Sex-specific Estimates Research Articles

Development of a sex-specific visceral fat area estimation using discrete multi-wavelength near-infrared spectroscopy measurements in Korean individuals

Development of a sex-specific visceral fat area estimation using discrete multi-wavelength near-infrared spectroscopy measurements in Korean individuals

The recombination landscape of the barn owl, from families to populations.

Homologous recombination is a meiotic process that generates diversity along the genome and interacts with all evolutionary forces. Despite its importance, studies of recombination landscapes are lacking due to methodological limitations and limited data. Frequently used approaches include linkage mapping based on familial data that provides sex-specific broad-scale estimates of realized recombination and inferences based on population LD that reveal a more fine scale resolution of the recombination landscape, albeit dependent on the effective population size and the selective forces acting on the population. In this study, we use a combination of these two methods to elucidate the recombination landscape for the Afro-European barn owl (Tyto alba). We find subtle differences in crossover placement between sexes that leads to differential effective shuffling of alleles. LD based estimates of recombination are concordant with family-based estimates and identify large variation in recombination rates within and among linkage groups. Larger chromosomes show variation in recombination rates, while smaller chromosomes have a universally high rate which shapes the diversity landscape. We find that recombination rates are correlated with gene content, genetic diversity and GC content. We find no conclusive differences in the recombination landscapes between populations. Overall, this comprehensive analysis enhances our understanding of recombination dynamics, genomic architecture, and sex-specific variation in the barn owl, contributing valuable insights to the broader field of avian genomics.

Sex differences in pneumonia risk during COVID-19 in Mexico.

This study aimed to evaluate the pneumonia risk based on the patient's sex during the COVID-19 pandemic and the early months of the endemic phase of the disease in Mexico. A retrospective cohort study was conducted using a dataset resulting from the epidemiological surveillance of COVID-19 (February 2020 to August 2023). Data from 1.6million adults with laboratory-positive disease, were analyzed. Risk ratios (RR) and 95% confidence intervals (CI), computed through generalized linear regression models, were used. The overall risk of pneumonia was 9.3% (95% CI 9.2-9.4%), with sex-specific estimates of 7.0% (95% CI 6.9-7.1%) for women and 12.0% (95% CI 11.9-12.1%) for men. This disparity was consistently observed throughout all phases of the pandemic, including the endemic phase of the disease. After adjusting for age, predominant viral genotype at illness onset and preexisting medical conditions, men had a 3.3% higher risk of severe manifestations when compared to women (RR = 1.033, 95% CI 1.032-1.034). Our research highlights the potential role of patients' sex as a factor influencing pneumonia risk during and after the COVID-19 pandemic in Mexico. These findings may provide useful considerations for healthcare planning and policy development focused on addressing the impact of the disease on vulnerable populations.

Burden of Parkinson's disease in Central Asia from 1990 to 2021: findings from the Global Burden of Disease study.

Central Asia is known to face various ecological challenges that constitutes major risk factors for Parkinson's disease (PD). This study examines the burden of PD in Central Asia, a region where data on neurological disorders is notably sparse. Building on the latest Global Burden of Disease Study (GBD 2021), this study investigates the Years of Life Lost (YLLs), Years Lived with Disability (YLDs), and Disability-Adjusted Life Years (DALYs) associated with PD in Central Asia and its countries from 1990 to 2021. The authors calculated average annual percent change (AAPC) to analyze trends, and compared individual country estimates to global figures. Additionally, incorporating data from the World Bank, both Bayesian hierarchical and non-hierarchical frequentist regression models were employed to assess their impact on DALYs. The DALYs varied across the study period, primarily driven by YLLs. While YLLs showed a uniform trend, YLDs were mostly incremental. Kazakhstan had the highest estimates across all metrics and was the only country aligned with global patterns. Age- and sex-specific estimates revealed substantial variations, with notably high figures found in male subjects from Tajikistan. The YLLs, YLDs, and DALYs for Kazakhstan, Uzbekistan, and Turkmenistan saw a significant increase in AAPCs. In contrast, Kyrgyzstan and Tajikistan saw declines, likely attributable to civic conflict and inter-country differences in population structure. Further comparison of DALY trends revealed significant deviations for all countries from the global pattern. This study showed an overall increase in PD burden from 1990 to 2021. These findings underscore the need for targeted strategies to reduce PD burden, with a particular focus on Kazakhstan. Integrating historical information is crucial for discussing the plausible mechanisms in studies sourced from the GBD.

