Significant Sex-related Differences Research Articles

Sex differences in autism spectrum disorder using class imbalance adjusted functional connectivity

Autism spectrum disorder (ASD) is an atypical neurodevelopmental condition with a diagnostic ratio largely differing between male and female participants. Due to the sex imbalance in participants with ASD, we lack an understanding of the differences in connectome organization of the brain between male and female participants with ASD. In this study, we matched the sex ratio using a Gaussian mixture model-based oversampling technique and investigated the differences in functional connectivity between male and female participants with ASD using low-dimensional principal gradients. Between-group comparisons of the gradient values revealed significant interaction effects of sex in the sensorimotor, attention, and default mode networks. The sex-related differences in the gradients were highly associated with higher-order cognitive control processes. Transcriptomic association analysis provided potential biological underpinnings, specifying gene enrichment in the cortex, thalamus, and striatum during development. Finally, the principal gradients were differentially associated with symptom severity of ASD between sexes, highlighting significant effects in female participants with ASD. Our work proposed an oversampling method to mitigate sex imbalance in ASD and observed significant sex-related differences in functional connectome organization. The findings may advance our knowledge about the sex heterogeneity in large-scale brain networks in ASD.

An Analysis of the Influence of a Patient's Sex on Quality of Life in Liver and Kidney Transplantation.

Renal and liver transplantation influences the quality of life of the patients who undergo these procedures. Therefore, the aim of the present study was to analyze possible differences in liver and kidney transplantation in relation to the patient's sex and to determine their impact on quality of life. An observational study was carried out with 147 patients with liver (n = 70) and kidney (n = 77) failure on the transplantation waiting list. The possible influence of sex on clinical, sociodemographic, and psychological aspects of the patients' quality of life before and 6 months after transplantation was analyzed. Questionnaires on health-related quality of life (SF-36), the perception of social and family support (EASP), and coping strategies (CEA), the depression and anxiety scale (HAD), and the Eysenck personality inventory (EPI) were used. A univariate analysis was performed according to sex using statistical tools including the Chi-square test, the t-test, and a univariate linear analysis of variance. In patients on the waiting list for liver transplantation, we found sex differences in terms of age (p = 0.040), time of evolution of end-stage liver disease (p = 0.013), etiology (p = 0.07), and associated complications, as well as in the consumption of tobacco and other psychotropic substances (p = 0.022), while patients on the waiting list for renal transplantation showed sex-related differences in terms of etiology (p = 0.012) and alcohol consumption (p = 0.005). The results showed significant sex-related differences in sociodemographic and psychological aspects, but no significant sex-related differences were observed in global quality of life in either of the two assessments in both groups. The findings suggest that improvement in quality of life after liver or kidney transplantation is not influenced by the patient's sex.

Current status of modifiable risk factors for cardiovascular disease in Korean women.

Hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking are the primary modifiable risk factors contributing to the increasing morbidity and mortality rates from cardiovascular disease (CVD) among Korean women. Significant sex-related differences exist in the prevalence, awareness, treatment, and control of these risk factors, highlighting the importance of age- and sex-specific approaches to the management and prevention of CVD. Notably, the prevalence of hypertension and diabetes mellitus increases with age, with a higher prevalence in elderly women compared to men. Dyslipidemia and obesity are also trending upward, particularly in postmenopausal women, highlighting the impact of menopause on cardiovascular risk. The present review advocates for improved diagnostic, therapeutic, and educational efforts to mitigate the risk of CVD among Korean women, with the goals of reducing the overall burden of the disease and promoting better cardiovascular health outcomes.

A Nationwide Analysis in France on Sex Difference and Outcomes Following Carotid Intervention in Asymptomatic Patients.

