Study Investigated Sex Differences Research Articles

Sex Differences in Impacts of Early Gestational and Peri-Adolescent Ozone Exposure on Lung Development in Rats: Implications for Later Life Disease in Humans

Air pollution exposure during pregnancy may affect fetal growth. Fetal growth restriction (FGR) is associated with reduced lung function in children that can persist into adulthood. Using an established model of asymmetrical FGR in Long-Evans rats, this study investigated sex differences in effects of early life ozone exposure on lung development and maturation. Adverse health effects for i) gestational exposure (with impacts on primary alveolarization), ii) peri-adolescent exposure (with impacts on secondary alveolarization), and iii) cumulative exposure across both periods were evaluated. Notably, female offspring were most affected by gestational ozone exposure, likely because of impaired angiogenesis and corresponding decreases in primary alveolarization. Females had diminished lung capacity, fewer mature alveoli, and medial hypertrophy of small and large pulmonary arteries. Males, especially FGR-prone offspring, were more affected by peri-adolescent ozone exposure. Males had increased ductal areas, likely due to disrupted secondary alveolarization. Altered lung development may increase risk of developing diseases, such as pulmonary arterial hypertension or chronic obstructive pulmonary disease. Pulmonary arterial hypertension disproportionately affects women. In the United States, chronic obstructive pulmonary disease prevalence is increasing, especially in women; and prevalence for both men and women is highest in urbanized areas. This investigation underlines the importance of evaluating results separately by sex, and provides biologic plausibility for later consequences of early-life exposure to ozone, a ubiquitous urban air pollutant.

Exploring sex differences in collaborative virtual environments for participation equality and user experience

Communication technology plays a crucial role in facilitating remote collaborative work. This study investigated sex differences in Perceived Participation Equality and User Experience across different communication formats, i.e., face-to-face communication, conventional video conferences, and Virtual Reality (VR). An empirical study was conducted involving 15 groups, each comprising three participants, who engaged in a decision-making task. A research model was developed to evaluate the interplay between perceived participation equality, empathy, and immersion. This model was employed across three communication conditions and included both male and female participants. These findings on sex differences in user experience could help create a connected, cohesive, and productive remote collaborative work environment.

Sex differences in all-cause mortality and life span between women with premature menopause and men: propensity score matching analysis.

This study investigated sex differences in all-cause mortality and life span between women undergoing premature menopause and men using propensity score matching analysis. Data were from the National Health and Nutrition Examination Survey (1999-2018) and the National Health and Nutrition Examination Survey III (1988-1994). We included 3,214 women experiencing premature menopause and 23,067 men. The participants were all older than 40 years. Propensity score matching analysis created matched cohorts of women and men using a 1:1 ratio. We employed Cox proportional hazard models to estimate unadjusted and adjusted hazard ratios (HR) (95% confidence interval [CI]) for the association between sex and both all-cause mortality and survival up to the 75th percentile of life span. A subgroup analysis examined the effects of hormone therapy on mortality and life span. Compared with men in the matched cohorts, the adjusted HR values (95% CI) for all-cause mortality in women with age at menopause at <35, 35 to 39, and <40 years were 0.65 (0.54-0.78), 0.72 (0.59-0.87), and 0.67 (0.60-0.76), respectively. However, the adjusted HR values (95% CI) for women and men to survive to the 75th percentile of life span were not statistically significant. Besides, there was no significant difference in the mean life span between deceased women and men in the matched cohorts. In the subgroup analysis, the mean life span did not differ significantly between deceased women taking hormone therapy and men. However, the average life span of women never using hormone therapy was significantly longer than that of men (78.3 ± 11.6 vs 76.6 ± 11.9 years, P = 0.0154). Women experiencing premature menopause had lower risks of all-cause mortality than men, but the advantage that women had in terms of life span was insignificant.

Sex-based factors influencing perceived relocation stress and glycemic control among older adults with diabetes.