Evaluating the accuracy of population-specific versus generic stature estimation regression equations in a South African sample.

Accurate estimates of stature play an important role in the personal identification of unknown decedents, however a drawback in the application of many stature estimation equations is the need for known sex and population, the assignment of which can be challenging. Researchers have formulated equations for stature estimation that are neither population- nor sex-specific and thereof the aim of this study was to assess the applicability of these stature estimation equations proposed by Albanese et al.. (2016) (Albanese J, Tuck A, Gomes J, Cardoso HFV (2016) An alternative approach for estimating stature for long bones that is not population- or group-specific. Forensic Sci Int 259:59-68). The physiological length of the femur, condylar malleolar length of the tibia and a combination of these measurements, collected from Magnetic Resonance Imaging Scanograms of adult (20-60 years) White South African males (n = 30) and females (n = 44) were used to assess the accuracy of the Albanese et al. (Albanese J, Tuck A, Gomes J, Cardoso HFV (2016) An alternative approach for estimating stature for long bones that is not population- or group-specific. Forensic Sci Int 259:59-68). sex-specific and generic stature estimation equations. The stature estimates were compared with measured living stature (LSM), using paired t-tests. Results indicated that the Albanese et al. (Albanese J, Tuck A, Gomes J, Cardoso HFV (2016) An alternative approach for estimating stature for long bones that is not population- or group-specific. Forensic Sci Int 259:59-68). equations underestimated living stature by between 1.1 and 5.0cm. These underestimations were significantly different between the LSM and the sex-specific estimates for females and the LSM and the generic estimates for males and the tibia for sex-specific equation. All stature estimates however fell in between two standard error of estimates for the sex-specific equations for males and the generic equations for the females. Although, the equations by Albanese et al. (Albanese J, Tuck A, Gomes J, Cardoso HFV (2016) An alternative approach for estimating stature for long bones that is not population- or group-specific. Forensic Sci Int 259:59-68). can be used to estimate stature in White South Africans in certain cases, the use of sex/population-specific equations remains the method of choice.

Risk of Suicide Across Medical Conditions and the Role of Prior Mental Disorder

According to the World Health Organization, more than 700 000 individuals worldwide die by suicide each year. Medical conditions likely increase the risk of suicide. To (1) provide age- and sex-specific pairwise estimates of the risk of suicide across a comprehensive range of medical conditions, (2) investigate whether there is a dose-response-like relationship at play (ie, the higher the disability burden due to medical morbidity, the higher the risk of suicide), and (3) determine if the risk of suicide with medical conditions is particularly pronounced among those who had mental disorder preceding the medical conditions. This cohort study was an observational study of population-based data for all individuals living in Denmark at some point between 2000 and 2020. The data analysis took place from September 2023 to May 2024. Thirty-one specific medical conditions as well as prior mental disorder. The main outcome was suicide. Associations between the 31 specific medical conditions, nested within 9 categories, and suicide were examined via Poisson regression, yielding incidence rate ratios (IRRs). Subsequent analyses included an interaction term to assess whether a previous hospital-treated mental disorder modified the associations. Finally, the association between the disability burden of medical conditions and suicide was examined for those with and without prior mental disorder, respectively. A total of 6 635 857 individuals (3 337 613 females and 3 298 244 males) were included in the analyses of the associations between medical conditions and suicide. Except for endocrine disorders, all categories of medical conditions were associated with a statistically significant increased risk of suicide (which was most pronounced for gastrointestinal conditions [IRR, 1.7; 95% CI,1.5-1.8], cancer [IRR, 1.5; 95% CI, 1.4-1.6], and hematological conditions [IRR, 1.5; 95% CI, 1.3-1.6]). Interaction between mental disorder and individual medical conditions did not seem to play a major role for suicide risk. For those without but not for those with mental disorder, there was a dose-response-like relationship between the disability burden of medical conditions and suicide. Medical conditions are generally associated with increased risk of suicide in a dose-response-like manner. Individuals with hospital-treated mental disorder appear to be at such elevated risk of suicide that additional disability associated with medical conditions has little impact in this regard.

