scholarly journals Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature

2020 ◽  
Author(s):  
Alberto Frigerio ◽  
Lucia Ballerini ◽  
Maria Del C. Valdés Hernández
Keyword(s):  
Systematic Review ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Small Sample Size ◽  
Human Sexuality ◽  
Hormonal Treatment ◽  
Small Sample ◽  
Small Samples ◽  
Opposite Sex ◽  
The Impact

Human sexuality is a complex reality, including gender identity and sexual orientation. A widespread approach to study human sexuality is to compare groups with opposite sexual approaches such as cisgenders vs transgenders and heterosexuals vs homosexuals. Neuroimaging studies have found brain differences between these groups of individuals. Nevertheless, they reported conflicting results and limitations such as small samples’ sizes and the considerable overlap between such groups makes it difficult to draw accurate conclusions. This systematic review explored structural, functional and metabolic features of the ‘cisgender brain’ compared with the ‘transgender brain’ before hormonal treatment and the ‘heterosexual brain’ compared to the ‘homosexual brain’ from the analysis of the neuroimaging literature up to 2018. Our main aim is to help identifying biological brain features that have been related to human sexuality to contribute to the understanding of the biological elements involved in gender identity and sexual orientation. Our results suggest that the majority of neuroanatomical, neurophysiological, and neurometabolic features in transgender individuals resemble those of their natal sex rather than those of their experienced gender and in homosexual individuals these resemble those of their same sex heterosexual population rather than their opposite sex heterosexual population. However, it is always difficult to interpret null findings with non-invasive neuroimaging. Given the gross nature of these measures, it is still possible that there are differences that are too subtle to measure with available tools yet have the impact of contributing to gender identity and sexual orientation. Moreover, conflicting results, also contributed to the impossibility of identifying specific brain features which consistently differ between cis- and transgender nor between hetero- and homosexual groups. The small number of studies, the small sample size of each study, and the heterogeneity of the investigations made impossible to meta-analyse all the data extracted. Further studies are necessary to increase the understanding of the neurological substrate of human sexuality.

scholarly journals Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature

2020 ◽  
Author(s):  
Alberto Frigerio ◽  
Lucia Ballerini ◽  
Maria Del C. Valdés Hernández
Keyword(s):  
Systematic Review ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Small Sample Size ◽  
Human Sexuality ◽  
Hormonal Treatment ◽  
Small Sample ◽  
Non Invasive ◽  
Opposite Sex ◽  
Neurological Substrates

This systematic review explored structural, functional, and metabolic features of the cisgender brain compared with the transgender brain before hormonal treatment and the heterosexual brain compared to the homosexual brain from the analysis of the neuroimaging literature up to 2018. Our main aim was to help identifying neuroradiological brain features that have been related to human sexuality to contribute to the understanding of the biological elements involved in gender identity and sexual orientation. We analyze 30 studies on gender identity and 21 on sexual orientation. Our results suggest that some neuroanatomical, neurophysiological, and neurometabolic features in transgender individuals resemble those of their experienced gender despite the majority resembling those from their natal sex. In homosexual individuals the majority resemble those of their same sex heterosexual population rather than their opposite sex heterosexual population. However, it is always difficult to interpret findings with non-invasive neuroimaging. Given the gross nature of these measures, it is possible that more differences too subtle to measure with available tools yet contributing to gender identity and sexual orientation could be found. Conflicting results contributed to the difficulty of identifying specific brain features which consistently differ between cisgender and transgender or between heterosexual and homosexual groups. The small number of studies, the small sample size of each study, and the heterogeneity of the investigations made it impossible to meta-analyze all the data extracted. Further studies are necessary to increase the understanding of the neurological substrates of human sexuality.

scholarly journals Structural, Functional, and Metabolic Brain Differences as a Function of Gender Identity or Sexual Orientation: A Systematic Review of the Human Neuroimaging Literature

2021 ◽  
Author(s):  
Alberto Frigerio ◽  
Lucia Ballerini ◽  
Maria Del C. Valdés Hernández
Keyword(s):  
Sexual Orientation ◽  
Gender Identity ◽  
Human Sexuality ◽  
Hormonal Treatment ◽  
Same Sex ◽  
Non Invasive ◽  
Moderate Sample Size ◽  
Opposite Sex ◽  
Neurological Substrates ◽  
Human Neuroimaging

