Posted by on September 16, 2016 - 5:48pm

Over the last several years, the term traumatic brain injury (TBI), has become commonplace, as evidence mounts that some of America’s favorite contact sports may cause severe and lasting brain injuries. TBIs occur when the brain is jolted by an external force which results in damage to the brain in surrounding tissue. However, TBI is not limited to the football field, instead motor vehicle accidents and falls are the leading cause for this type of neurological injury [1]. TBIs can range from mild to severe resulting in a brief period of disorientation (also known as a concussion), to complete loss of consciousness.

While men make up the majority of patients who are diagnosed with TBI, research suggests that women may experience TBI differently than men. Several studies have found that women may have more post-concussive symptoms, such as dizziness and headache, after a mild TBI as compared to men [2,3]. Additionally, women may have different post-concussive symptoms depending on their menstrual cycle stage at time of injury [4]. Furthermore, a post-concussive symptom of TBI may be menstrual cycle irregularity or amenorrhea [5]. More research is necessary to fully uncover the sex differences and sex-specific outcomes of TBI as it pertains to women's health. 

For additional information:   
Center for Disease Control
National Institute of Neurological Disorders and Stroke

 Sources:

  1. Centers for Disease Control
  2. Bazarian et al., J Neurotrauma. 2010; 27(3):527-39. 
  3. Colantonio et al., BMC Neurol. 2010 Oct 28;10:102.
  4. Wunderle et al., J Head Trauma Rehabil. 2014 Sep-Oct; 29(5):E1-8.
  5. Ranganathan et al., Brain Inj. 2016 Mar 10:1-10.
Posted by on August 16, 2016 - 7:07am

By Nicole C. Woitowich, PhD

Academic conferences and symposia provide scientists with the opportunity to learn about the most cutting edge research, establish professional networks and collaboration, and foster the exchange of ideas among colleagues. But for those invited to speak at a conference, it can provide the additional benefit of increased visibility and professional recognition within one’s field. However, for female scientists their invitation to present might have gotten “lost in the mail.”

A new study published in the journal, PloS One, analyzed the ratio of female to male speakers at conferences held by two scientific societies between the years 1999 and 2015 [1]. The authors found that neither the number of female presenters nor female symposia organizers increased significantly over time.

Lead author of the study, Stephanie Sardelis found this to be alarming, “We expected there to be more opportunity for women to excel…especially since both societies have been improving their gender policies,” she says.

Unfortunately, these results are not surprising. Several other studies have shown that women are underrepresented at academic symposia [2,3], and when women are given the chance to present, they speak for less time compared to their male peers [4]. In an attempt to mitigate gender bias at academic conferences the solution seems all too simple: Invite more women! Specifically, invite more women to be symposia organizers.  Sardelis and her colleague, Dr. Joshua Drew, found that when the number of female symposia organizers increased, so did the number of female presenters.  This suggests that women may be more attuned to gender bias and in turn, encourage the promotion of their female colleagues at conferences or symposia.

In addition to increasing the number of female conference organizers, Sardelis and her colleague suggest that scientific societies provide adequate travel funds, child-friendly facilities, and enforce a strict Code of Conduct that includes zero-tolerance for abuse towards women, minorities, and differently abled attendees.

Sardelis believes that gender bias at conferences is indicative of a more systemic problem harbored by academia as a culture. “To reduce the gender gap, all scientists must eliminate the misconception that women are less competent than their male colleagues,” she shares.

Yet, Sardelis remains confident that steps are being taken in the right direction after attending a recent conference citing numerous female speakers, gender neutral bathrooms and nursing rooms, along with a focus group dedicated to women at scientific conferences. “[This] was a testament to the fact that gender disparity is a serious issue, but one that is being (albeit slowly) targeted by the scientific community,” she says.

Let’s hope the scientific community can pick up the pace.  

 

Sources:

  1. Sardelis and Drew, PLoS One. 2016; 11(7):e0160015.
  2. Casadevall and Handelsman, mBio. 2014; 5(1):e00846-13.
  3. Schroeder et al., J Evol Biol. 2013; 26(9):2063-2069. 
  4. Jones et al., PeerJ. 2014; 2:e627. 
Posted by on August 8, 2016 - 9:51am

Type 2 diabetes is a chronic disease that occurs when the body can no longer regulate blood sugar levels, resulting in serious complications such as heart disease, kidney disease, loss of vision, and limb amputation. Typically, type 2 diabetes affects those who are older, overweight, and do not exercise.  Yet, family history and ethnicity can put individuals at greater risk for developing type 2 diabetes [1]. In the United States alone, over 29 million individuals are estimated to have diabetes, with over 245 billion dollars being spent on diabetes-related healthcare per year [2]. The good news is, the onset of type 2 diabetes can be delayed or even prevented with simple lifestyle changes such as losing weight, eating healthy, and staying active. However, some individuals may not know that they are at risk for developing type 2 diabetes before it is too late.