Life-Cycle Estimates of Earnings Growth by Education and Gender

Abstract This paper updates and refines the estimates of age-earnings profiles provided in William E. Even and David A. Macpherson (2018). Relative to the earlier work, the estimates provided here use more recent data, improve the controls for the impact of the labor market on earnings, and provide both sex-specific and sex-neutral estimates of age-earnings profiles by education.

Mortality attributable to diabetes in Cuba: Estimates for 2019

ObjectiveTo estimate the national and provincial number of excess deaths due to diabetes across Cuba in 2019. Study designCross-sectional design with secondary data. MethodsWe used DISMODII, a computerized generic disease model, to assess disease burden by modelling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, total mortality, and age- and sex-specific estimates for diabetes prevalence from the Cuban National Health Survey 2019, and available published estimates of the relative risk of death for people with diabetes compared to people without diabetes. The results were internally validated with DISMODII output for duration of diabetes (years). ResultsIn 2019, we estimated an excess of mortality attributable to diabetes of 7.5 times the diabetes mortality reported by the National Death Registry, which is equivalent to 16.4 % of all deaths in Cuba. The percentages of all-cause mortality among provinces varied between 10.7 % in Villa Clara and 24.5 % in Ciego de Avila. ConclusionsThese are the first estimates of mortality attributable to diabetes in Cuba and its provinces. Diabetes is likely to be a much more prominent leading cause of death than the 9th ranking reported by the Cuban National Death Registry 2019. Disease models similar to DISMODII are important tools to validate the epidemiologic indicators used in the burden of disease calculations.

A unified framework for estimating country-specific cumulative incidence for 18 diseases stratified by polygenic risk

Polygenic scores (PGSs) offer the ability to predict genetic risk for complex diseases across the life course; a key benefit over short-term prediction models. To produce risk estimates relevant to clinical and public health decision-making, it is important to account for varying effects due to age and sex. Here, we develop a novel framework to estimate country-, age-, and sex-specific estimates of cumulative incidence stratified by PGS for 18 high-burden diseases. We integrate PGS associations from seven studies in four countries (N = 1,197,129) with disease incidences from the Global Burden of Disease. PGS has a significant sex-specific effect for asthma, hip osteoarthritis, gout, coronary heart disease and type 2 diabetes (T2D), with all but T2D exhibiting a larger effect in men. PGS has a larger effect in younger individuals for 13 diseases, with effects decreasing linearly with age. We show for breast cancer that, relative to individuals in the bottom 20% of polygenic risk, the top 5% attain an absolute risk for screening eligibility 16.3 years earlier. Our framework increases the generalizability of results from biobank studies and the accuracy of absolute risk estimates by appropriately accounting for age- and sex-specific PGS effects. Our results highlight the potential of PGS as a screening tool which may assist in the early prevention of common diseases.

Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants

ObjectivesTo assess sex-specific differences in the association between pre-transfusion haemoglobin values and early neurodevelopmental function.DesignObservational follow-up of infants with birth weights <1000 g and gestational ages 22–28 weeks who were...

Better together against genetic heterogeneity: A sex-combined joint main and interaction analysis of 290 quantitative traits in the UK Biobank.