Objective: The impact of sex on outcomes following carotid endarterectomy (CEA) and carotid artery stenting (CAS) is not fully elucidated. The aim of this study was to analyze the association between sex and outcomes of asymptomatic patients who underwent primary carotid interventions in France. Methods: This nationwide retrospective study was performed using the French National Health Insurance Information System and included asymptomatic patients who underwent primary carotid intervention over a 10-year period (1 January 2013 to 31 August 2023). Symptomatic patients and patients who had peri-operative neurologic events were excluded. The primary endpoints were the occurrence of death and stroke/transient ischaemic attack (TIA) at 30 days, 1 and 5 years after patients' discharge. Results: In total, 115,879 patients were admitted for an index CEA (29.4% women) and 6500 for CAS (29.8% women). In the CEA group, no significant sex-related difference was observed for 30-day mortality; however, women had significantly lower 1-year and 5-year mortality rates compared to men (1.9% vs. 2.6%, p < 0.001 and 7.9% vs. 11.1%, p < 0.001). In the CAS group, women had lower 30-day, 1-year and 5-year mortality (0.6% vs. 1.0%, p = 0.040, 3.8% vs. 4.9%, p = 0.048, and 10.4% vs. 15.0%, p < 0.001). A multivariate analysis showed that sex was not associated with the risk of stroke/TIA and mortality at 30 days (OR 0.84 (95% CI 0.67-1.04) and 1.27 (95% CI 0.98-1.64)). Male sex was associated with a higher risk of 1-year and 5-year mortality (OR 1.24 (95% CI 1.13-1.36) and 1.25 (95% CI 1.18-1.31)), but a lower risk of stroke/TIA than female sex. Conclusions: No significant sex-related difference was observed at 30 days in patients being discharged alive and without peri-operative neurologic events. Male sex was associated with a higher risk of mortality but a lower risk of stroke/TIA at 1 and 5 years.

Relationships of body build and physical activity with the physical fitness of high school students

Background: Physical fitness determines resourcefulness, i.e. the ability to effectively solve various tasks faced by a person and, therefore, to cope with various situations. The aim of this study was to investigate the relationships of body build and physical activity with physical fitness in high school students. Methods: The research covered 194 students (104 women and 90 men) aged 16-18, attending randomly selected high schools in the Rzeszów district. The research methods were a diagnostic survey and the Eurofit test battery. The Mann-Whitney U test, Pearson’s chi-square test, and Spearman’s rank correlation were used in the analyses. Results: Statistically significant relationships were found between the preferred forms of physical activity (p=0.041, p=0.008) and the subjective assessment of physical fitness (p=0.015) and the sex of the respondents. There were statistically significant sex-related differences in the Sit-and-Reach (p&lt;0.001), Standing Broad Jump (p&lt;0.001), Hand Grip (p&lt;0.001), Sit- Ups (p&lt;0.001), Bent Arm Hang (p&lt; 0.001), Shuttle Run (p&lt;0.001), and Endurance Shuttle Run (p&lt;0.001). In both groups, there were statistically significant relationships between the subjective assessment of physical fitness and the results of physical fitness tests (p&lt;0.05). Conclusions: Women chose dancing more frequently and considered their physical fitness to be average, while men preferred team sports and assessed their physical fitness as very good. Women are characterized by greater flexibility, and men by greater explosive strength of lower limbs, static strength, strength endurance of trunk muscles, speed and agility, and cardiorespiratory endurance. In both groups, the higher the subjective assessment of physical fitness, the better the results of individual physical fitness tests.

Equity in Heart Failure Care: A Get With the Guidelines Analysis of Between- and Within-Hospital Differences in Care by Sex, Race, Ethnicity, and Insurance.

Disparities in guideline-based quality measures likely contribute to differences in heart failure (HF) outcomes. We evaluated between- and within-hospital differences in the quality of care across sex, race, ethnicity, and insurance for patients hospitalized for HF. This retrospective analysis included patients hospitalized for HF across 596 hospitals in the Get With the Guidelines-HF registry between 2016 and 2021. We evaluated performance across 7 measures stratified by patient sex, race, ethnicity, and insurance. We evaluated differences in performance with and without adjustment for the treating hospital. We also measured variation in hospital-specific disparities. Among 685 227 patients, the median patient age was 72 (interquartile range, 61-82) and 47.2% were women. Measure performance was significantly lower (worse) for women compared with men for all 7 measures before adjustment. For 4 of 7 measures, there were no significant sex-related differences after patient-level adjustment. For 20 of 25 other comparisons, racial and ethnic minorities and Medicaid/uninsured patients had similar or higher (better) adjusted measure performance compared with White and Medicare/privately insured patients, respectively. Angiotensin receptor neprilysin inhibitor measure performance was significantly lower for Asian, Hispanic, and Medicaid/uninsured patients, and cardiac resynchronization therapy implant/prescription was lower among women and Black patients after hospital adjustment, indicating within-hospital differences. There was hospital-level variation in these differences. For cardiac resynchronization therapy implantation/prescription, 278 hospitals (46.6%) had ≥2% lower implant/prescription for Black versus White patients compared with 109 hospitals (18.3%) with the same or higher cardiac resynchronization therapy implantation/prescription for Black patients. HF quality measure performance was equitable for most measures. There were within-hospital differences in angiotensin receptor neprilysin inhibitor and cardiac resynchronization therapy implant/prescription for historically marginalized groups. The magnitude of hospital-specific disparities varied across hospitals.

