Sex-specific Interventions Research Articles

Sex differences in childhood maltreatment, inflammation, and adulthood depression: A network analysis

BackgroundEfforts to improve treatment for adults with major depression (MD) and childhood maltreatment (CM) have identified inflammation as a potential target to improve health. Network models have emerged as a new way to understand the relationship between depressive symptoms and inflammation. However, none have accounted for the role of childhood maltreatment in the link between depressive symptoms and inflammation, or sex differences commonly found in these constructs. MethodsData from two waves of the Midlife Development in the United States study were used in this study (N = 1917). The Center for Epidemiological Studies Depression (CES-D) scale and Childhood Trauma Questionnaire, and six inflammation markers served as nodes in an undirected psychometric network analysis. Edges between nodes were calculated using partial Spearman's correlation. Separate networks were modeled for males and females. ResultsThe total network revealed several associations between nodes of CM, MD, and inflammation, with emotional abuse having a strong association with somatic complaints. Network comparison testing revealed male-female network invariance, with several edge differences between male and female networks. Males and females showed differences in associations across inflammatory markers and depressive symptom clusters, particularly among somatic complaints and interpersonal difficulties. ConclusionsSpecific associations between dimensions of inflammation, CM, and MD may represent important targets for treatment. Network models disaggregated by sex showed that males and females may have fundamentally different associations between these constructs, suggesting that future studies should consider sex-specific interventions.

Meet the First Authors

Meet the First Authors

Body Weight Does Not Associate with Smoking Prevalence or Cigarette Consumption in Adult Women

Introduction Women are reported to smoke more in association with body weight effects than nicotine dependence, findings that may support including sex-specific dietary interventions in smoking cessation programs. To evaluate this proposition, we examined the influence of sex and BMI classification on adult smoking prevalence and nicotine dependence (measured as cigarette consumption). Methods National Longitudinal Study of Adolescent and Adult Health (Add Health) data were filtered to US adults reporting smoking histories 10-15 years prior. Binary logistic regression modeling tested associations of sex and BMI classification (Normal, Overweight, Obese) with adult smoking status (former smoker versus smoker). Linear regression modeling tested the influence of sex and BMI classification on cigarette consumption in adult smokers. Results In 4,472 adults [Age x̅ (SD) = 37.89 (1.88) years)], significant sex-by-BMI classification interaction on smoking status was observed [Wald X2 = 257.2 on 8 df, p < 0.0001]. Normal BMI men smoked at the highest rates overall. No other pairwise comparisons showed between- or within-sex relationships. Median differences in cigarette consumption in persisting adult smokers, disaggregated by sex and BMI classification, amounted to no more than 2 cigarettes daily. Conclusion Adult women show no greater smoking prevalence or cigarette consumption in association with body weight. Sex-specific interventions do not appear to be indicated. Implications for multiple health behavior approaches are discussed.

Sex differences in depression for childhood cancer survivors.

This study examines the differential association between sex and depression, and the possible mediating pathways. We analysed survey data from 296 (age 7-17.1years) cancer survivors from three centres affiliated with Beijing Children's Hospital. Linear regression analysis was used to assess the association between sex and depression. Quantile regression analysis was used to estimate the regression coefficients (β) and 95% confidence intervals for sex in depression at different quantiles. Mediation analysis with multiple mediators was used to explore the effects of sex on depression. Using linear regression, we found that the age ranged from 8.7 to 10.4years and the regression coefficient of sex on depression was significant (β=-2.75, p=0.03). Quantile regression results showed a significant negative association between sex and depression in the 0.30-0.75 quantiles. Mediation analysis revealed that boys were 1.545 times more depressed than girls, with family resilience, self-perceived burden, and behavioural problems explaining approximately 16.79%, 21.57%, and 43.94% of the sex difference, respectively. The combined effect of family functioning, resilience, social support, self-perceived burden, and behavioural problems might explain the 89.17% sex difference. Clinicians should consider sex effects when assessing depression in childhood cancer survivors and target sex-specific interventions for further treatment.