This study investigated sex differences perceived relocation stress and glycemic control among older adults with type 2 diabetes in long-term care facilities. A cross-sectional correlation design was used to recruit 120 residents during their first year after moving into the facilities in southern Taiwan. The results showed that almost two-thirds of the participants (64.2%) were women. The mean age was 79.62 (SD = 1.71). Older women with diabetes were reported to have significantly lower levels of education and poor glycemic control but higher levels of perceived relocation stress than men; however, functional independence was significantly higher in men. Although perceived relocation stress significantly predicted HbA1c levels in both women and men, length of stay was also significant in predicting HbA1c levels in women. These findings indicate the need for effective physical and psychological measures to improve glycemic control during the first year of stay in long-term care facilities.

Sex differences in acute myocardial infarction - Preliminary results from an umbrella review

Abstract Background Cardiovascular disease (CVD) is the leading cause of premature death among women, and the negative impact on public health is profound. Women have higher rates of comorbidities, complications such as stroke, in addition to higher mortality compared to men (1-6) and targeting sex-related differences regarding the treatment of CVD in women is of great importance to prevent the number of CVD events. The purpose of this study was to get an overview of the systematic reviews and meta-analyses investigating sex differences in patients with acute myocardial infarction (AMI) the past 10 years. Methods A systematic search was carried out in Epistemonikos, the largest database of systematic reviews that screens PubMed, Cochrane, Embase, CINAHL, PsycInfo and others (i.e., currently nine databases) (7, 8). The search was conducted 12 January 2024, with the general search strings: (1) sex differences OR gender differences AND myocardial infarction, (2) sex differences OR gender differences OR women OR female AND myocardial infarction. The search was restricted to systematic reviews conducted the last 10 years. Results Forty-nine (search 1: 19, search 2: 30) systematic reviews and meta-analyses were identified, and five studies investigating sex differences in relation to AMI were included. Two systematic reviews, Babioakis (2021) and Meer (2015), reported of longer door-to-balloon (D2B) time and/or symptom-to-balloon (S2B) time in female patients presenting with STEMI and referred for PCI, compared to male patients (9). Chaudhary (2022) investigated adverse event of MINOCA (more commonly in women/ younger age (51-59 years) and reported higher risk of MACE among women than men (10.1% vs. 9.1%, OR 1.15, 1.04-1.23), in addition to higher incidence of stroke (3.5% vs. 2.2%, OR 1.3, 1.01-1.68), however no significantly differences were observed for all-cause mortality, non-fatal AMI, and cardiovascular readmissions between the groups (10). Three systematic reviews reported of higher risk of mortality after STEMI among women, compared to men (11-13). Xi (2022) reported of higher risk of short-term mortality (RR, 1.73; 95% CI 1.53 to 1.96)) (adjusted RR, 1.24; 95% CI 1.11 to 1.38) (13), Pancholy (2014) reported of higher risk of in-hospital mortality (RR, 1.93; 95% CI, 1.75-2.14) (adjusted RR, 1.48; 95% CI, 1.07-2.05) (11), and van der Meer (2015) reported of higher crude short- and long-term mortality in women, in addition to less use of GP IIb/IIIa inhibitors in women, compared to men (women 51%, men 57%) (12). Conclusions Our umbrella review revealed that women had longer timeline for treatment in AMI, had less use of medication and higher risk of mortality and MACE compared to men. Clinical practice needs further improvements in management in female patients.

Sex-Based Differences in Clinical Characteristics of Patients with Acute Myocarditis: A Cohort Study

BackgroundThis study investigated sex differences in acute myocarditis patients during index hospitalization. MethodsWe included 365 patients with acute myocarditis, hospitalized with continuous monitoring at the intensive care unit from 2000-2023 into the Basel Myocarditis Cohort study. We compared sex differences in clinical presentation, the presenting electrocardiogram, prior medical history, inflammatory and cardiac biomarkers, cardiac imaging, arrhythmia occurrence, and short- to midterm outcomes. ResultsMean age was 41.3 years, and 26.3% were female. Compared with men, women were older (median 49.7 vs 38.3 years, P < .001) at the time of diagnosis and presented more frequently with dyspnea (41 vs 26%, P = .013) and a higher Killip class (P = .011). In the presenting electrocardiogram, men had a higher occurrence of diffuse ST-elevation (38 vs 9%, P < .001) and PQ-depression (31 vs 20%, P = .042), compared with women. Women had higher N-terminal pro B-type natriuretic peptide levels (1180 vs 387 ng/L, P = .015), lower cardiac troponin T levels (389 vs 726 ng/L, P = .006), and fewer segments with nonischemic late gadolinium enhancement on cardiac magnetic resonance imaging (1 vs 3, P = .005), but similar left ventricular ejection fraction (55 vs 55%, P = .629), compared with men. Overall, hospital stay was longer in women compared with men (7 vs 5 days, P = .018), with a similar length of intensive care unit stay (2.6 vs 2.7 days, P = .922). Women more often developed severe arrhythmia (8.3 vs 2.2%, P = .015) and heart failure during the hospitalization (31.3 vs 16.4%, P = .003). ConclusionCompared with men, women with acute myocarditis were older at the time of diagnosis, presented more often with heart failure, and had an increased frequency of severe arrhythmia.

