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Objectives: We explored whether gender differences in burnout and work engagement characteristics among residents changed after the representation of female physicians has surpassed the 30% threshold of critical mass between 2005 and 2015, as well as if these gender differences are influenced by working in a surgical versus a non-surgical specialty., Methods: This study used data of two questionnaire surveys on the well-being of Dutch residents, collected in 2005 ( N  = 2115) and 2015 ( N  = 1231). Burnout was measured with the validated Dutch translation of the Maslach Burnout Inventory, covering the characteristics emotional exhaustion, depersonalisation and personal accomplishment. Work engagement was measured with the Utrecht Work Engagement Scale, covering the characteristics vigour, dedication and absorption. Gender differences in residents' engagement and burnout characteristics in 2005 and 2015 were analysed using hierarchical regression analyses. Factorial analyses of variance were used to compare gender differences in residents' burnout and engagement characteristics in general surgery with those in internal medicine., Results: In both years, female residents reported higher emotional exhaustion, lower depersonalisation, personal accomplishment, and vigour than males. These gender differences were similar in general surgery and internal medicine., Conclusions: This study demonstrated unchanged gender differences in burnout and work engagement characteristics among residents after 10 years of demographic feminisation (increasing female representation), indicating higher risk for burnout and lower work engagement among females, both in surgical and non-surgical specialties. In view of the ever-increasing number of female residents, educators and hospitals need to create supporting work environments that safeguard residents' well-being., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s) 2024.)

Background: Human exposure to pesticides is being associated with feminisation for which a decrease of the anogenital distance (AGD) is a sensitive endpoint. Dose addition for the cumulative risk assessment of pesticides in food is considered sufficiently conservative for combinations of compounds with both similar and dissimilar modes of action (MoA)., Objective: The present study was designed to test the dose addition hypothesis in a binary mixture of endocrine active compounds with a dissimilar mode of action for the endpoint feminisation., Methods: Compounds were selected from a list of chemicals of which exposure is related to a decrease of the AGD in rats and completed with reference compounds. These chemicals were characterised using specific in vitro transcriptional activation (TA) assays for estrogenic and androgenic properties, leading to a final selection of dienestrol as an ER-agonist and flutamide, linuron, and deltamethrin as AR-antagonists. These compounds were then tested in an in vivo model, i.e. in zebrafish (Danio rerio), using sex ratio in the population as an endpoint in order to confirm their feminising effect and MoA. Ultimately, the fish model was used to test a binary mixture of flutamide and dienestrol., Results: Statistical analysis of the binary mixture of flutamide and dienestrol in the fish sexual development tests (FSDT) with zebrafish supported dose addition., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Wolbachia-induced feminisation is an extended phenotype that has been observed in only three models: isopods, butterflies and leafhoppers. Even among these, the process of feminisation differs markedly, especially since sexual differentiation is coordinated body-wide by a hormone in isopods, whereas in insects it is a chromosomally determined process and enforced cell by cell. For isopods, Armadillidium vulgare has contributed substantially to an understanding of Wolbachia-mediated feminisation, because a wide array of know-how and methods has been tailored to this model. Here, we describe establishment and maintenance of Wolbachia-infected laboratory lineages from animals collected in the field, the grafting of an androgenic gland to demonstrate the mode of action of Wolbachia (i.e. the disruption of the Androgenic Hormone pathway), and transinfection of naïve adults with Wolbachia. Finally, we describe selection of a ZZ genetic background in lineages created from transinfected WZ females, which is necessary to benefit from a property intrinsic to the naturally infected lineages: In a ZZ background, the vertical transmission rate of Wolbachia directly equates to the female ratio in the progeny. These protocols provide the essential framework for investigating molecular aspects of Wolbachia-induced feminisation., (© 2024. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