Respirasome Proteins Are Regulated by Sex-Hormone Interactions in the Brain

The existence of sex differences in disease incidence is attributed, in part, to sex differences in metabolism. Uncovering the precise mechanism driving these differences is an extraordinarily complex process influenced by genetics, endogenous hormones, sex-specific lifetime events, individual differences and external environmental/social factors. In fact, such differences may be subtle, but across a life span, increase susceptibility to a pathology. Whilst research persists in the hope of discovering an elegant biological mechanism to underpin sex differences in disease, here, we show, for the first time, that such a mechanism may be subtle in nature but influenced by multiple sex-specific factors. A proteomic dataset was generated from a gonadectomized mouse model treated with Tibolone, a menopausal hormone therapy. Following functional enrichment analysis, we identified that Alzheimer's disease and the electron transport chain-associated pathways were regulated by sex-hormone interactions. Specifically, we identified that the expression of three respirasome proteins, NDUFA2, NDUFA7 and UQCR10, is significantly altered by compounding factors that contribute to sex differences. These proteins function in bioenergetics and produce reactive oxygen species, which are each dysregulated in many diseases with sex differences in incidence. We show sex-specific reprogrammed responses to Tibolone following gonadectomy, which primarily influence the expression of proteins contributing to metabolic pathways. This further infers that metabolic differences may underpin the observed sex differences in disease, but also that hormone therapy research now has potential in exploring sex-specific interventions to produce an effective method of prevention or treatment.

Abstract 15676: Sex Differences in Leg Microvascular Arteriolar Function in Patients With Limb Ischemia

Introduction: There are known sex differences in peripheral artery disease (PAD) symptom presentation with women manifesting atypical symptoms and a higher vascular burden. Women are also more prone to periprocedural complications possibly due to sex-specific endothelial dysfunction and microvascular impairment. There is a critical need to understand sex specific differences in microvascular function to improve outcomes for women with PAD. Hypothesis: Lower limb arteriolar flow induced dilation (FID) will be significantly reduced in women, compared to men. Methods: Combined muscle and fat tissue were obtained from the affected leg in patients undergoing revascularization due to PAD. Arterioles were dissected, cannulated, and suspended in a physiological chamber at a stable intraluminal pressure. FID was assessed at increasing intraluminal pressure gradients. A subsample of vessels underwent arteriolar dilation with ACh with and without L-NAME, and SNP. Results: We quantified arteriolar FID in 24 arterioles (7=not viable) from 18 patients undergoing revascularization due to PAD (age 60.2 + 7.4, 44%=F, 61%=Black). Heterogeneity was observed in FID with significantly reduced response observed in women. FID in women at 60 cmH 2 O was 24.7 + 20.5%, compared to 52.6 + 28.0% in men, p=.05, and AUC was 69.0 + 66.8 in women, compared to 147.6 + 82.0 in men (p=.07). Findings were similar in both muscle and adipose arterioles. Vessels treated with Ach responded similar to FID. Vessels treated with L-NAME and SNP showed variable blunted response. Conclusions: Women had more impairment in arteriolar function compared to men, providing insight into sex dimorphism in the PAD population. Findings indicated that FID in arterioles is mostly nitric oxide dependent, although patient and sex specific changes in vascular smooth muscle signaling/function are present. This study support the need to develop microvascular and sex specific interventions for patients with PAD.

Sex differences in cancer incidence and mortality among patients managed at King Hussein Cancer Center.

We investigated if female survival advantage trends in cancer are consistent within Jordanian patients with cancer across different age groups and nonsex specific cancer types. We explored the King Hussein Cancer Center registry for primary malignant tumors from 2006 to 2019. The registry (n=16 454) was stratified into three groups based on age: children (<15 years), adolescents and young adults (AYA) (modified; 15-49 years), and older adults (≥50 years). Kaplan-Meier analysis was used to estimate the 5-year all-site cancer-specific survival probabilities, which were compared using the log-rank test by sex and age group. Out of 16 454 eligible records, 2286 (13.9%) were children, 5975 (36.3%) were AYAs, and 8193 (49.8%) were older adults. Males outnumbered females 10 339 (62.8%) to 6115 (37.2%). The 5-year OS rates were 74.0% (71.6%-76.4%) and 72.7% (69.9%-75.5%) for pediatric males and females, respectively, 57.3% (55.6%-59.0%) and 64.5% (62.6%-66.4%) for male and female AYAs, respectively, and 37.5% (36.2%-38.9%) and 44.2% (42.3%-46.2%) for older adult males and females, respectively. Females demonstrated significantly better overall survival in the AYA and older adults' groups. In conclusion, females exhibit a survival advantage in terms of nonsex specific cancers. This advantage peaks at the AYA age stratum and mitigates thereafter. Further studies are warranted to examine the etiological factors behind such discrepancy on a site-by-site basis so that sex-specific interventions can be designed and validated.