Trends in sex differences of functional outcome after intravenous thrombolysis in patients with acute ischemic stroke.

Intravenous thrombolysis (IVT) is an approved treatment for patients with acute ischemic stroke irrespective of sex. However, the current literature on sex differences in functional outcomes following IVT is inconsistent. So far, a number of studies-including a previous analysis based on data from the Austrian Stroke Unit Registry (ASUR)-detected significant sex-related differences in functional outcome, while others did not report any differences between women and men. In addition, currently there is a lack of data on how sex-related differences evolve over time. To assess time trends of sex-related differences in functional outcome of ischemic stroke in a large nationwide cohort and to investigate associations of patient characteristics with functional outcome post thrombolysis in women and men. These data will offer crucial insights into whether sex differences in functional outcome persist despite the large advances in acute stroke treatment. We analyzed retrospective data of consecutive patients with acute ischemic stroke treated with IVT in 39 stroke centers contributing to the ASUR between 2006 and 2021. We included patients over 18 years of age diagnosed with an acute ischemic stroke who received IVT and with available data on functional outcome at 3 months after treatment. The primary outcome parameter was favorable functional outcome (modified Rankin Scale (mRS) of 0-2) at 3 months. Multivariable logistic regression analysis was performed in the overall population and stratified by sex to assess associations of baseline characteristics with functional outcome. Among 11,840 patients receiving IVT, 2489 of 5503 (45.4%) women achieved favorable functional outcome compared to 3787 of 6337 (59.8%) men. Overall, female sex was a statistically significant predictor of functional outcome after thrombolysis, but additional predictors of outcome differed between women and men. Female sex was independently associated with decreased chances of achieving functional independency (adjusted odds ratio (adjOR) = 0.87, 95% confidence interval (CI) = 0.79-0.96, p = 0.005) and we detected a statistically significant improvement in functional outcome over time only in men (year of treatment, adjOR (per year) = 1.04, 95% CI = 1.02-1.06, p < 0.001) but not in women (adjOR (per year) = 1.01, 95% CI = 0.99-1.03, p = 0.280). Hypertension, smoking, and longer or unknown onset-to-door times were statistically significant predictors of outcome only in male patients, whereas atrial fibrillation, prior myocardial infarction, and longer door-to-needle times were significantly associated with outcome only in women. Sex differences in functional outcome after IVT for acute ischemic stroke are persisting over the past years. Results of our analysis can increase awareness and a resulting focus on sex differences in predictors of outcome could be helpful in mitigating these differences in the future by supporting a more individualized patient care in clinical routine. Follow-up analyses are needed to assess this potential impact and its effect in the future. Data from the Austrian Stroke Unit Registry can only be accessed by the employed statistician (D.M.), access inquiries have to be addressed to the registry's academic review board.

Effect of sex on chronic stress induced alterations in hindbrain catecholaminergic system and autonomic dysfunction resulting in gastrointestinal dysmotility

