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回顾发现:在疼痛研究中存在男性偏见

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2020年05月23日

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Review finds persistent male bias in pain research

回顾发现:在疼痛研究中存在男性偏见

It is increasingly clear that male and female humans and rodents process pain in different ways. And that there are important differences in the underlying mechanisms involved at genetic, molecular, cellular, and physiological levels. Despite this fact, according to a review paper from McGill University published today in Nature Reviews Neuroscience, most pain research remains overwhelmingly based on the study of male rodents, continuing to test hypotheses derived from earlier experiments on males. This points to an important blind spot in pain research, particularly as it relates to advancing research into new pain medications. This is especially troublesome given that it is well-documented that most chronic pain sufferers are female.

越来越明显的是,男性和女性以及啮齿动物处理疼痛的方式不同。在遗传、分子、细胞和生理水平上的潜在机制存在重大差异。尽管如此,根据麦吉尔大学今天在《自然评论神经科学》上发表的一篇综述论文,大多数关于疼痛的研究仍然绝大多数基于对雄性啮齿动物的研究,继续测试来自早期男性实验的假设。这指出了疼痛研究中一个重要的盲点,尤其是当它涉及到新止痛药的研究进展时。考虑到大多数慢性疼痛患者都是女性,这一点尤其麻烦。

Canadian funding agencies began recognizing sex as a biological variable and asking pain researchers to include female rodents in their experiments in 2006. In the US, a similar shift took place in 2016. Indeed, of the more than 1000 scholarly articles that Mogil reviewed published between January 2015 and December 2019 in Pain, the leading journal in the field, starting in 2016 more and more papers featured testing of both female and male rodents, with male-only studies dropping from 80% of the total in 2015 to only 50% of the total in 2019.

2006年,加拿大的资助机构开始认识到性别是一个生物变量,并要求疼痛研究人员将雌性啮齿动物纳入他们的实验中。在美国,2016年也发生了类似的转变。事实上,莫吉尔对2015年1月至2019年12月发表在《疼痛》(Pain)——该领域的权威期刊——的1000多名学术文章进行了回顾发现,从2016年开始,其中越来越多的论文同时对雌性和雄性啮齿动物进行了测试,仅对雄性的研究从2015年的80%下降到2019年的50%。

At first glance, the presence of these articles may represent a promising shift in research design. But when Mogil looked more closely at the existing sex differences in pain literature, he found clear evidence of a persistent male bias.

乍一看,这些文章的出现可能代表了研究设计的一个有希望的转变。但当Mogil更仔细地研究疼痛文献中存在的性别差异时,他发现了男性偏见存在的明显证据。

回顾发现:在疼痛研究中存在男性偏见

"The very ideas we come up with for experiments, are based on experiments in males and therefore they work in males and not in females. I discovered that in those papers where both sexes were actually tested and results reported on the differences by sex, the experiments "worked out", meaning the scientific hypothesis being tested was found to be true, in males 72.4% of the time and in females only 27.6%," said Mogil. "If there were no bias in the literature and there were a number of papers were the experiment worked in one sex and not the other, it should work in females just as often as in males. Why has this happened? Because the hypothesis that that experiment tested out was generated based on prior data from experiments on only males. So, of course, it only worked in males."

“我们为实验提出的想法,是基于对男性的实验,因此它们在男性身上起作用,而不是在女性身上。”莫吉尔说:“我发现,在那些对两性进行实际测试并报告性别差异结果的论文中,实验“成功了”,这意味着被测试的科学假设是正确的,男性的72.4%和女性只有27.6%。”“如果在文献中没有偏见,并且有很多论文证明这个实验只适用于一种性别而不适用另一种性别,那么这个实验在女性身上的效果应该和在男性身上一样。为什么会这样?因为实验验证的假设是基于之前只对男性的实验数据。所以,当然,它只对男性有效。”

According to Mogil, the conclusion that can be reached from this overview is that researchers are still some way away from developing analgesics that will work in women.

莫吉尔认为,从这一综述中可以得出的结论是,研究人员距离开发出适用于女性的止痛剂还有一段距离。

"This research suggests that lots of what's in the pipeline right now, if it works in anyone at all, will largely be men. Whereas the clear majority of chronic pain patients have been and continue to be women."

“这项研究表明,目前正在进行的许多研究,如果对任何人都奏效的话,将主要指的是男性。然而,绝大多数慢性疼痛患者过去及将来都是女性。”


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