Associations between childhood and adulthood socioeconomic position and grip strength at age 46 years: findings from the 1970 British Cohort Study

BackgroundMuscle weakness is a key criterion for important age-related conditions, including sarcopenia and frailty. Research suggests lower childhood socioeconomic position (SEP) may be associated with muscle weakness in later life but there is little evidence on associations in younger adults closer to peak muscle strength. We aimed to examine relationships between indicators of SEP in childhood and adulthood and grip strength at age 46y.MethodsWe examined 7,617 participants from the 1970 British Cohort Study with grip strength measurements at 46y. We used sex-specific linear regression models to test associations between five different indicators of SEP in childhood and adulthood (paternal occupational class and parental education levels at age 5 and own occupational class and education level at age 46) and maximum grip strength. Models were adjusted for birth weight, BMI in childhood and adulthood, adult height, disability in childhood, leisure-time physical activity in childhood and adulthood, sedentary behaviour in childhood and adulthood, occupational activity and smoking at age 46.ResultsAmong women, lower SEP in childhood and adulthood was associated with weaker grip strength even after adjustments for covariates. For example, in fully-adjusted models, women whose mothers had no qualifications at age five had mean grip strength 0.99 kg (95% CI: -1.65, -0.33) lower than women whose mothers were educated to degree and higher. Among men, lower levels of father’s education and both adult SEP indicators were associated with stronger grip. The association between own occupational class and grip strength deviated from linearity; men in skilled-manual occupations (i.e. the middle occupational group) had stronger grip than men in the highest occupational group (Difference in means: 1.33 kg (0.60, 2.06)) whereas there was no difference in grip strength between the highest and lowest occupational groups. Adjustment for occupational activity largely attenuated these associations.ConclusionFindings highlight the need to identify age and sex-specific interventions across life to tackle inequalities in important age-related conditions related to weakness.

0318 Subjective Sleep and Cognition in Middle-aged and Older Adults: Chronotype and Sex as Moderators

Abstract Introduction Associations between sleep and cognition are well studied in aging populations. However, less is known regarding the moderating impact of chronotype (morningness vs. eveningness) and sex on these relationships. We aimed to determine the sex-specific moderating impact of subjective chronotype on the association between subjective sleep and subjective cognition in middle-aged and older adults. Methods Participants (N=260, 142 men/118 women) aged 50+ completed surveys measuring subjective sleep [Pittsburgh Sleep Quality Scale (PSQI)], chronotype [Morning-Evening Questionnaire (MEQ)], and everyday subjective cognition [Cognitive Failures Questionnaire (CFQ)]. Moderated regressions determined independent and interactive roles of subjective sleep (PSQI-total, sleep disturbances, sleep efficiency), chronotype (MEQ total), and sex on everyday subjective cognition (CFQ scores: total, memory, distractibility, and blunders). Analyses controlled for age, education, depressive/anxiety symptoms, and sleep medication use. Results Sex moderated the interactive associations of chronotype and PSQI-total on CFQ-total (p=.005) and CFQ-memory (p<.001). Specifically, higher PSQI-total was associated with higher CFQ-total (B=0.87, SE=0.38, p=.02) and CFQ-memory scores (B=0.33, SE=0.13, p=.009) in men with a tendency for eveningness. Sex also moderated the interactive associations of chronotype and PSQI-sleep disturbances on CFQ-memory (p=.04) and CFQ-blunders (p=.02). In men with a tendency for eveningness, greater PSQI-sleep disturbances were associated with worse CFQ-memory (B=2.65, SE=.84, p=.002) and CFQ-blunders scores (B=1.85, SE=0.83, p=.03). In women with a tendency for morningness, greater PSQI-sleep disturbances were associated with worse CFQ-memory (B=2.65, SE=.81, p= .001) and CFQ-blunders scores (B=2.37, SE=0.81, p=.004). Conclusion There are sex-specific patterns regarding the moderating impact of chronotype on associations between sleep and everyday cognition in middle aged and older adults. In men prone to eveningness, worse overall sleep quality and sleep disturbances may exacerbate negative perceptions of overall and memory specific cognitive function. However, in women prone to morningness, greater sleep disturbances may exacerbate negative perceptions of memory and task execution. Further investigating chronotype on objective sleep and cognition in prospective studies may help further explain underlying mechanisms of the impact of sleep on cognition, in addition to sex-specific sleep interventions to mitigate cognitive decline in aging populations. Support (If Any)