It has been reported that the clinical symptoms of functional dyspepsia (FD) exacerbate upon stress while the gender-related factors have been incompletely understood. This study aims to investigate the role of sex in chronic heterotypic stress (CHS)-induced autonomic and gastric motor dysfunction. For CHS, the rats were exposed to the combination of different stressors for 7 consecutive days. Subsequently, electrocardiography was recorded in anesthetized rats to evaluate heart rate variability (HRV) for the determination of autonomic outflow and sympathovagal balance. Solid gastric emptying (GE) was measured in control and CHS-loaded male and female rats. The immunoreactivities of catecholaminergic cell marker tyrosine hydroxylase (TH), choline acetyltransferase (ChAT), corticotropin releasing factor (CRF), and estrogen receptor (ER-α/β) were evaluated in medullary and pontine brainstem sections by immunohistochemistry. Compared with the controls, CHS significantly delayed GE in males but not in females. There was no significant sex-related difference in parasympathetic indicator HF under either control or CHS conditions. Sympathetic indicator LF was significantly higher in control females compared to the males. The higher sympathetic output in females was found to be attenuated upon CHS; in contrast, the elevated sympathetic output was detected in CHS-loaded males. No sex- or stress-related effect was observed on ChAT immunoreactivity in the dorsal motor nucleus of N.vagus (DMV). In males, greater number of TH-ir cells was observed in the caudal locus coeruleus (LC), while they were more densely detected in the rostral LC of females. Regardless of sex, CHS elevated immunoreactivity of TH throughout the LC. Under basal conditions, greater number of TH-ir cells was detected in the rostral ventrolateral medulla (RVLM) of females. In contrast, CHS remarkably increased the number of TH-ir cells in the RVLM of males which was found to be decreased in females. There was no sex-related alteration in TH immunoreactivity in the nucleus tractus solitarius (NTS) of control rats, while CHS affected both sexes in a similar manner. Compared with females, CRF immunoreactivity was prominently observed in control males, while both of which were stimulated by CHS. ER-α/β was found to be co-expressed with TH in the NTS and LC which exhibit no alteration related to either sex or stress status. These results indicate a sexual dimorphism in the catecholaminergic and the CRF system in brainstem which might be involved in the CHS-induced autonomic and visceral dysfunction occurred in males.

Sex-related differences in the load-velocity and load-power relationships of the decline bench press exercise

ABSTRACT The purpose of this study was to analyse the load-velocity and load-power relationships of the decline bench press exercise (DBPE) and to compare sex-related differences. Twelve young healthy men and women performed a progressive loading test for the determination of 1RM strength and individual load-velocity and load-power relationship in the DBPE. A very close relationship between mean propulsive velocity (MPV) and %1RM was observed (R 2 = 0.94). This relationship improved when plotting data separately by sex (R 2 = 0.96–97). Individual load-velocity profiles gave an R 2 = 0.99 ± 0.01. The relationship between mean propulsive power (MPP) and %1RM was R 2 = 0.23. When separating data by sex, R 2 = 0.64–73 were obtained. Individual load-power profiles gave an R 2 of 0.93 ± 0.07. Significant sex-related differences were found for MPV, with males having faster velocities than females from 30% to 40% 1RM (p = 0.01) and for MPP, with males having greater MPP (W) than females from 30% to 95% 1RM (p < 0.001). The results of this study show that a strong correlation exists between relative load and MPV/MPP in the DBPE, allowing the possibility of using one to predict the other with great precision, especially when a sex-specific equation is used.

Predictors of Mortality in Infective Endocarditis: A Retrospective Study

Introduction: Infective endocarditis (IE) remains a major health problem with significant morbidity and mortality rates. Despite its serious implications, data on prognostic factors remain scarce. Aim: We aim to determine predictive factors of mortality during infective endocarditis. Methods: We performed a retrospective study including patients admitted to university hospital Mohammed 6 of Marrakech between September 2019 and January 2024 for a confirmed IE based on Dukes modified criteria. Results: Of 43 patients included, 30 were males (69%) and 13 were females (30%). The mean age was 47.4 for men and 49.30 for women. 44.1% of our patients were admitted in heart failure, and 37% presented themselves late to our facility for management. Only 25.58% suffered from kidney failure and 55.8% presented an LV dysfunction. Complications were noted at a rate of 48%. Male’s group had less complication rate with 10% vs 38% in females’ group (p=0.042). And an overall mortality rate was at 34% and there were no significant sex related differences in terms of mortality between the two groups (33% in males vs 38% in females, p = 0.742). The analytical study concluded that heart failure at admission(p&lt;0.001), neurological complications(p=0.024), anemia (p=0.049), kidney failure (p=0.002), prolonged antibiotics (p=0.016), LV dysfunction (p=0.027) and an emergency surgery (p&lt;0.001) were independent risk factors for mortality. Conclusion: Our study underscores the urgent need to identify predictive factors of mortality in infective endocarditis (IE), and to adopt a multidisciplinary approach to enhance the care and management of patients, ultimately aiming to improve their survival rates.