Genetic effects can be sex-specific, particularly for traits such as testosterone, a sex hormone. While sex-stratified analysis provides easily interpretable sex-specific effect size estimates, the presence of sex-differences in SNP effect implies a SNP×sex interaction. This suggests the usage of the often overlooked joint test, testing for an SNP's main and SNP×sex interaction effects simultaneously. Notably, even without individual-level data, the joint test statistic can be derived from sex-stratified summary statistics through an omnibus meta-analysis. Utilizing the available sex-stratified summary statistics of the UK Biobank, we performed such omnibus meta-analyses for 290 quantitative traits. Results revealed that this approach is robust to genetic effect heterogeneity and can outperform the traditional sex-stratified or sex-combined main effect-only tests. Therefore, we advocate using the omnibus meta-analysis that captures both the main and interaction effects. Subsequent sex-stratified analysis should be conducted for sex-specific effect size estimation and interpretation.

Effects of temperature, body size, and sex on the standard metabolic rates of a sexually dimorphic freshwater piscivore, walleye (Sander vitreus)

Walleye ( Sander vitreus) are a sexually dimorphic freshwater piscivore that have long been studied using bioenergetics modeling, yet robust estimates of metabolic rates for use in those models have been lacking. Therefore, we quantified the effects of body mass, water temperature, and sex, on standard metabolic rate (SMR). We estimated SMR across temperatures ranging 0.5–24 °C using intermittent-flow respirometry for male ( n = 54) and female ( n = 53) walleye raised in hatchery conditions. We found a significant interaction between sex and temperature, whereby males had lower SMR below 16 °C, but increased such that SMR was ∼16% higher than females at 22 °C. The mass-scaling coefficient, b, was similar for both sexes at a value around 1. These estimates are the first to be generated using respirometry for adult walleye and differ slightly from those being used by previous bioenergetics models, which may have underestimated the energetic costs of SMR, and did not include sex-specific estimates for metabolism.

Sex-Specific Association of Alcohol Use Disorder With Suicide Mortality

Despite individual studies suggesting that sex differences exist in the association between alcohol use disorder (AUD) and suicide, most existing systematic reviews and meta-analyses have reported associations across the sexes. To estimate the sex-specific association between AUD and suicide mortality. Embase, MEDLINE (including MEDLINE In-Process), PsycINFO, PubMed, and Web of Science were searched from database inception to April 27, 2022. Inclusion criteria consisted of the following: (1) original, quantitative study, (2) inclusion of a measure of association and its corresponding measure of variability (or sufficient data to calculate these [eg, 95% CI]), and (3) results stratified by sex. Data extraction was completed by one reviewer and then cross-checked by a second reviewer. Risk of bias was assessed by study design. Categorical random-effects meta-analyses were conducted to obtain sex-specific pooled estimates of the association between AUD and suicide mortality risk. Methodological moderators (ie, study design and comparator group) were assessed using sex-stratified meta-regressions. The association between AUD and suicide mortality. A total of 16 347 unique records were identified in the systematic search; 24 studies were ultimately included for 37 870 699 participants (59.7% male and 40.3% female) (23 risk estimates for male and 17 for female participants). Participants ranged in age from 15 years to 65 years or older. Sex-specific meta-regression models indicated that study design (ie, longitudinal vs cross-sectional study design) affected the observed association between AUD and suicide mortality for both male participants (log odds ratio, 0.68 [95% CI, 0.08-1.28]; P = .03) and female participants (log odds ratio, 1.41 [95% CI, 0.57-2.24]; P < .001). For males and females, among longitudinal studies, the pooled odds ratios were 2.68 (95% CI, 1.86-3.87; I2 = 99% [n = 14]) and 2.39 (95% CI, 1.50-3.81; I2 = 90% [n = 11]), respectively. This systematic review and meta-analysis yielded substantive evidence that AUD was associated with suicide mortality and that the association was similar across the sexes. The findings underscore the importance of identifying and treating AUD as part of a comprehensive suicide prevention strategy.