In snakeskin gourami (Trichopodus pectoralis), females are generally larger than males, and estradiol-17β (E2)-sex reversal to produce female monosex has gained interest in this species. In this study, we aimed to investigate the effects of E2-induced sex reversal on growth, physiological and immune parameters, and gonadal gene expression in adult snakeskin gourami. Fry (7 days posthatching) were divided into different experimental groups based on the dose of E2: control (no E2 (0 mg kg -1 ) supplementation), E2-100 (100 mg kg -1 ), E2-200 (200 mg kg -1 ), and E2-300 (300 mg kg -1 ), fed with the E2 doses for 90 d and cultured for 11 months (adult stage). The findings revealed that E2 supplementation produced 88.89-100% of female population. After 11 months of culture, the effects of sexual dimorphism on the growth performance of the E2-100 group were not significant compared to that on the growth performance of the control male and female groups; however, it improved significantly in the E2-200 and E2-300 groups (P < 0.05). E2 elevated the CP and fat contents in body in E2-200 and E2-300 groups (P < 0.05) compared to that in the control group. No sex differences in blood metabolites, haematological values, or immune parameters were identified. Nevertheless, E2-200 and E2-300 groups showed increased blood glucose, triglyceride, haemoglobin, and total immunoglobulin (P < 0.05) compared to control male fish. In addition, all concentrations of E2 increased alternative complement 50 (P < 0.05). Several genes, including bHLH, cyp19a1, daz, deadend, esrb, esrrg, gnrhr, gpa, gsg1l, hsd17β, mospd1, nanos2, p53, piwi2, rerg, rps6ka, tgfb, and vgr, showed differential expression between testis and ovary in control female and E2-treated groups. The expression patterns of the genes were similar in the ovary of the control female and E2-200-treated fish. In conclusion, the findings demonstrate that a feminisation duration of 7-97 days and two doses of E2 at 200 or 300 mg kg -1 successfully produced all-female stocks in snakeskin gourami. Furthermore, the findings showed that E2-treated females were maintained throughout adulthood and exhibited several superior characteristics to male fish. Together with the information generated on differentially expressed sex-related genes, these findings could enable the culturing of faster-growing sex to increase productivity and contribute to the development of intensive snakeskin gourami farming., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Purpose: Despite the feminization of the medical profession, the academic world remains largely male-dominated. Several studies conducted in the English-speaking world have shown that women are published less than men. Our goal is to define the evolution of the role of women in five French medical journals., Materials and Methods: The articles from five French journals (Revue du Praticien, Bulletin du Cancer, Exercer, Presse Médicale, Cancer/Radiothérapie) published in February between 1983 and 2019 were included. We selected twelve years from that period of time. The analysis was completed using Cochran-Armitage tests with a significance level of<0,05. Among the authors, 4397 were included in total and we were able to determine the gender of 4309 of them., Results: The percentage of female authors went from 16% in 1983 to 36.4% in 2019 (p<0.001). This rise is more significant for those specializing in surgery than for those specializing in medicine, with a percentage going from 14% to 38.5% (p<0.001) against 16.8% to 35.4% (p<0.001) respectively. In 2019, women still only represent 30.2% of the last authors, 27.6% of editorial authors and 30.6% of corresponding authors., Conclusion: Our study underlines a significant increase in the number of female authors and highlights that their position as authors remains on the margins of the most prestigious authorial positions. While we can celebrate this increase, we nevertheless notice that there are fewer female authors than female practitioners., (Copyright © 2022 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Facial feminisation surgery (FFS) is integral to the management of transgender adult females. Literature detailing the conduct and outcomes of FFS is lacking. The aim of this project was to review surgical practices in NHS Scotland. We identified Gender Identity Clinics throughout Scotland. These clinics were then contacted to discuss which services were available regarding FFS and to whom they refer patients. Retrospective review of electronic case notes between June 2014 and June 2019 was carried out and data was recorded on patient demographics, procedures employed, surgical complications, and postoperative outcome. FFS was carried out in two centres. Sixty patients received FFS during the study period, in 160 separate surgical procedures. Patients were all transitioning from natal biological male to female gender, with an average age of 36 years. The most common procedure was rhinoplasty (n = 36). Surgical complications occurred in eight procedures, and negative outcomes were recorded in 12/88 operating sessions. Increasing demand for surgery was noted throughout the study period. These results suggest that a wide variety of procedures are used, and that FFS is well accepted with relatively few surgical complications and negative outcomes. In depth understanding of patient's perceptions and views of their experiences, alongside objective measures, are essential to determine the impacts of FFS., (Copyright © 2021 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: The implications of the feminisation of medicine, which is characterised by a growing proportion of female doctors, is a topic currently being debated worldwide. To date, however, there has been no systematic survey of the viewpoint of present and future doctors on this subject. The aim of the present study is to determine how future and present doctors view this trend in terms of its relevance