This review systematically explored structural, functional, and metabolic features of the cisgender brain compared with the transgender brain before hormonal treatment and the heterosexual brain compared to the homosexual brain from the analysis of the neuroimaging literature up to 2018, and identified and discussed subsequent studies published up to March 2021. Our main aim was to help identifying neuroradiological brain features that have been related to human sexuality to contribute to the understanding of the biological elements involved in gender identity and sexual orientation. We analyze 39 studies on gender identity and 24 on sexual orientation. Our results suggest that some neuroanatomical, neurophysiological, and neurometabolic features in transgender individuals resemble those of their experienced gender despite the majority resembling those from their natal sex. In homosexual individuals the majority resemble those of their same sex heterosexual population rather than their opposite sex heterosexual population. However, it is always difficult to interpret findings with non-invasive neuroimaging. Given the gross nature of these measures, it is possible that more differences too subtle to measure with available tools yet contributing to gender identity and sexual orientation could be found. Conflicting results contributed to the difficulty of identifying specific brain features which consistently differ between cisgender and transgender or between heterosexual and homosexual groups. The small number of studies, the small-to-moderate sample size of each study, and the heterogeneity of the investigations made it impossible to meta-analyze all the data extracted. Further studies are necessary to increase the understanding of the neurological substrates of human sexuality.

scholarly journals What is the evidence for mirtazapine in treating cancer-related symptomatology? A systematic review

2019 ◽  
Vol 28 (4) ◽  
pp. 1597-1606 ◽  
Author(s):  
Guillaume Economos ◽  
Natasha Lovell ◽  
Anna Johnston ◽  
Irene J. Higginson
Keyword(s):  
Systematic Review ◽  
Small Sample Size ◽  
Poor Quality ◽  
Small Sample ◽  
Assessment Tools ◽  
Data Synthesis ◽  
Small Sample Sizes ◽  
Randomised Controlled ◽  
Multiple Symptoms ◽  
The Impact

Abstract Purpose Cancer patients often experience multiple distressing symptoms which are challenging to manage. It would therefore be helpful to find a treatment that alleviates more than one symptom, to avoid polypharmacy: mirtazapine has been used in several studies for this purpose. The objective of this study was to assess the effectiveness and safety of mirtazapine in alleviating one or more frequently encountered cancer-related symptoms. Methods Systematic review of clinical trials in English or French. Eight databases were searched. Included studies assessed the effectiveness of mirtazapine in alleviating one or more frequently encountered cancer-related symptoms. Comparator and validated assessment tools were required. Studies were independently appraised by two investigators before data synthesis. Results The search yielded 1898 references, from which we identified 12 relevant articles evaluating highly heterogeneous outcomes. These were two randomised-controlled (RCTs), three non-randomised controlled, and seven non-randomised non-controlled trials. In total, 392 participants were included and 185 were in RCTs. No study assessed the effectiveness of mirtazapine in alleviating symptoms at the same time, but some considered more than one symptom. Overall, the data was of poor quality, limited by small sample size and bias. However, mirtazapine showed effectiveness in treating depression, anxiety, sleep disorders, emesis and neuropathic pain. Across all studies, mirtazapine is safe to use, with drowsiness and dizziness the most common side-effects. Conclusion Study design and small sample sizes limit the ability to interpret results. Trials to assess the impact of mirtazapine or other medicines in alleviating multiple symptoms would be valuable.

Employment programmes and interventions targeting adults with autism spectrum disorder: A systematic review of the literature

Autism ◽  
2016 ◽  
Vol 21 (8) ◽  
pp. 929-941 ◽  
Author(s):  
Darren Hedley ◽  
Mirko Uljarević ◽  
Lauren Cameron ◽  
Santoshi Halder ◽  
Amanda Richdale ◽  
...  
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorder ◽  
Family System ◽  
Small Sample Size ◽  
Empirical Studies ◽  
Autism Spectrum ◽  
Small Sample ◽  
Spectrum Disorder ◽  
Future Research ◽  
The Impact

Individuals with autism spectrum disorder face significant challenges entering the workforce; yet research in this area is limited and the issues are poorly understood. In this systematic review, empirical peer-reviewed studies on employment programmes, interventions and employment-related outcomes in individuals with autism spectrum disorder over 18 years with and without intellectual disability were identified and evaluated. The review was prefaced by a summary of previous systematic reviews in the area. Web of Science, Medline, PsychINFO, ERIC and Scopus databases were systematically searched through to October 2015. From 32,829 records identified in the initial search, 10 review and 50 empirical articles, comprising N = 58,134 individuals with autism spectrum disorder, were included in the review. Selected articles were organised into the following themes: employment experiences, employment as a primary outcome, development of workplace skills, non-employment-related outcomes, assessment instruments, employer-focused and economic impact. Empirical studies were limited by poor participant characterisation, small sample size and/or a lack of randomisation and use of appropriate controls. Poor conceptualisation and measurement of outcomes significantly limited study quality and interpretation. Future research will require a multidisciplinary and multifaceted approach to explore employment outcomes on the individual, the family system, co-workers and the employer, along with the impact of individual differences on outcome.

scholarly journals Are Non-Binary People Really Essentialist?: A response to Garrison’s 2018 article “On the Limits of ‘Trans Enough’: Authenticating Trans Identity Narratives.”