Global estimates on the number of people blind or visually impaired by cataract: a meta-analysis from 2000 to 2020

BackgroundTo estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by cataract and their proportion of the total number of vision-impaired individuals.MethodsA systematic review and meta-analysis of published population studies and gray literature from 2000 to 2020 was carried out to estimate global and regional trends. We developed prevalence estimates based on modeled distance visual impairment and blindness due to cataract, producing location-, year-, age-, and sex-specific estimates of moderate to severe vision impairment (MSVI presenting visual acuity <6/18, ≥3/60) and blindness (presenting visual acuity <3/60). Estimates are age-standardized using the GBD standard population.ResultsIn 2020, among overall (all ages) 43.3 million blind and 295 million with MSVI, 17.0 million (39.6%) people were blind and 83.5 million (28.3%) had MSVI due to cataract blind 60% female, MSVI 59% female. From 1990 to 2020, the count of persons blind (MSVI) due to cataract increased by 29.7%(93.1%) whereas the age-standardized global prevalence of cataract-related blindness improved by −27.5% and MSVI increased by 7.2%. The contribution of cataract to the age-standardized prevalence of blindness exceeded the global figure only in South Asia (62.9%) and Southeast Asia and Oceania (47.9%).ConclusionsThe number of people blind and with MSVI due to cataract has risen over the past 30 years, despite a decrease in the age-standardized prevalence of cataract. This indicates that cataract treatment programs have been beneficial, but population growth and aging have outpaced their impact. Growing numbers of cataract blind indicate that more, better-directed, resources are needed to increase global capacity for cataract surgery.

Estimating subnational excess mortality in times of pandemic. An application to French départements in 2020.

The COVID-19 pandemic's uneven impact on subnational regions highlights the importance of understanding its local-level mortality impact. Vital statistics are available for an increasing number of countries for 2020, 2021, and 2022, facilitating the computation of subnational excess mortality and a more comprehensive assessment of its burden. However, this calculation faces two important methodological challenges: it requires appropriate mortality projection models; and small populations imply considerable, though commonly neglected, uncertainty in the estimates. We address both issues using a method to forecast mortality at the subnational level, which incorporates uncertainty in the computation of mortality measures. We illustrate our approach by examining French départements (NUTS 3 regions, or 95 geographical units), and produce sex-specific estimates for 2020. This approach is highly flexible, allowing one to estimate excess mortality during COVID-19 in most demographic scenarios and for past pandemics.

Sex difference in incidence of major depressive disorder: an analysis from the Global Burden of Disease Study 2019

BackgroundMajor depressive disorder (MDD) is a leading mental disorder causing severe impairment. This study was aimed to evaluate sex difference in global MDD incidence by year, age, and socioeconomic status, according to the Global Burden of Disease Study 2019 (GBD 2019).MethodsGlobal and national sex-specific incidence estimates of MDD, from 1990 to 2019, in different age groups, were extracted from the GBD 2019. Socioeconomic development index (SDI) as an indicator of national socioeconomic development was used. Absolute (female minus male) and relative (female to male ratio) sex difference in age-standardized incidence rates (ASRs), as well as risk ratios (RR and 95% confidence interval), were computed by year and age. Linear regression analyses were conducted to investigate socioeconomic-associated sex difference in incidence.ResultsAbsolute and relative sex difference in ASRs showed a slight declining trend during 1990 and 2019, with absolute difference decreasing from 1818.23 to 1602.58, and relative difference decreasing from 1.71 to 1.61. Worldwide, females had a higher risk of MDD than males in 1990 (RR: 1.706 (1.705–1.706)) and 2019 (RR: 1.602 (1.619–1.620)). The highest RRs were observed in the Region of the Americas. Sex difference in incidence rates increased rapidly with age for those under 20 years old. The highest RR (1.913 (1.910–1.915)) was observed in the age group of 10–14. Relative sex difference had a significant positive relationship with SDI (standardized β = 0.267, P < 0.001).ConclusionsDespite that slight improvement in sex difference in global MDD incidence has been achieved, sex difference still persists in the past decades, with females always having a higher incidence than males. Greater sex difference was found at younger ages and in more developed countries. The findings highlight the importance of making sex-specific health policy to reduce sex difference in MDD incidence.