Sex differences of 12 lead electrocardiographic findings of the rugby football league athlete

Cardiac electrical adaptations occur within athlete populations. Sex-related variations in the normal athlete electrocardiogram (ECG) have been observed, with males exhibiting increased QRS and PR intervals, while females have demonstrated increased QTc intervals in university-level athletes. Male athletes also maintain greater weekly training hours compared to female athletes, which is associated with increased ECG changes. The presence of these differences within Rugby Football League (RFL) athletes is unknown. This study aimed to investigate any sex-related variations in the 12-lead ECG in RFL athletes. Fifty nine RFL athletes (32 males [age = 25 ± 5 years] and 27 females [age = 24 ± 5 years]) were included in the study. One female was excluded with inferior T wave inversion and was referred for further investigation. The 12-lead ECG was collected as part of the athlete’s pre-season cardiac screening alongside completion of a health questionnaire, assessment of height and weight and brachial artery pressure. Continuous variables (i.e. heart rate, PR interval, QRS interval etc.), were analysed using an independent t-test or a Mann-Whitney U test as appropriate. For assessment of nominal data (i.e. incidence of early repolarisation and junctional rhythm etc.) a chi-squared test or Fishers exact test were used. A Spearman’s correlation coefficient was used to determine any association between training hours and ECG findings. Ethics approval was obtained from Liverpool John Moores University Ethics Committee. Height (183 ± 5 vs. 169 ± 5 cm, P &lt;0.001), weight (95 ± 11 vs. 77 ± 11 kg, P &lt;0.001) and weekly training hours (18 ± 5 vs. 12 ± 5 hrs, P = 0.001) were higher in male athletes. PR interval (156 ± 34 vs. 142 ± 19 ms, P = 0.002), QRS duration (98 ± 9 vs. 88 ± 7 ms, P &lt;0.001) and incidence of early repolarisation (47% vs. 11%, P = 0.004) were greater in males. Heart rate (57 ± 9 vs. 63 ± 11 bpm P = 0.016) and QTc interval (391 ± 20 vs. 414 ± 17 ms, P &lt;0.001) were greater in females. There was a significant negative correlation between weekly training hours and QTc interval (rs = −0.355, P = 0.009) only. In conclusion, there are significant sex-related ECG differences within RFL athletes that partially mirror previous research. These findings emphasise the importance of considering sex-related variations, during cardiac screening on RFL athletes and enhance our understanding of the normal RFL athlete ECG.

Structural and functional alteration of the gut microbiota in elderly patients with hyperlipidemia.

To investigate the structure, composition, and functions of the gut microbiota in elderly patients with hyperlipidemia. Sixteen older patients diagnosed with hyperlipidemia (M group) and 10 healthy, age-matched normal volunteers (N group) were included. These groups were further subdivided by sex into the male normal (NM, n = 5), female normal (NF, n = 5), male hyperlipidemia (MM, n = 8), and female hyperlipidemia (MF, n = 8) subgroups. Stool samples were collected for high-throughput sequencing of 16S rRNA genes. Blood samples were collected for clinical biochemical index testing. Alpha- and beta-diversity analyses revealed that the structure and composition of the gut microbiota were significantly different between the M and N groups. The relative abundances of Bacteroides, Parabacteroides, Blautia, Peptococcus, and Bifidobacterium were significantly decreased, while those of Lactobacillus, Helicobacter, and Desulfovibrio were significantly higher in the M group. There were also significant sex-related differences in microbial structure between the NM and NF groups, and between the MM and MF groups. Through functional prediction with PICRUSt 2, we observed distinct between-group variations in metabolic pathways associated with the gut microbiota and their impact on the functionality of the nervous system. Pearson's correlation coefficient was used as a distance metric to build co-abundance networks. A hypergeometric test was used to detect taxonomies with significant enrichment in specific clusters. We speculated that modules with Muribaculaceae and Lachnospiraceae as the core microbes play an important ecological role in the intestinal microbiota of the M group. The relative intestinal abundances of Agathobacter and Faecalibacterium in the M group were positively correlated with serum triglyceride and low-density lipoprotein levels, while the relative abundance of Bifidobacterium was negatively correlated with the serum lipoprotein a level.