Sex differences in age-varying trends of depressive symptoms, substance use, and their associations among South Korean adults: A Time-Varying Effect Modeling (TVEM) analysis of a nationwide sample

BackgroundThis study investigated sex differences in the age-varying trends of depressive symptoms, substance use, and their relationships throughout the adult lifespan. Using a nationwide sample from South Korea, this study aimed to confirm existing patterns and identify unique characteristics specific to the South Korean context. MethodTime-Varying Effect Modeling (TVEM) was applied to data from 17,484 participants (9987 women and 7497 men) in the Korea National Health and Nutrition Examination Survey. ResultsConsistent with global trends, the results revealed a higher prevalence of depressive symptoms among women and a greater prevalence of substance use among men. However, the findings also illuminated unique patterns within the South Korean context. Substance use among South Korean men peaked during their 40s, whereas South Korean women consistently exhibited lower rates of substance use. Additionally, a stronger association between depressive symptoms and substance use was identified in women compared to men. LimitationsThe study used cross-sectional data, limiting the analysis of temporal dynamics between depressive symptoms and substance use. Additionally, TVEM cannot distinguish between aging and cohort effects. Furthermore, the assessments of depressive symptoms and substance use were based on self-report. Finally, the study did not include adolescents or sex and gender minorities in its sample. ConclusionsThese results emphasize the need for targeted interventions, particularly among women in their 20s and older adulthood, where there is a heightened co-occurrence of depressive symptoms and substance use. These findings also highlight the importance of sex- and culture-sensitive approaches tailored to the South Korean context.

Adolescent Developmental Pathways Among Depression, Conduct Problems, and Rejection: Integrative Data Analysis Across Three Samples

ABSTRACT Objective The current study investigated sex differences in longitudinal associations among youth depression, conduct problems, and peer rejection from ages 11 to 16. We hypothesized that girls would follow the irritable depression model, which posits that depression leads to conduct problems, and that peer rejection would mediate this relationship. We hypothesized that boys would follow the cumulative failure model, which suggests that conduct problems predict future depression, mediated by peer rejection. Method We used integrative data analysis to combine three datasets, creating an aggregate sample of 2,322 adolescents, 58.4% of an ethnic minority group, and 51.3% boys. Using random-intercept cross-lagged panel modeling with data from ages 11–16, we conducted a nested model comparison. Results Results indicated that a model which allowed paths to differ by sex demonstrated better model fit than a constrained model. While depression, conduct problems, and peer rejection were relatively stable over time and had correlated random intercepts, there were few crossover paths between these domains for either sex. When the strengths of individual crossover pathways were compared based on sex, only the path from conduct problems at age 13 to depression at age 14 was significantly different, with this path being stronger for girls. Conclusions These results suggest that stable, between-person effects largely drive relationships between depression, conduct problems, and peer rejection during adolescence, whereas there are few transactional, within-person pathways between these domains. This pattern of findings demonstrates the utility of random intercept cross-lagged panel modeling for disentangling between- and within-person effects.