Genetically predicted androgenic profiles and adverse cardiac markers: a sex-specific Mendelian randomization study.

Observational evidence suggests associations between sex hormone levels and heart failure (HF). We used sex-specific genetic variants associated with androgenic sex hormone profiles to investigate the causal relevance of androgenic sex hormone profiles on cardiac structure and function and HF using Mendelian randomization (MR). Sex-specific uncorrelated genome-wide significant (P<5×10-8 ) variants predicting sex hormone-binding globulin (SHBG), total testosterone, and bioavailable testosterone were extracted from summary statistics of genome-wide association study (GWAS) on 425097 participants in the UK Biobank. Sex-specific gene-outcome association estimates were computed for left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volumes (LVEDV and LVESV, respectively), left ventricular stroke volume (LVSV), cardiac index, and cardiac output in 11528 female and 14356 male UK Biobank Imaging Study participants and for incident or prevalent HF in an external cohort of 47309 cases and 930014 controls. Inverse-variance weighted MR was the primary analysis method. In females, higher genetically predicted bioavailable testosterone was associated with lower LVEDV [β per nmol/L=-0.11 (-0.19 to -0.03), P=0.006], lower LVESV [β=-0.09 (-0.17 to -0.01), P=0.022], lower LVSV [β=-0.11 (-0.18 to -0.03), P=0.005], lower cardiac output [β=-0.08 (-0.16 to 0.00), P=0.046], and lower cardiac index [β=-0.08 (-0.16 to -0.01), P=0.034] and a higher risk of HF [odds ratio 1.10 (1.01-1.19), P=0.026] on external validation analysis in larger scale, sex-adjusted GWAS data. Higher genetically predicted SHBG was associated with higher LVEDV [β per nmol/L=0.17 (0.08-0.25), P=2×10-4 ], higher LVESV [β=0.13 (0.05-0.22), P=0.003], and higher LVSV [β=0.18 (0.08-0.28), P=2×10-4 ]. In males, higher genetically predicted total and bioavailable testosterone was associated with lower LVESV [β=-0.07 (-0.12 to -0.02), P=0.007] and LVEF [β=-0.11 (-0.18 to -0.04), P=0.003], respectively. This study supports a causal effect of pro-androgenic sex hormone profiles in females on adverse markers of left ventricular structure and function typically associated with HF with preserved ejection fraction and with HF. There was weaker evidence of association in males.

Prevalence of depressive disorder in the adult population of Latin America: a systematic review and meta-analysis

Depressive disorder is one of the leading causes of disability worldwide; however its prevalence and association with inequality and crime is poorly characterised in Latin America. This study aimed to: i. systematically review population-based studies of prevalence of ICD/DSM depressive disorder in Latin America, ii. report pooled regional, country, and sex-specific prevalence estimates, and iii. test its association with four country-level development indicators: human development (HDI), income (Gini) and gender inequality (GII), and intentional homicide rate (IHR). We conducted a systematic review and meta-analysis of population-based studies reporting primary data on the prevalence of ICD/DSM depressive disorder in Latin America from 1990 to 2023, irrespective of language. We searched PubMed, PsycINFO, Cochrane Library, SciELO (regional database), LILAC (regional database), and available grey literature. Study quality was assessed using JBI's critical appraisal tools. We generated pooled estimates using random-effects meta-analysis; heterogeneity was assessed using the I2 statistic. Meta-regression analyses were used to test associations of depression prevalence with indicators of inequality and human development. The study was registered with PROSPERO (CRD42019143054). Using data from 40 studies in Latin America, lifetime, 12-month, and current prevalence of ICD/DSM depressive disorder were calculated at 12.58% (95% CI 11.00%-14.16%); 5.30% (4.55-6.06%), and 3.12% (2.22-4.03), respectively. Heterogeneity was high across lifetime, 12-month, and current prevalence, sex, and countries. 12-month and current prevalence was associated with higher Gini and GII, 12-month prevalence with lower HDI, and current prevalence with higher IHR. We found a high prevalence of ICD/DSM depressive disorders in Latin America, and a statistically significant association with inequality and development indicators. The high heterogeneity found across prevalence periods and the major gaps in country representation underscore the need to escalate efforts to improve mental health access and research capabilities in Latin America. Systematic, comparable prevalence estimates would inform more effective decision-making in the region. Pfizer Independent Medical Education Grant.