to the medical profession and its present impacts., Methods: Of a total sample of 3813 people, 181 applicants for the winter term 2014, 590 medical students and 225 doctors of the UMG participated in this cross-sectional electronic questionnaire. The answers were analysed by means of the statistics program IBM SPSS Statistics 22. Open answers were qualitatively evaluated and categorised using the "Basiswissengeleitete offene Kategorienfindung" (Werner Früh) and coded for statistical analysis., Results: The majority of our participants favoured a balanced gender-ratio among doctors: 77% of applicants, 68% of students and 61% of doctors rated this as important or very important. The results from the student and applicant groups differed concerning female gender. When answering in the role of a patient, the doctor's gender was found to be more relevant than when the participants were answering in the role of the doctor. The majority of the respondents opined that feminisation had had an impact on their workplace: particular factors included part-time work, work-related organisation and the diversity of the medical profession. Commentaries were mostly categorised as negative., Conclusions: The feminisation of medicine was viewed largely critically by the participants of this study. The respondents evaluated gender as being relevant for the medical profession and favoured a diverse workforce; however, the significance of one's own gender in medical practice was underrated in comparison, implying a need for more awareness of the effect of a doctor's gender on the patient-doctor-relationship. The mainly negative comments concerning the impact of feminisiation on work organisation, work satisfaction and patient care show the need for further research and action to adapt current medical work practices to the changing demographics in order to improve work satisfaction and quality of care.

As a result of scandals concerning sexual harassment in Hollywood and in the media, as well as questions regarding the size of the gender pay gap, considerable attention has recently been paid to questions of gender diversity and discrimination in organisations. Gender issues would appear particularly salient within the veterinary profession, not least because women are beginning to outnumber men as practitioners. While this research on veterinary surgeons was not initially focused on gender, as the study progressed gender became an issue of such importance that it could not be ignored. Although 'feminized in numerical terms', the veterinary profession and 'its professional structure and culture remains gendered masculine'. Translated into practice, this means that although 76 per cent of vet school graduates are currently female, disproportionately few have risen or are rising through the hierarchy. On the surface it is easy to rationalise this away partly by simply stating how many female vets appear to sacrifice career for family, but the authors' aim is to go beyond merely repeating and reinforcing the common sense view of female reproduction and parenting as the sole explanation for gender inequality within this and other professions., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

The astrocytic glutamine (Gln)-glutamate (Glu) cycle (GGC) supplies Gln for the regulation of glutamatergic synaptic transmission (GST) in the adult hippocampus. Increased synaptic Glu release in the perinatal ventrolateral ventromedial nucleus of the hypothalamus (vlVMH) modulates sexual differentiation, however, whether GGC regulates GST in the perinatal vlVMH has not been determined. Sex differences in oestradiol (E 2 ) levels exist in the neonatal hypothalamus, and E 2 increases levels of glutamine synthetase and glutaminase, two key enzymes involved in the GGC. Thus, it is hypothesised that sexually dimorphic phenotypes may exist in glutamatergic synapses associated with the GGC in the vlVMH in perinatal rats. Whole-cell voltage-clamp recordings in vlVMH neurones in brain slices from male and female pups revealed that pharmacological disruption of the GGC by α-(methylamino) isobutyric acid (5 mmol L -1 ), which blocks neuronal Gln uptake; or by l-methionine sulphoximine (1.5 mmol L -1 ), which inhibits astrocytic Gln synthesis, decreased miniature excitatory postsynaptic current (mEPSC) amplitudes in female but not male pups. By contrast, GGC interruptions decreased evoked (e)EPSC amplitudes in both sexes following increased synaptic activity produced by a period of stimulation. In male pups, the decreased eEPSCs were attributable to reduced Glu release, as assessed by paired-pulse stimulations, whereas, in female pups, they were attributable to decreased Glu content in the synaptic vesicles, as measured by strontium-evoked mEPSCs. The l-methionine sulphoximine-mediated decrease in eEPSCs was rapidly rescued by exogenous Gln in female but not male pups. The reductions in mEPSCs and eEPSCs in female pups were accompanied by enhanced blocking effects of the low-affinity Glu AMPA receptor antagonist, γ-d-glutamylglycine, consistent with diminished Glu release. In conclusion, female, but not male pups, rely on constitutive astrocytic Gln for sustained synaptic Glu release in the vlVMH. This glutamatergic synaptic phenotype may be associated with brain and behaviour feminisation and/or defeminisation in rats., (© 2018 British Society for Neuroendocrinology.)