A recent study published in the journal, Menopause, found that reproductive history may help predict the risk of developing type 2 diabetes [3]. This longitudinal study analyzed the reproductive history of over 124,000 women who had already gone through menopause.  The study participants answered questions about their reproductive health such as the age that they had their first period and when they entered menopause, in addition to basic information about their general health. From this information, the authors categorized women into groups based on their reproductively active period, calculated by the number of years between a woman’s first and last period. Interestingly, they found that women who had reproductive periods less than 30 years and greater than 45 years were at increased risk for developing type 2 diabetes.

The authors suggest that there may be a “Goldilocks effect” to the amount of estrogen a woman is exposed to throughout her lifetime: If the reproductive period is too short or too long it may lead to complications in metabolism. Based on this information, healthcare providers may be able to identify women at risk of developing type 2 diabetes and encourage them to lower their risk by modifying their diet and maintaining a healthy lifestyle.  

Sources

  1. National Institutes of Health   
  2. Centers for Disease Control
  3. LeBlanc et al., Menopause. 2016 Jul 25. [Epub ahead of print]
Posted by on August 4, 2016 - 7:38am

A recent study conducted by the World Health Organization (WHO) found that women in countries across the globe, report being in poorer health than men [1]. The WHO administered a survey to over 250,000 individuals in 59 countries, which asked participants to answer questions regarding chronic health conditions, the ability to partake in daily activities, and overall wellbeing. Across all geographical regions and age demographics, women were more likely to report being in “poor health” and exhibit greater limitations in their daily activities.

Does this mean that women worldwide face health inequities due to their gender or their biological makeup? The study authors suggest it may be a combination of both. First, biological factors dependent on sex may play a role in disease incidence, prevalence, symptoms, age at onset, and severity. Yet, sociological factors such as discriminatory values and behaviors towards women coupled with biases from healthcare systems may factor into poor health outcomes.

The WHO is currently conducting additional research necessary to determine if the self-reported “poor health” matches to actual clinical and biological data through the study on Global Ageing and Adult Health [2]. This will provide a clearer view on where women’s health issues stand across globe.

 

 Sources:

1.    Boerma et al., BMC Public Health. 2016; 16:657.
2.    World Health Organization

 

Posted by on August 1, 2016 - 2:23pm

By: Nicole C. Woitowich, PhD

Over the weekend, Newsweek published an article highlighting the inequities that exist in women’s health research [1]. I think it’s fantastic that major media outlets are drawing attention to an issue that has been central to the Women’s Health Research Institute’s mission since its inception. However, as I read along, I can’t help but cringe when I come across the following mistake: sex and gender are not synonyms. 

In the opening paragraph, author Jessica Firger mentions how “biological factors beyond a patient’s control – especially gender – can determine [cancer] treatment outcome.”  But the truth is, gender is not a biological factor whereas sex is. Gender is a social construct which defines the appearance, actions, thoughts, and behaviors associated with the male or female sex and can change depending on the cultural context. Sex on the other hand, is strictly a biological construct determined by the presence or absence of the Y chromosome. To use sex and gender interchangeably, especially when discussing biomedical research, is in error.

Perhaps what’s more embarrassing, is that scientists continue to make this mistake as well (and quite frankly, they should know better). A quick search through PubMed will reveal article titles relating to “gender differences” in the context of pancreatic cancer, orthostatic hypotension, and proton pump inhibitor pharmacology, when they should have been properly attributed to “sex differences.” How can we expect the media and general public to understand the differences between sex and gender if we can’t get it right ourselves?

 So, I offer you the following Public Service Announcement from your friendly local scientist:

  1. Cell lines have a sex.
  2. Model organisms have a sex.
  3. Humans have both a sex and gender and it’s important to differentiate between the two.  

If we are to advance sex- and gender-inclusive biomedical and clinical research, it is of the utmost importance to understand these concepts.

Lastly, don’t say gender instead of sex just because you’re afraid of saying the word sex. This is a stigma we all need to get over because sex (in both definitions) is a natural, biological concept. It’s time we start attributing it as such.

 

 Source:
1. Firger, J. "Females Suffer From Gender Gap in Cancer Trials, Drug Development." Newsweek, 30 July 2016. Web.

Posted by on July 27, 2016 - 10:47am

Routine breast and cervical cancer screenings aid in the early detection and diagnosis of cancer. However, for women who face socioeconomic hardships and are under- or uninsured, preventative cancer screening may be a luxury which they cannot afford. A recent study published in the journal, JAMA Internal Medicine, suggests that patient navigators play a critical role in helping women access gynecological cancer screening.