2019 ◽  
Author(s):  
Mary Ann Vega ◽  
Jesse Holzman ◽  
Ningning Zhao ◽  
Barbara Risman
Keyword(s):  
Gender Identity ◽  
Small Sample Size ◽  
Small Sample ◽  
Recruitment Strategy ◽  
Small Samples ◽  
Theoretical Understanding ◽  
Complex Issue ◽  
Gender Binary ◽  
Identity Narratives ◽  
Wide Range

In a response to Spencer Garrison’s 2018 article “On the Limits of ‘Trans Enough’: Authenticating Trans Identity Narratives”, we argue that despite the author’s contributions to the theoretical understanding of non-binary identities, there are serious issues with the paper. We challenge Garrison’s assertions that non-binary individuals reproduce the gender binary in that they are more likely than binary trans individuals to use essentialist narratives to construct their gender identity. Due to Garrison’s criteria for participation in his study, all participants identified as trans and were in the process of transitioning. However, not all non-binary individuals identify as trans and consequently Garrison’s theorizing from a small sample of trans identified non-binary folks is problematic. We argue that the small sample size and Garrison’s recruitment strategy do not capture the wide range of individuals who identify as non-binary and that this small sample is not enough for Garrison to generalize about non-binary identified folks. Gender identity is a complex issue and while we commend Garrison for his contribution to the field, we argue that such work should be done with diligence as to ensure that research does not render identities invisible in early attempts to theorize with small samples.

scholarly journals A-070 Parental Perception of the Utility of Pediatric Neuropsychological Evaluation: A Systematic Review

2020 ◽  
Vol 35 (6) ◽  
pp. 861-861
Author(s):  
Deluco T ◽  
Katz N ◽  
Spano P ◽  
Stein C ◽  
Montalto D
Keyword(s):  
Systematic Review ◽  
Small Sample Size ◽  
Parent Satisfaction ◽  
Small Sample ◽  
Cochrane Library ◽  
Parental Perception ◽  
Neuropsychological Evaluation ◽  
Qualitative Synthesis ◽  
Neuropsychological Evaluations ◽  
The Impact

Abstract Objective Pediatric neuropsychological evaluations are intended to support children in their development and ability to function successfully in their everyday settings; however, limited efforts have been made to synthesize the available literature regarding the utility of these evaluations. To improve the impact of pediatric neuropsychological evaluations, a systematic review was conducted to identify components of the assessment and feedback process that are associated with parents’ perception of helpfulness (help parent understand child), usefulness (provide actionable information/elicit change) and overall parent satisfaction. Data Selection We followed PRISMA guidelines to conduct a systematic review of the literature to identify research on parental perception of the utility of pediatric neuropsychological evaluations for children aged 3–21 years. We searched PubMed, PsychINFO, Cochrane Library, and Web of Science databases using the terms “neuropsychology,” “pediatric,” “neuropsychological evaluation,” “neurodevelopmental disorders,” “perceived utility,” and “parental utility.” Data Synthesis We identified 1,029 abstracts and after full review included 9 articles in our qualitative synthesis. Conclusions Parents generally reported high levels of satisfaction with their child’s evaluation. The research has also suggested that parents find evaluations and feedback helpful for understanding their child’s pattern of strengths and weaknesses. Recommendations from the neuropsychologists provided useful information for obtaining support and eliciting change. Limitations of the studies reviewed included small sample size, variability in methods, and reduced generalizability of results.

An influence of social isolation on the level of physical activity as well as on well-being and mental state of people during the coronavirus COVID-19 pandemic

2019 ◽  
Vol 129 (4) ◽  
pp. 127-131
Author(s):  
Agnieszka Parfin ◽  
Krystian Wdowiak ◽  
Marzena Furtak-Niczyporuk ◽  
Jolanta Herda
Keyword(s):  
Physical Activity ◽  
Social Isolation ◽  
Small Sample Size ◽  
Statistical Tests ◽  
Population Group ◽  
Well Being ◽  
Small Sample ◽  
Subjective Well Being ◽  
Tract Infections ◽  
The Impact