Sex differences in prevalence and clinical correlates of internet addiction among Chinese adolescents with schizophrenia

BackgroundPatients with schizophrenia (SCZ) exhibit sex differences in various aspects, and patients with SCZ have a high prevalence of internet addiction (IA). However, sex differences in IA among patients with SCZ mostly remain unstudied, particularly in Chinese adolescent patients with SCZ. This study investigated sex differences in prevalence, risk factors, and clinical correlates of IA among Chinese adolescent patients with SCZ.MethodsA total of 706 adolescent patients with SCZ were enrolled in this study using a cross-sectional design and a convenience sampling method. Demographics and clinical data of the patients were collected using a standardized clinical assessment form. The Positive and Negative Syndrome Scale (PANSS) and the Young’s Internet Addiction Test were used to evaluate psychopathological symptoms and IA respectively.ResultsOverall, the prevalence of IA among Chinese adolescent patients with SCZ was 26.30% (95% CI: 23.09-29.60%). In Chinese adolescents with SCZ, there was a sex difference in the comorbidity of IA (males: 33.33% vs. females: 21.69%). Binary logistic regression analysis showed that IA was significantly predicted by good socioeconomic status in male and female patients with SCZ. City of living and PANSS total score were associated with IA in male patients with SCZ. In contrast, hospitalization rate and depression score were associated with IA in female patients with SCZ.ConclusionOur study suggests sex differences in clinical correlates of IA in Chinese adolescent patients with SCZ. An additional longitudinal study is required to confirm the findings of the present study.

In females, salivary secretion was significantly lower in patients with severe reflux esophagitis than in healthy controls.

The salivary secretion in patients with mild reflux esophagitis (RE) and non-erosive reflux disease is significantly lower in females, but not in males. However, sex differences in salivary secretion in patients with severe RE remain unknown. Therefore, the present study investigated sex differences in saliva secretion in patients with severe RE. Subjects consisted of 23 male patients with severe RE, 24 male healthy controls (HCs), 26 female patients with severe RE, and 25 female HCs. Saliva secretion was assessed as follows: each patient chewed sugarless gum for 3min prior to endoscopy, and the amount and pH of saliva secreted before and after acid loading as an index of the acid-buffering capacity were measured. In males, no significant differences were observed in the amount of saliva secretion, salivary pH, or the acid-buffering capacity between severe RE patients and HCs. In females, the amount of saliva secretion (severe RE: 2.4 [1.8-4.1], HCs: 5.3 [3.4-7.5], p = 0.0017), salivary pH (severe RE: 7.0 [6.7-7.3], HCs: 7.2 [7.1-7.3], p = 0.0455), and the acid-buffering capacity (severe RE: 5.9 [5.3-6.2], HCs: 6.2 [6.1-6.5], p = 0.0024) were significantly lower in severe RE patients than in HCs. Among females, the salivary secretion was significantly lower in severe RE patients than in HCs. This reduction in salivary secretion may contribute to the pathophysiology of severe RE in females.

Auditing the Representation of Females Versus Males in Heat Adaptation Research.

The aim of this audit was to quantify female representation in research on heat adaptation. Using a standardized audit tool, the PubMed database was searched for heat adaptation literature from inception to February 2023. Studies were included if they investigated heat adaptation among female and male adults (≥18-50years) who were free from noncommunicable diseases, with heat adaptation the primary or secondary outcome of interest. The number and sex of participants, athletic caliber, menstrual status, research theme, journal impact factor, Altmetric score, Field-Weighted Citation Impact, and type of heat exposure were extracted. A total of 477 studies were identified in this audit, including 7,707 participants with ∼13% of these being female. Most studies investigated male-only cohorts (∼74%, n = 5,672 males), with ∼5% (n = 360 females) including female-only cohorts. Of the 126 studies that included females, only 10% provided some evidence of appropriate methodological control to account for ovarian hormone status, with no study meeting best-practice recommendations. Of the included female participants, 40% were able to be classified to an athletic caliber, with 67% of these being allocated to Tier 2 (i.e.,trained/developmental) or below. Exercise heat acclimation was the dominant method of heat exposure (437 interventions), with 21 studies investigating sex differences in exercise heat acclimation interventions. We recommend that future research on heat adaptation in female participants use methodological approaches that consider the potential impact of sexual dimorphism on study outcomes to provide evidence-based guidelines for female athletes preparing for exercise or competition in hot conditions.

Sex Differences in Cancer Incidence Rates by Race and Ethnicity: Results from the Surveillance, Epidemiology, and End Results (SEER) Registry (2000-2019).

