have been well characterized, the majority of studies have focused on a single sex and sex differences in gene expression in aging are poorly understood. In this study, we explore sex dimorphism in gene expression in aging mice across three tissues.MethodsWe collected gastrocnemius muscle, liver and white adipose tissue from young (6 months, n = 14) and old (24 months, n = 14) female and male C57BL/6NIA mice and performed RNA-seq. To investigate sex dimorphism in aging, we considered two levels of comparisons: (a) differentially expressed genes between females and males in the old age group and (b) comparisons between females and males across the aging process. We utilized differential expression analysis and gene feature selection to investigate candidate genes. Gene set enrichment analysis was performed to identify candidate molecular pathways. Furthermore, we performed a co-expression network analysis and chose the gene module(s) associated with aging independent of sex or tissue-type.ResultsWe identified both tissue-specific and tissue-independent genes associated with sex dimorphism in aged mice. Unique differentially expressed genes between old males and females across tissues were mainly enriched for pathways related to specific tissue function. We found similar results when exploring sex differences in the aging process, with the exception that in the liver genes enriched for lipid metabolism and digestive system were identified in both females and males. Combining enriched pathways across analyses, we identified amino acid metabolism, digestive system, and lipid metabolism as the core mechanisms of sex dimorphism in aging. Although the vast majority of age-related genes were sex and tissue specific, we identified 127 hub genes contributing to aging independent of sex and tissue that were enriched for the immune system and signal transduction.ConclusionsThere are clear sex differences in gene expression in aging across liver, muscle and white adipose. Core pathways, including amino acid metabolism, digestive system and lipid metabolism, contribute to sex differences in aging.

Reproductive hormones and sex chromosomes drive sex differences in the sleep–wake cycle

There are well-documented gender differences in the risk and severity of sleep disorders and associated comorbidities. While fundamental sex differences in sleep regulatory mechanisms may contribute to gender disparities, biological responses to sleep loss and stress may underlie many of the risks for sleep disorders in women and men. Some of these sex differences appear to be dependent on sex chromosome complement (XX or XY) and the organizational effects of reproductive hormones. Reproductive development plays a critical role in the ability of sex chromosomes and reproductive hormones to produce sex differences in sleep and wakefulness. Rodent models reveal that reproductive hormones drive many but not all sex differences in sleep–wake architecture. The ability of reproductive hormones to alter sleep are often dependent on responses to sleep loss and stress. However, in the absence of reproductive hormones (in gonadectomized rodents) sex differences in sleep amount and the ability to recover from sleep loss persist. The suprachiasmatic nucleus (SCN) and the ventrolateral preoptic nucleus (VLPO) of the hypothalamus play crucial regulatory roles in mediating the effects of reproductive hormones on the sleep–wake cycle. Taken together, the work reviewed here reveals that the reproductive hormone environment and sex chromosome complement may underlie gender disparities in sleep patterns and the risk for sleep disorders.

Sex differences in extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: nationwide multicenter retrospective study in Japan

BackgroundPrevious studies examining sex differences in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) have indicated that women have favorable outcomes; however, detailed evidence remains lacking. We aimed to investigate sex differences in the backgrounds and outcomes of patients undergoing ECPR for OHCA.MethodsThis study was a secondary analysis of the registry from the SAVE-J II study, a retrospective multicenter study conducted in Japan from 2013 to 2018. Adult patients without external causes who underwent ECPR for OHCA were included. The primary outcome was a favorable neurological outcome (Cerebral Performance Status 1 or 2) at hospital discharge. We used multilevel logistic regression to evaluate the association of sex differences, adjusting for center-level (hospital) and individual-level variables (patient background, cardiac arrest situation, and in-hospital intervention factors). For sensitivity analyses, we performed three models of multilevel logistic regression when selecting confounders.ResultsAmong the 1819 patients, 1523 (83.7%) were men, and 296 (16.3%) were women. The median age (61.0 vs. 58.0 years), presence of a witness (78.8% vs. 79.2%), and occurrence of bystander CPR (57.5% vs. 61.6%) were similar between groups. Women were more likely to present with an initial non-shockable rhythm (31.7% vs. 49.7%), as well as a non-shockable rhythm at hospital arrival (52.1% vs. 61.5%) and at ECMO initiation (48.1% vs. 57.1%). The proportion of favorable neurological outcomes was 12.3% in males and 15.9% in females (p = 0.10). Multilevel logistic regression analysis showed that the female sex was significantly associated with a favorable neurologic outcome at discharge (adjusted odds ratio: 1.60 [95% confidence interval: 1.05–2.43]; p = 0.03). This advantage in women was consistently observed in the sensitivity analyses.ConclusionsThe female sex is significantly associated with favorable neurological outcomes at hospital discharge in patients who received ECPR for OHCA.

A new species of the Prophaethontidae (Aves, Phaethontiformes) from the early Eocene London Clay

ABSTRACT We report new specimens of the stem group phaethontiform Prophaethon from the early Eocene London Clay of Walton-on-the-Naze (Essex, UK). The two partial skeletons are distinctly smaller than a previously described record of Prophaethon from this locality, which was assigned to P. shrubsolei. Even though some extant aquatic birds show a pronounced sexual dimorphism in size, this is considered unlikely to explain the size disparity of the Prophaethon fossils from Walton-on-the-Naze and the new specimens are here described as P. waltonensis, sp. nov. The distal end of the humerus of the new species differs from that of other Phaethontiformes in the presence of a small but well-defined processus supracondylaris dorsalis. With regard to this feature, it shows a resemblance to the humerus of the Procellariiformes, which is unexpected in light of the recently proposed hypothesis that the sister taxon of the Phaethontiformes are the terrestrial Eurypygiformes. Finally, we comment on prophaethontid remains from the late Paleocene of Kazakhstan, which were assigned to the taxa Zhylgaia Nessov, 1988 and Tshulia Nessov, 1988. We synonymise the latter with the former taxon and also consider it possible that Zhylgaia Nessov, 1988 is a junior synonym of Prophaethon Andrews, 1899.

Effectiveness of cryotherapy in preventing oral mucositis in pediatric cancer patients in Jordan: a randomized controlled trial.

The study aimed to evaluate the effectiveness of cryotherapy in preventing oral mucositis in pediatric patients receiving chemotherapy. An evidence-based practice project utilized a randomized control trial design with two groups (experimental and control groups). Fifty-nine pediatric patients with cancer in Jordan, aged 8-18 years, were randomly assigned to the experimental group (n=29) or the control group (n=30). The intervention was conducted from June 2022 to December 2022. The severity of oral mucositis among pediatric cancer patients was assessed using the World Health Organization oral mucositis grade. There were no significant differences in sex or disease type among the groups. On days 7, 14, and 21, we observed notable between-group differences in treatment responses and the intensity of oral mucositis, highlighting the efficacy of cryotherapy in diminishing the severity of oral mucositis. This study supports the use of cryotherapy as a preventive measure for oral mucositis among pediatric oncology patients in Jordan. The findings suggest that cryotherapy effectively reduces the severity of oral mucositis. Further research is necessary to investigate the broader impacts of cryotherapy.