Patient navigators are individuals who work alongside patients and assist them in making appropriate healthcare choices, provide information and education relevant to their needs, and advocate on their behalf [2]. Oftentimes, patients may need access to health information in their native language, assistance in arranging transportation to-and-from appointments, or simply someone to accompany them to their visit. In this study, patients who were overdue for routine breast, cancer, and colon cancer screening were randomized into two groups: One group of patients was provided access to a patient navigator, the other group received typical notifications of overdue screening by phone or electronic reminders. The study authors found that patients who had access to a patient navigator were more likely to complete their cancer screening than those who did not.   

Kristin Smith, a patient navigator within the Northwestern Medical Group, is not surprised by these results. She states, “Having one person to help break down the complexities of healthcare can make or break the experience that a patient has in a hospital or physician’s office.”

 “By enabling a patient through a navigator, hospital systems can more readily serve immediate patient needs,” shares Smith. Thus, integration of patient navigators within interdisciplinary healthcare teams may lead to improved quality of care for all.  

Sources:

  1. Percac-Lima et al., JAMA Intern Med. 2016. 1;176(7):930-7.
  2. American Medical Association
Posted by on July 18, 2016 - 3:30pm

Biomarkers are proteins or small molecules which can be measured in order to diagnose conditions, identify disease, track disease progression, or monitor therapeutic interventions.  Some examples of biomarkers include the hormone human chorionic gonadotropin, a biomarker for pregnancy, and the protein prostate specific antigen, a biomarker for prostate cancer. The identification of new biomarkers has beneficial clinical implications, yet it can often be challenging to discover reliable and reproducible biomarkers from the research perspective.

 Sex may play an important factor in the variability of biomarkers within a clinical setting as sex hormones, such as estrogen, progesterone, and testosterone, may alter the amount of biomarkers present in the blood. A study published in the journal Scientific Reports, analyzed the levels of over 170 protein and small molecule biomarkers in men and women with varying hormonal status [1]. This includes women in the follicular phase or luteal phase of the menstrual cycle, women who were post-menopausal, utilizing hormone replacement therapy, or taking oral contraceptives. The study authors found that concentration of 56% of biomarkers varied between men and women. Furthermore, the concentration of 38% of biomarkers varied between female hormonal status.  Together, these results call into question the validity and reproducibility of these biomarkers in a clinical context.

 Some of the biomarkers analyzed in this study are proposed to diagnose cancer, schizophrenia, and major depressive disorder. Therefore, the observed sex and hormonal status differences found in this study highlight the necessity to incorporate sex-specific controls when developing clinical markers in order to prevent false positive or negative results.  Taking sex-based differences and hormonal status into account in any research endeavor will lead to better clinical translation and efficacy for all. 

 Source:

  1. Ramsey et al., Scientific Reports. 2016; 6:26947.
Posted by on July 13, 2016 - 2:47pm

by Nicole C. Woitowich, PhD

I am what you might stereotype as a “girly girl.” I love everything that comes in pink, I have seen the movie Legally Blonde more times than I would like to admit, and whatever Taylor Swift song is popular at the moment is probably my “jam.”

 I am also a biochemist.

 Are these things mutually exclusive? Do women need to hide their love for bold colors, high heels, and pop culture in order to be taken seriously as a scientist? Apparently so, according to many blogs and articles written by other female scientists. Their advice ranges from keeping makeup natural, to wearing dark colors to look more authoritative, or adding “soft touches” such as scarves if you must feel “feminine.”

 The worst part is, their advice isn’t entirely wrong. A recent study by Dr. Sarah Banchefsky and colleagues at the University of Colorado Boulder asked participants to rank photos, unbeknownst to them of real scientists, on their gendered appearance (masculine or feminine) and career likelihood (scientist or early childhood educator). They found that the more feminine a woman appeared, the less likely she was deemed to be a scientist.

 Together with the current climate in the scientific workforce where women are under-represented in leadership roles and tenured faculty, I almost understand why women would want to “tone it down,” and adopt the dress and social behaviors of their male peers.

 Banchefsky, lead author of the study, provides some insight, “We all, to a certain degree, adapt and conform to fit into the environment around us and avoid having people ask questions or look at us askance. I think women do this to be taken seriously, to avoid being asked, ‘Are you really a scientist?’”

 Furthermore, she adds, “…men serve as the power holders and gate-keepers in [STEM] fields, so women work hard to and want to be a part of their circle. Unfortunately, women’s assimilation reinforces the masculine culture in STEM.”