Mercury and rare earth elements (REEs) show different spatial trends in feathers of Kentish plover (Charadrius alexandrinus) breeding along the Adriatic Sea coast, Italy.

Feather analysis is an ethical and effective method for assessing the exposure of wild birds to environmental contamination due to trace elements and organic pollutants. We used feather to monitor the exposure to three toxic and non-essential metals (Hg, Cd, and Pb) and rare earth elements (REEs) of Kentish plover (Charadrius alexandrinus) breeding in different coastal areas (Veneto, Emilia-Romagna, Marche, Abruzzo, and Apulia) along the Italian coast of the Adriatic Sea. Feathers (n = 113) were collected from April to June. Feather concentrations evidenced a significant exposure to Hg (13.05 ± 1.71 mg kg−1 dw) and REEs (447.3 ± 52.8 ng g−1 dw) in the Kentish plover breeding in Veneto (n = 21) compared to the other coastal areas, with several individuals showing Hg concentrations above the adverse effect (5 mg kg−1 dw) and high-risk (9.14 mg kg−1 dw) thresholds reported for birds. Higher REE concentrations compared to Marche (n = 29), Abruzzo (n = 11) and Apulia (n = 13) were also reported for birds breeding in Emilia-Romagna (474.9 ± 41.9 ng g−1 dw; n = 29). The exposure to Cd and Pb was low in all the coastal areas, and only a few samples (n = 6 and n = 4 for Cd and Pb, respectively) exceeded the adverse effect thresholds (0.1 and 4 mg kg−1 for Cd and Pb, respectively). A significant sex-related difference was observed for REE-concentrations, with females showing higher concentration than males. These data highlight the need to monitor the exposure of the Kentish plover to Hg and REEs, especially in the northern basin of the Adriatic Sea, since these elements might negatively affect species' reproductive success and threaten its conservation.

Customized Landing Task for ACL Injury Risk Assessment: Kinematic Sex-Related Differences.

Women present a higher anterior cruciate ligament (ACL) injury rate than men, suggesting sex-related biomechanical differences. Task characteristics are often fixed for both sexes, possibly affecting the perceived difficulty. We investigated kinematic sex differences across landing tasks for ACL injury risk assessment, adjusted to participants' anthropometrics/performance, and whether different tasks affect kinematic sex comparisons. Female subjects would exhibit motion patterns more associated with ACL injury risk, and sex-related differences may depend on task type. Descriptive laboratory study. Level 3. A total of 27 female and 29 male amateur players (18-30 years) executed horizontal hop, drop jump (DJ), and DJ followed by vertical or forward jump (length, proportional to maximal forward jump; box, 20% participant's height). An optoelectronic system provided lower limb kinematics at initial contact and peaks until maximum knee flexion (KF), analyzed separately by multivariate analysis of variance (MANOVA) (α = 0.05). At initial contact, the interaction term had significant effects on hip adduction (P < 0.01) and knee abduction (KAb) (P = 0.04); female participants demonstrated higher KAb (P < 0.01) and knee internal rotation (P = 0.05). For peaks analysis, the interaction term had no significant effects on any individual variable, although significant in MANOVA; female participants had higher KAb (P = 0.01) and lower KF (P = 0.04). Task type affected hip flexion and knee angles in both analyses. All variables in which significant sex-related differences were found are potential ACL injury risk factors, and all findings indicate that the analyzed female sample exhibited higher injury-related patterns. Although customized, male and female participants showed different landing strategies depending on the task. The findings underline how female participants adopted potentially harmful kinematics while executing customized landing tasks (adjusted by subject's anthropometrics/performance), which may enhance risk of ACL injury.