Sex differences in the relationships between body composition, fat distribution, and mitochondrial energy metabolism: a pilot study

BackgroundAdiposity and mitochondrial dysfunction are related factors contributing to metabolic disease development. This pilot study examined whether in vivo and ex vivo indices of mitochondrial metabolism were differentially associated with body composition in males and females.MethodsThirty-four participants including 19 females (mean 27 yr) and 15 males (mean 29 yr) had body composition assessed by dual energy x-ray absorptiometry and magnetic resonance (MR) imaging. Monocyte reserve capacity and maximal oxygen consumption rate (OCR) were determined ex vivo using extracellular flux analysis. In vivo quadriceps mitochondrial function was measured using 31P-MR spectroscopy based on post-exercise recovery kinetics (τPCr). The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin levels. Variables were log-transformed, and Pearson correlations and partial correlations were used for analyses.ResultsMitochondrial metabolism was similar between sexes (p > 0.05). In males only, higher fat mass percent (FM%) was correlated with lower reserve capacity (r = − 0.73; p = 0.002) and reduced muscle mitochondrial function (r = 0.58, p = 0.02). Thigh subcutaneous adipose tissue was inversely related to reserve capacity in males (r = − 0.75, p = 0.001), but in females was correlated to higher maximal OCR (r = 0.48, p = 0.046), independent of FM. In females, lean mass was related to greater reserve capacity (r = 0.47, p = 0.04). In all participants, insulin (r = 0.35; p = 0.04) and HOMA-IR (r = 0.34; p = 0.05) were associated with a higher τPCr.ConclusionsThese novel findings demonstrate distinct sex-dependent associations between monocyte and skeletal muscle mitochondrial metabolism with body composition. With further study, increased understanding of these relationships may inform sex-specific interventions to improve mitochondrial function and metabolic health.

The E3 ubiquitin ligase RNF216/TRIAD3 is a key coordinator of the hypothalamic-pituitary-gonadal axis

SummaryRecessive mutations in RNF216/TRIAD3 cause Gordon Holmes syndrome (GHS), in which dysfunction of the hypothalamic-pituitary-gonadal (HPG) axis and neurodegeneration are thought to be core phenotypes. We knocked out Rnf216/Triad3 in a gonadotropin-releasing hormone (GnRH) hypothalamic cell line. Rnf216/Triad3 knockout (KO) cells had decreased steady-state GnRH and calcium transients. Rnf216/Triad3 KO adult mice had reductions in GnRH neuron soma size and GnRH production without changes in neuron densities. In addition, KO male mice had smaller testicular volumes that were accompanied by an abnormal release of inhibin B and follicle-stimulating hormone, whereas KO females exhibited irregular estrous cycling. KO males, but not females, had reactive microglia in the hypothalamus. Conditional deletion of Rnf216/Triad3 in neural stem cells caused abnormal microglia expression in males, but reproductive function remained unaffected. Our findings show that dysfunction of RNF216/TRIAD3 affects the HPG axis and microglia in a region- and sex-dependent manner, implicating sex-specific therapeutic interventions for GHS.

Sex Dimorphism in the Metabolome of Metabolic Syndrome in Morbidly Obese Individuals.