AbstractIntroduction. The COVID-19 is the name of an infectious disease caused by a new strain of coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). It was first diagnosed in December 2019 in patients in Wuhan City, Hubei Province, China. The symptoms are dominated by features of respiratory tract infections, in some patients with a very severe course leading to respiratory failure and, in extreme cases to death. Due to the spread of the infection worldwide, the WHO declared a pandemic in March 2020.Aim. An investigation of the impact of social isolation introduced due to the coronavirus pandemic on selected aspects of life. The researchers focused on observing changes in habits related to physical activity and their connections with people’s subjective well-being and emotional state.Material and methods. The study was carried out within the international project of the group „IRG on COVID and exercise”. The research tool was a standardized questionnaire.Results. Based on the data collected and the analysis of the percentage results, it can be observed that the overwhelming majority of people taking up physical activity reported a better mood during the pandemic. However, statistical tests do not confirm these relationships due to the small sample size.Conclusions. Isolation favours physical activity. Future, in-depth studies, by enlarging the population group, are necessary to confirm the above observations.

scholarly journals The Role of Dopamine Receptor D2 in Bridging the Intention-Behavior Gap in Sport Participation

2021 ◽  
Vol 18 (5) ◽  
pp. 2379
Author(s):  
Seiyeong Park ◽  
Junhye Kwon ◽  
Chiyoung Ahn ◽  
Hae-Sung Cho ◽  
Hyo Youl Moon ◽  
...  
Keyword(s):  
University Students ◽  
Dopamine Receptor ◽  
Sport Participation ◽  
Small Sample Size ◽  
Behavioral Model ◽  
Small Sample ◽  
Male Students ◽  
Future Research ◽  
Dopamine Receptor D2 ◽  
The Impact

Previous studies have identified that a behavior can occur through the strongest predictor intention, but there is a gap between intention and behavior. Dopamine receptor D2 (DRD2) is known to account for a variance in sporting behaviors in human and animal subjects. However, the relationship between DRD2 and sport participation has been poorly studied, and the limited available reports are inconsistent. The present study was performed to examine the impact of DRD2 on sport participation among Korean university students based on the integrated behavioral model (IBM). Data were collected from enrolled university students in Seoul (N = 45). Participants answered survey questions first, and then they gave investigators their hair to provide DNA information (i.e., the A1 allele of DRD2). DRD2 had a significant effect on sport participation, but only in male students. Male students who carried the A1 allele of DRD2 significantly participated in 105.10 min more sporting activities than male students who did not. Moreover, the effect of intention on sport participation was significantly decreased when considering DRD2. Despite the small sample size, the results of this study could be a preliminary case for a larger study and indicate the direction of future research. Our results suggest that DRD2 may have played an important role as the “actual skill” shown in the IBM.

scholarly journals Treatment strategies for cerebrospinal shunt infections: a systematic review of observational studies

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038978
Author(s):  
Joan L Robinson ◽  
Dolores Freire ◽  
Liza Bialy
Keyword(s):  
Systematic Review ◽  
Small Sample Size ◽  
Treatment Strategies ◽  
Small Sample ◽  
Cochrane Library ◽  
Csf Shunt ◽  
Entry Site ◽  
Recurrence Rates ◽  
Ovid Medline ◽  
Shunt Infections

ObjectiveA systematic review was conducted of studies comparing time to cerebrospinal fluid (CSF) sterilisation or rate of recurrence with different treatment strategies for CSF shunt infections.MethodsA librarian-directed search was conducted of Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid Medline Daily and Ovid Medline, Ovid Embase, Wiley Cochrane Library, CINAHL Plus with Full Text via EBSCOhost, Scopus Advanced Search, and Web of Science Core Collection from 1990 to May 2019. Studies of any design that compared outcomes in groups of any age with different management strategies were included. Studies that compared complete versus incomplete shunt removal were excluded. Quality assessment was performed with the Newcastle-Ottawa Scale.ResultsThe search identified 2208 records, of which 8 met the inclusion criteria. All were cohort studies of moderate quality. Four studies compared the duration of antibiotics; none demonstrates that a longer course prevented recurrences. Two studies analysed addition of rifampin, with one showing a decrease in recurrences while the other had a small sample size. No studies analysed the addition of intraventricular antibiotics, but one showed equally good results with once versus twice daily administration. One study reported no difference in recurrences with placement of antibiotic-impregnated catheters. Recurrence rates did not differ with shunt replacement minimum of 7 days vs less than 7 days after CSF became sterile. There were no recurrences in either group when shunt replacement was performed after sterile CSF cultures were obtained at 24 vs 48 hours after antibiotics were discontinued. A new shunt entry site did not decrease recurrences.DiscussionThe main limitations are the lack of high-quality studies, the small sample sizes and the heterogeneity which precluded meta-analysis. Addition of rifampin for staphylococcal infections may decrease relapse but requires further study.

scholarly journals The incidence and prevalence of cardiovascular diseases in gout: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Peter Cox ◽  
Sonal Gupta ◽  
Sizheng Steven Zhao ◽  
David M. Hughes
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Random Effect ◽  
Small Sample ◽  
Future Research ◽  
Increased Risk

AbstractThe aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.

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