 Hiding or limiting femininity may impart damaging consequences on young and aspiring scientists as well. According to Banchefsky, “If [young women] have in their mind that first, women aren’t typically in science, and when they are, they need to be gender-neutral or non-feminine -  they may worry that they won’t be able to express part of who they are [through] their gender identity in a science field.”

  “I think it’s important to highlight that it just doesn’t have to be this way,” Banchefsky states, and I completely agree.

 To this end, I will continue to match my pink goggles to my outfit and wear pink nitrile gloves because it makes me feel more like “me.” So when young women visit the laboratory they can see that a scientist can be whomever she wants to be.

 Source: Banchefsky et al., Sex Roles. 2016; Epub ahead of print. 

 

Posted by on July 11, 2016 - 8:35am

A recent study published in the American Journal of Emergency Medicine found that sex-differences exist in emergency room evaluation and treatment times for patients presenting with a heart attack [1]. The retrospective study conducted at the University of Pennsylvania analyzed treatment times for over 250 patients with confirmed heart attacks. The study authors found that women, on average, wait 3 minutes longer to receive an initial EKG than men. Additionally, women wait 7 minutes longer than men for a heart attack treatment protocol to be activated, with the total average time being 25.5 minutes for women and 18.5 minutes for men. Current recommendations suggest that anyone presenting with a suspected heart attack should be evaluated and a treatment protocol initiated in less than 20 minutes [2]. Thus, women may be subject to additional heart damage as time passes without intervention.

According to the American Heart Association, women may experience a wide variety of symptoms during a heart attack which can include:

  • Chest pain
  • Shortness of breath
  • Sweating
  • Pain in the arms, jaw, back or stomach
  • Nausea or vomiting

 However, the most common symptom is chest pain or discomfort which is experienced by both men and women. It may be possible that sex-based bias exists in the initial diagnosis of heart attacks as evidence by this research. Additional studies which explore sex-differences within evaluation, diagnosis, and treatment of heart attacks and other cardiovascular disease may promote enhanced survival for both men and women.

 To learn more about the signs and symptoms of heart attacks in women check out the following video by the American Heart Association which was directed by, and stars Elizabeth Banks: It’s Just a Little Heart Attack.  

 Sources:

  1. Choi et al., Am J Emerg Med. 2016; EPub ahead of print.
  2. McCabe et al., Circ Cardiovasc Qual Outcomes. 2012; 5(5):672-9.
  3. American Heart Association
Posted by on June 29, 2016 - 7:53am

This year, the Summer Olympics are scheduled to be held in Rio De Janeiro, Brazil, throughout the month of August. However, several athletes, coaches, staff, and journalists have decided to stay home this year, citing concerns for Zika virus infection. Brazil is currently experiencing a Zika virus outbreak with over 148,00 suspected cases of Zika virus disease as of May 2016 [1]. According to the Centers for Disease Control (CDC), the Zika virus disease is spread through the bite of an infected mosquito and can cause symptoms such as fever, rash, and joint pain. While in a healthy individual, Zika virus disease may only cause a mild illness, less is known about its effects in the elderly, immunocompromised, and those with underlying health problems. Perhaps most concerning is the risk of associated birth defects, such as microcephaly, which can occur if a pregnant woman is infected with Zika virus. Furthermore, it has recently been shown that Zika virus can be transmitted through sexual contact. This has left many individuals scheduled to travel to Brazil concerned for the health of themselves and their families.

Savannah Guthrie, a TV journalist who is currently pregnant, has reported that she will not be attending the Olympics due to concerns for the Zika virus [3]. Additionally, professional golfer Rory McIlroy has stated the same [4]. Those who do plan on traveling to the Olympic games, such as U.S. men’s volleyball coach John Speraw, are taking numerous precautions to avoid Zika virus. Speraw plans wearing long sleeves, staying indoors, and as an extra measure of precaution, he will freeze his sperm prior to the Olympics in the event that he contracts the virus while in Brazil [5].

The CDC recommends that all individuals traveling to Brazil practice enhanced precautions which include:

  • Covering all exposed skin with long sleeved shirts and pants
  • Applying insect repellent containing DEET
  • Pre-treating clothes with the repellant permethrin
  • Staying indoors in air-conditioning

To date, no mosquito-borne transmission of Zika virus has been reported in the United States. However, as of June 22nd, there are 820 confirmed cases of individuals living in the U.S. who have contracted the virus while travelling abroad. If you plan on travelling abroad or to other U.S. territories this summer, check with the CDC for travel health notices and updates for local precautions.

 Sources:

  1. Pan American Health Organization Epidemiological Update
  2. Centers for Disease Control and Prevention
  3. New York Times
  4. ESPN
  5. New York Times

Pages