Adult morbid obesity is defined as abnormal or excessive fat accumulation, mostly resulting from a long-term unhealthy lifestyle. Between 10% and 30% of people with obesity exhibit low cardiometabolic risk. The metabolic syndrome has been suggested as an indicator of obesity-related metabolic dysregulation. Although the prevalence of obesity does not seem to be sex-related and metabolic syndrome occurs at all ages, in the last few years, sex-specific differences in the pathophysiology, diagnosis, and treatment of metabolic syndrome have received attention. The aim of this study was to determine the prevalence of metabolic syndrome and its components in different sex and age groups in people with metabolic unhealthy obesity and to compare them with people with metabolic healthy obesity. We analyzed the metabolome in 1350 well-phenotyped morbidly obese individuals and showed that there is a strong sex-dependent association of metabolic syndrome with circulating metabolites. Importantly, we demonstrated that metabolic dysregulation in women and men with severe obesity and metabolic syndrome is age-dependent. The metabolic profiles from our study showed age-dependent sex differences in the impact of MetS which are consistent with the cardiometabolic characterization. Although there is common ground for MetS in the metabolome of severe obesity, men older than 54 are affected in a more extensive and intensive manner. These findings strongly argue for more studies aimed at unraveling the mechanisms that underlie this sex-specific metabolic dysregulation in severe obesity. Moreover, these findings suggest that women and men might benefit from differential sex and age specific interventions to prevent the adverse cardiometabolic effects of severe obesity.

Burden of disease and risk factors among children under 5 years in China from 1990 to 2019: a perspective of international comparison

Based on the Global Burden of Disease study 2019, the standardized mortality rate and disability-adjusted life years (DALYs) rate of children under 5 years old were selected as evaluation indicators to compare and analyze the current situation and differences of disease burden of children under 5 years old between China and other regions from 1990 to 2019. The change trend and difference of disease burden of children under 5 years old in China were analyzed by sexes. From 1990 to 2019, the all-cause standardized mortality rate of children under 5 years old in China decreased from 1 153.81/100 000 to 160.39/100 000, and the all-cause standardized DALY rate decreased from 104 426.40/100 000 to 16 479.01/100 000. In 2019, neonatal preterm birth, congenital heart anomalies and lower respiratory infections ranked the top three disease burden of children under 5 years old in China. Except that the disease burden of neonatal preterm birth was lower than that in North America, they were much higher than that in Western Europe and North America in the same period. The burden of unintentional injury diseases, including pulmonary aspiration and foreign body in airway and drowning, was higher than that in Western Europe and North America. The standardized mortality and DALY rate of the top ten diseases and injuries in boys and girls under 5 years old in China showed a downward trend (P<0.05), and most of them were higher in boys than girls (P<0.05). From 1990 to 2019, the disease burden of children under 5 years old in China decreased significantly. However, compared other regions, it is still necessary to strengthen the prevention and control of neonatal premature birth, birth defects and unintentional injuries, and take different sex-specific interventions to improve the overall health of children.

Macrophage inflammatory response increases in adult female exposed to neonate stress

Abstract Impacts of stress on the immune system vary depending on the nature, intensity, and time during which stress is experienced (eg, acute stress is pro-inflammatory vs chronic stress is anti-inflammatory). However, there is limited knowledge on the long-term impact of early life stress on immune responses. Given that immune programming occurs early in life and that immunity and stress both involve sexual dimorphisms, our hypothesis is that neonatal maternal separation (NMS) induces sex-specific immune alterations. Objective Our objective is to evaluate the influence of early life stress on immune response in adult and its dimorphism related to biological sex. Methods We used a well-established rat model of early life stress, NMS, in which we observed sex-specific modulations of the myeloid compartment. Thus, we evaluated the impact of NMS on macrophage activation using LPS stimulation of bone-marrow derived macrophages (BMDM) in vitro. Expression of activation (MHCII, CD40, CD86 and CD80) and maturation markers (SIRPα, CD11b, CD200 and CD200R) were analyzed by flow cytometry. TNF levels were measured by ELISA. Results LPS stimulation of female NMS BMDM had higher expression of activation markers compared to controls. Inflammatory cytokine levels, TNF, increased after LPS stimulation and further increased in female NMS, whereas male NMS level was lower than control male. Futhermore, LPS stimulation lowered CD200 receptor (CD200R) to a greater extent in male NMS than in female NMS. Conclusion These results suggest that NMS accentuates the pro-inflammatory response in adult female (but not in male) and will provide a strong base for improving sex-specific interventions in the context of diseases involving stress and the immune system. Supported by grants from CIHR, QRHN and CRIUCPQ

Patterns of sexual behaviour associated with repeated chlamydia testing and infection in men and women: a latent class analysis