Men have 2-3 times the rate of most non-sex-specific cancers compared to women, but whether this is due to differences in biological or environmental factors remains poorly understood. This study investigated sex differences in cancer incidence by race and ethnicity. Cancer incidence data from the Surveillance, Epidemiology, and End Result (SEER) program (2000-2019) were used to calculate male-to-female incidence rate ratios (MF IRRs) for each cancer site, stratified by race and ethnicity, and age-standardized to the 2000 U.S. population for individuals ages ≥ 20 years. Among 49 cancer sites, 44 showed male predominance (MF IRR > 1), with seven inconsistencies across race and ethnicity, including cancers of the lip, tongue, hypopharynx, retroperitoneum, larynx, pleura cancers, and Kaposi sarcoma. Four cancers exhibited a female predominance (MF IRR < 1), with only gallbladder and anus cancers varying by race and ethnicity. The MF IRRs for cancer of the cranial nerves and other nervous system malignancies showed no sex differences and were consistent (MF IRR = 1) across race and ethnicity. The MF IRRs for most cancers were consistent across race and ethnicity, implying that biological etiologies are driving the observed sex difference. The lack of MF IRR variability by race and ethnicity suggests a minimal impact of environmental exposure on sex differences in cancer incidence. Further research is needed to identify biological drivers of sex differences in cancer etiology.

Sex differences in energy balance, body composition, and metabolic and endocrine markers during prolonged arduous military training.

This study investigated sex differences in energy balance, body composition, and metabolic and endocrine markers during prolonged military training. Twenty-three trainees (14 women) completed 44-wk military training (three terms of 14 wk with 2-wk adventurous training). Dietary intake and total energy expenditure were measured over 10 days during each term by weighed food and doubly labeled water. Body composition was measured by dual-energy X-ray absorptiometry (DXA) at baseline and at the end of each term. Circulating metabolic and endocrine markers were measured at baseline and at the end of terms 2 and 3. Absolute energy intake and total energy expenditure were higher, and energy balance was lower, for men than women (P ≤ 0.008). Absolute energy intake and balance were lower, and total energy expenditure was higher, during term 2 than terms 1 and 3 (P < 0.001). Lean mass did not change with training (P = 0.081). Fat mass and body fat increased from term 1 to terms 2 and 3 (P ≤ 0.045). Leptin increased from baseline to terms 2 and 3 in women (P ≤ 0.002) but not in men (P ≥ 0.251). Testosterone and free androgen index increased from baseline to term 3 (P ≤ 0.018). Free thyroxine (T4) decreased and thyroid-stimulating hormone (TSH) increased from baseline to term 2 and term 3 (P ≤ 0.031). Cortisol decreased from baseline to term 3 (P = 0.030). IGF-I and total triiodothyronine (T3) did not change with training (P ≥ 0.148). Men experienced greater energy deficits than women during military training due to higher total energy expenditure.NEW & NOTEWORTHY Energy deficits are common in military training and can result in endocrine and metabolic disturbances. This study provides first investigation of sex differences in energy balance, body composition, and endocrine and metabolic markers in response to prolonged and arduous military training. Men experienced greater energy deficits than women due to higher energy expenditure, which was not compensated for by increased energy intake. These energy deficits were not associated with decreases in fat or lean mass or metabolic or endocrine function.

Sex differences in the relationships between macronutrients and all-cause mortality in individuals with metabolically unhealthy overweight/obesity

This study investigates sex differences in the effects of macronutrient quantity, quality, and timing on mortality in metabolically unhealthy overweight/obesity (MUO) populations. The study included 18,345 participants, including 9204 men and 9141 women. The Cox proportional risk model and isocaloric substitution effects were used to examine the association of macronutrient intake and subtype with all-cause mortality in the MUO populations. After adjusting for the potential covariates, The risk of all-cause mortality was elevated in men in the highest 25% percentile of poor-quality carbohydrates compared with men in the lowest quartile (odds ratio [OR]: 2.04; 95% confidence interval [CI], 1.40–2.98). Compared with women in the lowest quartile, the risk of all-cause mortality for women in the highest 25% percentile for high-quality carbohydrates (OR: 0.74; 95% CI, 0.55–0.99) and unsaturated fatty acids (OR: 0.54; 95% CI, 0.32–0.93) were decreased. In women, replacing low-quality carbohydrates with high-quality carbohydrates on an isocaloric basis reduces the risk of all-cause mortality by approximately 9%. We find that different macronutrient consumption subtypes are associated with all-cause mortality in MUO populations, with differential effects between men and women, and that the risk of all-cause mortality is influenced by macronutrient quality and meal timing.