Differences between male and female patients with pilonidal disease

BackgroundPilonidal disease begins in puberty when males and females have different sex hormone expression. We hypothesize that sex differences can lead to clinical differences in pilonidal disease. MethodsPatient demographics, Fitzpatrick skin type, hair characteristic, presentation, pain score, recurrence were recorded 2019–2022. All patients underwent regular epilation+/-pit excision. Excised pits were stained for estrogen receptor, progesterone receptor, and androgen receptor. Results237 patients (110F, 127 M) were followed 351±327days. Females present younger than males (17.5 ± 3.9 vs.18.4 ± 3.6years). While no sex-related differences noted in recurrence rate (4.5% vs.7.9 %) or skin type, there were significant sex-related differences in hair amount, thickness, density, and color. More males had granuloma than females (34% vs.12 %): 63 % granuloma were located left of midline, 30 % right, 7 % center. More males than females presented with drainage (67% vs.35 %). Significant differences were noted in patient-reported pain: Females’ mean initial pain score was higher than that of males’ (5.6 ± 2.5 vs.4.7 ± 2.2). 35 % females had menstruation-related gluteal cleft pain (MRGCP), not associated with recurrence or pads/tampons use. Females on contraceptives (15.5 %females) had lower pain score than those who were not (3.9 ± 2.7 vs.5.8 ± 2.4) and none of these females reported MRGCP. Patients with drainage had lower pain score than those without (4.5 ± 2.4 vs.5.8 ± 2.2). Excised pits from females with MRGCP had higher proportion of fibroblasts stain positive for estrogen receptor and androgen receptor compared to those without MRGCP (28.4 %±9.0 %vs.14.4 %±6.5 %, 18.0 %±11.7 %vs.6.9 %±9.0 %, respectively). ConclusionsMale and female pilonidal patients differ in pain intensity, drainage, and granuloma formation. More fibroblasts with estrogen receptor and androgen receptor expression is a potential mechanism for MRGCP that is ameliorated by contraceptive use.

Gut Biogeography Accentuates Sex-Related Differences in the Murine Microbiome.

Recent studies have highlighted the influence of factors such as sex and sex-linked hormones on microbiome composition, raising concerns about the generalizability of findings. Here, we explore whether gut geography, specifically the upper and lower gastrointestinal tract (GI), contributes to sex-linked microbiome differences in mice. We collected microbial samples throughout the length of the GI from male and female C57B6/J mice at 6- and 8-weeks old, and conducted 16S rRNA sequencing. Our findings revealed significant sex-related differences, with Clostridium_sensu_stricto_1 more abundant in the male colon, while females exhibited higher levels of Dubosiella newyorkensis across all organs at 6 weeks. We also observed decreased Shannon alpha diversity in the small intestine compared to the lower GI, and this diversity decreased further at 8 weeks. Interestingly, our results suggest that age mitigates sex-related, but not gut geography-related differences in beta diversity, with implications for experimental outcomes and treatment strategies. This study underscores the dynamic nature of microbial diversity, influenced by sex, age, and GI localization, emphasizing the need for a more comprehensive understanding of microbiome dynamics in experimental research and clinical interventions.

Radiologic Examination of High Riding Vertebral Artery and Analysis of Secure Areas

ObjectiveTo radiologically examine the pedicle, lamina, and vertebral artery foraminal anatomies at the C2 vertebra for pedicular and laminar screw instrumentation at the axis in a Turkish population. Materials and MethodsFrom 2018 to 2019, we evaluated 100 patients who underwent cervical computed tomography (CT) for various reasons (excluding cervical pathologies) at Marmara University Hospital. The C2 pedicles were measured on CT images using measurement tools. In addition, axial computed tomography was performed at 0.1-mm intervals. Bilateral measurements were performed for each case. ResultsThe median right and left pedicle axial diameters were respectively 5.01 and 5.09 mm for the male patients and 4.31 and 4.38 mm for the female patients, showing a statistically significant difference between the sexes (p < 0.01). Of the patients, 15% had narrow pedicles. The pedicle sagittal diameters were smaller than 5 mm in 30% of the computed tomographic series. The internal height was <2 mm in 4% of the cases. ConclusionOur findings suggest significant individual and sex-related differences. Vertebral artery groove anomalies are commonly observed. Before performing a posterior craniocervical instrumentation surgery, a CT examination is beneficial because high-riding vertebral arteries must be kept in mind in determining the appropriate screw diameter and screw trajectory.

Sex differences in patients with Non-Small Cell Lung Cancer harboring driver fusions treated with tyrosine kinase inhibitors: a systematic review.