BackgroundAdolescents and young adults are at higher risk of acquiring Chlamydia trachomatis infection (chlamydia), so testing is promoted in these populations. Studies have shown that re-testing for chlamydia is common amongst them. We investigated how sexual risk behaviour profiles are associated with repeated testing for chlamydia.MethodsWe used baseline data from a cohort of 2814 individuals recruited at an urban STI -clinic. We applied latent class (LC) analysis using 9 manifest variables on sexual behaviour and substance use self-reported by the study participants. We fitted ordered logistic regression to investigate the association of LC membership with the outcomes repeated testing during the past 12 months and lifetime repeated testing for chlamydia. Models were fit separately for men and women.ResultsWe identified four LCs for men and three LCs for women with increasing gradient of risky sexual behaviour. The two classes with the highest risk among men were associated with lifetime repeated testing for chlamydia: adjOR = 2.26 (95%CI: 1.50–3.40) and adjOR = 3.03 (95%CI: 1.93–4.74) as compared with the class with lowest risk. In women, the class with the highest risk was associated with increased odds of repeated lifetime testing (adjOR =1.85 (95%CI: 1.24–2.76)) and repeated testing during past 12 months (adjOR = 1.72 (95%CI: 1.16–2.54)). An association with chlamydia positive test at the time of the study and during the participant’s lifetime was only found in the male highest risk classes.ConclusionPrevention messages with regard to testing for chlamydia after unprotected sexual contact with new/casual partners seem to reach individuals in highest risk behaviour classes who are more likely to test repeatedly. Further prevention efforts should involve potentially more tailored sex-specific interventions taking into consideration risk behaviour patterns.

What do we know about the experience of seclusion in a forensic setting? An integrative literature review.

Seclusion is used in forensic and general mental health settings to protect a person or others from harm. However, seclusion can result in trauma‐related harm and re‐traumatization with little known about the experience of seclusion for consumers in forensic mental health settings from their perspectives. This article explores consumer experiences of seclusion in forensic mental health settings and explores the differences between female and male experiences of seclusion. Five electronic databases were systematically searched using keywords and variations of experience, attitude, seclusion, coercion, forensic mental health, and forensic psychiatry. Inclusion criteria were original peer‐reviewed studies conducted in adult forensic mental health settings reporting data on the experiences of or attitudes towards seclusion. Seven studies met the criteria for inclusion and a quality assessment was undertaken. Results found consumers in forensic mental health settings perceive seclusion to be harmful, a punishment for their behaviour, and largely a negative experience that impacts their emotional health. Some consumers report positive experiences of seclusion. Differences in the experience of seclusion for females and males are unclear. Further research is required to understand the experience of seclusion for women in forensic mental health settings. Identification and consideration of differences in the experience of seclusion for males and females may assist in identifying sex‐specific interventions and may inform policy and practices to eliminate or reduce the trauma associated with seclusion use.

Gender differences in the association of body composition and biopsy-proved nonalcoholic steatohepatitis.

Body composition was associated with nonalcoholic steatohepatitis (NASH), but results were controversial probably due to gender differences. Hence, we aim to explore the association of body composition and NASH in males and females. We conducted a cross-sectional analysis of obese subjects undergone liver biopsy. According to NASH Clinical Research Network system, subjects were categorized as Normal Control (NC), non-NASH or NASH. Body composition was accessed by dual-energy X-ray absorptiometry. This study enrolled 336 subjects (mean age 32.0years, mean BMI 39.15kg/m2, female, 64.0%). Males have lower relative muscle mass (RMM 55.21 ± 4.07%) and females have higher android to gynoid ratio (AGR, 0.82 ± 0.21) in NASH when compared with non-NASH (RMM 57.49 ± 4.75%; AGR 0.7 ± 0.15) and NC (RMM 58.69 ± 4.09%; AGR 0.66 ± 0.19, p < 0.05 for each). After adjusting for confounding factors, low RMM was the independent risk factor for NASH in males (odds ratio [OR] 0.550; 95% confidence interval [CI] 0.312-0.970), high AGR was the independent risk factor for NASH in females (OR 1.694; 95% CI 1.073-2.674). Further, RMM in males and AGR in females, respectively, was associated with liver steatosis and activity, but not with fibrosis. ROC curve revealed that the optimal cutoff value of RMM was 58.09% in males and AGR was 0.92 in females for predicting NASH. We firstly revealed that low RMM and high AGR were the independent risk factors for NASH in males and females, respectively, indicating that sex-specific interventions for improving body composition may reduce the risk of NASH in obese subjects.