Sex Differences in Self-Reported Causes, Symptoms, and Recovery Strategies Associated With Underperformance in Endurance Athletes.

This study investigated sex differences in self-reported causes, symptoms, and recovery strategies associated with underperformance in endurance athletes. A total of 82 athletes (40 women) meeting the inclusion criteria (performance level ≥tier 3, used training diaries, and experienced 1 or more periods of underperformance during their career) completed an online questionnaire. The questionnaire encompassed inquiries regarding load monitoring and experiences with underperformance, focusing on causes, symptoms, and recovery strategies. The most frequently reported symptoms associated with underperformance included psychological (31%), physiological (23%), and health-related (12%) symptoms. Notably, female athletes were more likely to report psychological symptoms associated with underperformance (38% vs 25%, P = .01) compared with male athletes. The leading causes of underperformance comprised illness (21%), mental/emotional challenges (20%), training errors (12%), lack of recovery (10%), and nutritional challenges (5%). Female athletes reported nutritional challenges more frequently as the cause of underperformance compared with males (9% vs 1%, P = .01), whereas male athletes more often attributed underperformance to training errors (15% vs 9%, P = .03). Overall, 67% of athletes reported recovering from underperformance, with a tendency for more male than female athletes to recover (76% vs 58%, P = .07). Furthermore, a higher proportion of male than female athletes reported implementing changes in the training process as a recovery strategy (62% vs 35%, P = .02). This study offers valuable insights into sex differences in experiences with underperformance in endurance athletes. The findings could inform coaches and athletes in both the prevention and treatment of such incidents.

Age, Sex, and Training Specific Effects on Cross-Education Training.

An extensive number of publications have examined cross-education effects with adults, primarily investigating contralateral homologous (same) muscles. There are far fewer investigations on cross-education effects on contralateral heterologous (different) muscles and age (youth vs adult) and no studies investigating sex differences. Hence, the objective was to compare cross-education in female and male youth and young adults to contralateral homologous (chest press [CP], elbow flexors and extensors, handgrip isometric strength, and shot put) and heterologous (leg press, knee extension isometric strength, and countermovement jump) muscles. Twenty-eight female adults, 28 female youth, 28 male adults, and 28 male youth (total: 112) were examined before and after an 8-week (3 sessions/wk) unilateral, dominant arm, CP training program. Unilateral testing assessed dominant and nondominant leg press and CP 1-repetition maximum, knee extensors, elbow extensors, elbow flexors, and handgrip maximum voluntary isometric contraction (MVIC) strength, as well as shot put distance and countermovement jump height. Unilateral CP training induced training specific (CP 1-repetition maximum) and nonspecific (elbow extensors, elbow flexors, handgrip MVIC force, and shot put distance) improvements (P < .04, η2: .45-.85) but no significant lower body improvements. There was evidence for testing limb specificity as the dominant arm provided significantly (P < .021, η2: .17-.75) greater training gains than the nondominant arm. Youth's training adaptations exceeded with unilateral CP 1-repetition maximum, elbow extensors MVIC force, and shot put distance (P < .049, η2: .14-.49). No sex main effect differences were apparent. In conclusion, cross-education was training specific (greatest gains with upper body and dominant limbs) with greater benefits for youth and generally no sex differences with the exception of elbow extensors MVIC.

Sex differences in the relationship between post-vaccination adverse reactions, decision regret, and WTP for the booster dose of COVID-19 vaccine in Taizhou, China

This study investigated sex differences in the relationship between post-vaccination adverse reactions, decision regret, and willingness to pay (WTP) for the booster dose of COVID-19 vaccines. This research carried out an online cross-sectional investigation among healthcare workers (HCWs) in Taizhou, China. In total, 1,054 respondents (165 males and 889 females) have received two-dose COVID-19 vaccination. We performed descriptive analysis, chi-square test, and mediation analysis on the exported data. In this study, 67 (40.6%) males and 429 (48.3%) females had WTP for the booster dose. Our study presented that decision regret mediated the effect of adverse reactions after vaccination on WTP for the booster dose in both male and female groups. In males, decision regret played a completely mediating role, while in females, it acted as a partial mediator. Sex differences in the relationship between post-vaccination side effects, decision regret, and WTP for the third dose were demonstrated in a sample of healthcare workers.