While targeted therapies have transformed the treatment landscape of oncogene-addicted non-small cell lung cancer (NSCLC), the influence of sex on treatment outcomes remains insufficiently understood. This systematic review aimed to investigate the impact of sex on clinical outcomes in patients with NSCLC harboring driver fusions treated with targeted therapies enrolled in clinical trials. A comprehensive literature search was conducted using PubMed, Embase, and relevant conference abstracts to identify phase III randomized and early clinical trials that reported sex-specific data, including progression-free survival (PFS), overall survival (OS), overall response rate, and adverse events (AEs), in patients with fusion-positive NSCLC treated with tyrosine kinase inhibitors (TKIs). This review involved 10 studies reporting PFS data and 3 studies with OS data, focusing on first-line treatments for ALK fusion (9 studies) and RET fusion-positive (1 study) NSCLC. Pooled analysis of hazard ratios (HRs) for PFS and OS in ALK inhibitors trials revealed no significant differences in survival outcomes based on sex. Additionally, none of the studies provided data on sex-based differences in response rates or toxicities, highlighting a significant knowledge gap regarding the impact of sex on secondary outcomes in targeted therapy. This review found no significant sex-related differences in survival outcomes among patients treated with ALK inhibitors. However, the lack of data on sex-specific response and toxicity emphasizes the need for future research to better understand the role of sex in modulating treatment outcomes and treatment decisions with TKIs.

Electromyographic Activity of Lower Limb Muscles during Ankle Destabilizing Tests.

Ankle destabilizing devices were developed to improve the recruitment of the evertor muscles. Nevertheless, the activity of lower-leg muscles has never been compared to each other during functional tests performed with destabilization. The objectives were i) to compare the electromyographic activity between the lower-leg muscles during four functional tests performed with ankle destabilization, and ii) to determine sex-related differences in neuromuscular activation. Twenty-six healthy volunteers (13 males, 13 females) performed the modified Star Excursion Balance Test (mSEBT), unipedal balance and weight-bearing inversion and eversion tests with a destabilizing device, while recording electromyographic activity of the peroneus longus and brevis, tibialis anterior, gastrocnemius lateralis and gluteus medius. The activity of peroneal muscles was significantly greater than other muscles during all functional tests. Furthermore, the anterior direction of the mSEBT was the one implying the greatest activity of the peroneus longus muscle compared to the posteromedial (p=0.003) or posterolateral (p<0.001) directions. Finally, no significant sex-related differences in neuromuscular activity were reported. This study highlights the effectiveness of the destabilizing device to involve specifically the peroneal muscles when performing various functional tests. This device should be used by clinicians to be more specific to the stabilizers of the ankle joint during functional exercises.

Sex-related disparities in cardiac masses: clinical features and outcomes

Abstract Background Cardiac masses (CM) represent a heterogeneous clinical scenario. Sex-related differences of these patients remain to be established. Purpose: To evaluate sex-related disparities in CMs regarding clinical presentation and outcomes. Material and Methods Thestudy cohort included 321 consecutive patients with cardiac mass enrolled in our Centre between 2004 and 2022. A definitive diagnosis was achieved by histological examination or, in case of cardiac thrombi, with radiological evidence of thrombus resolution after anticoagulant treatment. All-cause death at follow-up was evaluated. Multivariable regression analysis was performed to assess potential prognostic disparities between men and women. Results Out of 321 patients with CM, 172 (54%) were female. Women were more frequently younger (p=0.02) than men. Regarding CM histotypes, females were more frequently affected by benign masses (with cardiac myxoma above all), while metastases were more common in men (p&amp;lt;0.001). At presentation, peripheral embolism occurred predominantly in women (p=0.03). Echocardiographic features such as greater dimension, irregular margin, infiltration, sessile mass and immobility were far more common in men. Despite a better overall survival in women, no sex-related differences were observed in the prognosis of benign or malignant masses. In fact, at multivariate analyses, sex was not independently associated with all-cause death. Conversely, age, smoking habit, malignancy and peripheral embolism resulted independent predictors of mortality. Conclusion In a large cohort of heart masses, a significant sex-related difference in histotype prevalence was found: benign CMs affected female patients more frequently, while malignant tumours affected predominantly men. Despite better overall survival in women, sex does not influence prognosis in benign and malignant masses.