Less Screen Time, More Frequent Fruit and Vegetable Intake and Physical Activity are Associated with Greater Mental Wellbeing in Adolescents

Wellbeing declines during adolescence, for which the reasons are unclear. This analysis explored associations between wellbeing and multiple lifestyle, socioeconomic and school-level factors in young people. Data were collected as part of the Wellbeing in School (WiSe) survey of adolescent school children in Northern Ireland at age 13–14 years (N = 1618; 49% female) and 15–16 years (N = 1558; 50.5% female). Wellbeing was assessed using the short-form Warwick-Edinburgh Mental Wellbeing Scale (sWEMWBS), where scores declined between time one (13–14 years) and time two (15–16 years) in both sexes and were significantly lower in females at both timepoints. Multilevel, multivariate modelling was therefore undertaken separately for males and females with sWEMWBS scores as the dependent variable. Physical activity, family affluence, fruit and vegetable intake, social media use, sleep duration, school factors (size and type) and religion were independent variables. More frequent physical activity in both sexes at both timepoints was associated with higher sWEMWBS scores. In females, higher sWEMWBS scores were associated with less social media use at time one (and marginally at time two), greater family affluence at time two, and being Catholic at both timepoints. In males, higher sWEMWBS scores were associated with more frequent fruit and vegetable intake at time one. Mental wellbeing was unrelated to sleep duration or school factors in either sex, at both time points. Efforts to maximize mental wellbeing in adolescents should promote engagement in physical activity and implement sex-specific interventions.

Genomic Analysis of Community Transmission Networks for MRSA Among Females Entering a Large Inner-city Jail.

BackgroundIt is unclear if there are differences in methicillin-resistant Staphylococcus aureus (MRSA) risk between sexes in high-risk populations.MethodsFemales incarcerated at the Cook County Jail were enrolled within 72 hours of intake. Surveillance cultures (nares, throat, groin) were collected to determine the prevalence of MRSA colonization. A survey was administered to identify colonization predictors. Univariate and multivariate analyses were performed to identify predictors of colonization at intake. Genomic sequencing was performed on MRSA colonization and archived clinical isolates.ResultsTwo hundred fifty women were enrolled (70% African American, 15% Hispanic), with 70% previously in jail. The prevalence of MRSA colonization at intake was 20%, with 42% of those colonized solely in the throat or groin. Univariate predictors of MRSA colonization at entrance were illicit drug use, unstable housing, engaging in anal sex, recent exchange of sex for drugs/money, and a higher number of recent sexual partners. With multivariate adjustment for race/ethnicity, use of needles for illicit drugs was a significant predictor of MRSA. Use of illicit drugs was also associated with inclusion in a genomic cluster. Nares colonization was significantly associated with not being in a genomic cluster (18.8% vs 78.6%; P < .001), whereas exclusive extranasal colonization was associated (odds ratio, 15.89; P < .001).ConclusionsWe found that a high proportion (20%) of females entered jail colonized with MRSA, suggesting that previously reported sex disparities of a lower risk in women may not apply to high-risk populations. Our findings suggest high-risk activities or venues in the community for MRSA, with potential for directing sex-specific interventions.

A Comparative Study of the Factors Associated with Geriatric Depression between Two Sex Groups Living Alone

Purpose: The aims of this study were to identify depression rates depending on the sex among elderly people living alone and to compare depression-related ecological system factors between two sex groups.Methods: A cross-sectional study was conducted using secondary data from the 7th Korean Longitudinal Study of Aging survey in 2018. A total of 893 elders living alone were included (152 men and 741 women). Hierarchical logistic regression was used to identify depression-related ecological system factors depending on the sex.Results: Men had significantly higher rates of depression (28.6%) than women (24.0%, p&lt;.001). Depression-related ecological system factors in elderly women were higher educational level, poor subjective health status, impairment of instrumental activities of daily living, low satisfaction with children’s relation, financial based on children’s support, and rare meetings with close people. However, relation satisfaction with children was the only relevant depression-related ecological system factor in the men’s group.Conclusion: Our study findings show that depression-related ecological system factors vary depending on the sex of elderly people living alone. Thus, mental health professionals should provide sex-specific interventions to develop or implement depression-prevention strategies for the elderly living alone depending on the sex.