Prenatal per- and polyfluoroalkyl substances (PFAS) exposure in relation to preterm birth subtypes and size-for-gestational age in the LIFECODES cohort 2006–2008

BackgroundPer- and polyfluoroalkyl substances (PFAS) are a group of synthetic chemicals widely used in consumer and industrial products. Numerous studies have linked prenatal PFAS exposures to increased risks of adverse pregnancy outcomes such as preterm birth (PTB) and small-for-gestational age (SGA).However, limited evidence is available for the effects of PFAS on PTB subtypes and large-for-gestational age (LGA). ObjectiveTo examine the associations of PFAS with PTB [overall, placental (pPTB), spontaneous (sPTB)], BW Z-score, and size-for-gestational age (SGA, LGA). MethodsOur nested case-control study included 128 preterm cases and 373 term controls from the LIFECODES cohort between 2006 and 2008 (n = 501). Plasma concentrations of nine PFAS were measured in early pregnancy samples. Logistic regression was used to assess individual PFAS-birth outcome associations, while Bayesian Kernel Machine Regression (BKMR) was used to evaluate the joint effects of all PFAS. Effect modification by fetal sex was examined, and stratified analyses were conducted to obtain fetal sex-specific estimates. ResultsCompared to term births, the odds of pPTB were higher from an interquartile range increase in perfluorodecanoic acid (PFDA) (OR = 1.60, 95% CI: 1.00–2.56), perfluorononanoic acid (PFNA) (OR = 1.67, 95% CI: 1.06–2.61), and perfluoroundecanoic acid (PFUA) (OR = 1.77, 95% CI: 1.00–3.12), with stronger associations observed in women who delivered males. BKMR analysis identified PFNA as the most important PFAS responsible for pPTB (conditional PIP = 0.78), with increasing ORs at higher percentiles of PFAS mixture. For LGA, positive associations were observed with PFDA and perfluorooctanoic acid in females only, and with PFUA in males only. BKMR analysis showed increasing, but null effects of PFAS mixture on LGA. ConclusionsThe effect of prenatal exposure to single and multiple PFAS on PTB and LGA depended on fetal sex. Future studies should strongly consider examining PTB subtypes and sex-specific effects of PFAS on pregnancy outcomes.

Should we consider the sex when estimating bone age from hand bone biometrics?

Recently, it was proposed to estimate age from the biometric information of hand bones. We observed that these estimations became less precise as children get older, especially from the age of 13-15years. This study aimed to evaluate the influence of considering sex for age estimation based on hand bones biometrics. The study sample consisted of metacarpals and proximal phalanges measurements collected on 1003 medical images performed at Nancy and Marseille Hospitals of individuals aged under 21years. This sample was divided into two subgroups delineated by the age of 13, as it is a relevant legal threshold for most European countries. First, the influence of sex on the hand bones biometrics and on the estimated age was evaluated. Then, based on these results, new sex-specific age estimation formulas were constructed from linear models and their precision was assessed using residual analysis, in comparison with previous global formulas. An influence of sex was only highlighted from the age of 13 and for the total study sample. Thus, new sex-specific age estimation formulas were built for the [1-21] global sample and the [13-21] subsample. Even though the differences with the previous formulas were minor, age was more accurately estimated when sex was considered. Considering sex in age estimation is relevant when relying on hand bone biometrics. A new tool was proposed to select the most appropriate age estimation formula, based on the discriminant analysis result and the a priori knowledge of the sex.