Interpersonal Violence and Gender Inequality in Adolescents: A Systematic Analysis of Global Burden of Disease Data From 1990 to 2019

PurposeInterpersonal violence is a leading cause of adolescent deaths and disability. This study investigates sex differences in burden of interpersonal violence for adolescents and explores associations with gender inequality. MethodUsing data from the 2019 Global Burden of Disease study, we report numbers, proportions, rates of interpersonal violence deaths and disability adjusted life years (DALYs) for all ages, and rate of change (from 1990 to 2019) in adolescents aged 10–24 years disaggregated by sex and geography. We explored associations with gender inequality using gender inequality index. ResultsOne in four (24.8%) all-age interpersonal violence deaths are in adolescents. In 2019, the rate of deaths in adolescent males was almost six times higher than females (9.3 vs. 1.6 per 100,000); and since 1990, the rate of decline in DALYs for females was double than that for males (−28.9% vs. −12.7%). By contrast, the burden of sexual violence is disproportionately borne by adolescent females, with over double the rate than males (DALYs: 42.8 vs. 17.5 per 100,000). In countries with greater gender inequality, the male-to-female ratio (deaths and DALYs) was increased among older adolescents, pointing to benefits for males in more gender equal settings. DiscussionSocial identities, relationships, and attitudes to violence are established in adolescence, which is an inflection point marking the emergence of disproportionate burdens of interpersonal violence. Our findings affirm that global agendas must be expanded to address interrelated factors driving multiple forms of interpersonal violence experienced by adolescents and reverberating to the next generation.

Maximizing utility of neuropsychological measures in sex-specific predictive models of incident Alzheimer's disease in the Framingham Heart Study.

Sex differences in neuropsychological (NP) test performance might have important implications for the diagnosis of Alzheimer's disease (AD). This study investigates sex differences in neuropsychological performance among individuals without dementia at baseline. Neuropsychological assessment data, both standard test scores and process coded responses, from Framingham Heart Study participants were analyzed for sex differences using regression model and Cox proportional hazards model. Optimal NP profiles were identified by machine learning methods for men and women. Sex differences were observed in both summary scores and composite process scores of NP tests in terms of adjusted means and their associations with AD incidence. The optimal NP profiles for men and women have 10 and 8 measures, respectively, and achieve 0.76 mean area under the curve for AD prediction. These results suggest that NP tests can be leveraged for developing more sensitive, sex-specific indices for the diagnosis of AD.

Among females older than 50years, saliva secretion is significantly lower in non-erosive reflux disease patients than in healthy controls.

Saliva secretion is significantly lower in patients with non-erosive reflux disease (NERD) than in healthy controls (HC). A previous study on HC showed that saliva secretion was lower in females than in males. Saliva secretion may be lower in female patients with NERD than in male patients. Therefore, the present study investigated sex differences in saliva secretion in patients with NERD. Subjects older than 50years were included in the present study and consisted of 20 male patients with NERD, 19 male HC, 25 female patients with NERD, and 23 female HC. Saliva secretion was assessed as follows: each patient chewed sugar-free gum for 3min prior to endoscopy, and the amount and pH of saliva before and after acid loading as an index of the acid-buffering capacity were measured. In males, no significant differences were observed in the amount of stimulated saliva secretion or salivary pH between NERD patients and HC. However, the acid-buffering capacity (NERD: 6.1 [5.9-6.5], HC: 6.4 [6.2-6.6]) was significantly lower in NERD patients than in HC. In females, the amount of stimulated saliva secretion (NERD: 2.6 [2.0-4.1], HC: 5.8 [3.7-7.5]), salivary pH (NERD: 7.0 [6.8-7.2], HC: 7.2 [7.0-7.2]), and the acid-buffering capacity (NERD: 5.8 [5.4-6.2], HC: 6.2 [6.0-6.5]) were significantly lower in NERD patients than in HC. Among females older than 50years, saliva secretion was significantly lower in NERD patients than in HC. This reduction in saliva secretion may contribute to the pathophysiology of NERD in females.