Purpose/objective: This research investigates the participation and completion rates of Irish female undergraduate dental students from 2003 to 2014., Methods: The Higher Education Authority database was accessed and dental students enrolment and completion figures were extracted, compiled and analysed according to gender distribution., Result: From 2003 to 2014, there has been a steady increase in the number of female students enrolled in and completing Ireland's undergraduate dentistry programmes., Conclusions: The findings reveal that a distinct process of feminisation has occurred in Ireland since the early 2000s. The feminisation of dentistry in Ireland will impact on workforce projections for the Irish dental service. However, more research needs to be undertaken to explore why female students are motivated to pursue a career in dentistry. Due regard also needs to be given to ensuring these women progress in their dental career. Dental education can play an important role here., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The shortage of skilled personnel is ubiquitous, basic and further training is a key aspect in the recruitment of new medical colleagues. The significance of the nursing practicum in its function as gateway to the gynaecology and obstetrics discipline is practically unexplored. Methods: In an online questionnaire, medical students in all German faculties were questioned about the practica in their courses. The questionnaire reached 9079 medical students. 149 participants in nursing practica were selectively asked to answer 140 questions. We analysed those students who could, on the basis of their experiences in nursing practica, imagine undertaking an internship (clinical elective) in gynaecology (internship yes "Iy") separately from those who could not or were still undecided (internship no "In" or, respectively, internship perhaps "Ip"). Results: Altogether 149 medical students who participated in a nursing practicum in the gynaecology discipline were selected, of these 94.9 % were female. 92 (61.7 %) of the students replied that, after their gynaecological nursing practicum, they wanted to undertake an internship in gynaecology (Iy); 39 (26.2 %) answered negatively (In) and 18 (12.1 %) were still undecided (Ip). With regard to the parameters gender, age and duration of study, there were no significant differences among the 3 groups (χ 2  0.83). Besides the didactic and professional quality of the training, Iy also mentioned having had a higher practical orientation. They attained their aims more frequently, were better integrated in the health-care team and acquired more practical competences. Satisfaction with the practicum was evaluated as highest among the Iy. Discussion: Those students who could imagine taking an internship in gynaecology were seen to be more satisfied with their practica than those participants who declined or were undecided. The high proportion of females is an early indicator for a feminisation of the specialty. If necessary this could be countered with the help of nursing management.

Globally, amphibians are undergoing a precipitous decline. At the last estimate in 2004, 32% of the approximately 6000 species were threatened with extinction and 43% were experiencing significant declines. These declines have been linked with a wide range of environmental pressures from habitat loss to climate change, disease and pollution. This review evaluates the evidence that endocrine-disrupting contaminants (EDCs) - pollutants that affect hormone systems - are impacting on wild amphibians and contributing to population declines. The review is limited to anurans (frogs and toads) as data for effects of EDCs on wild urodeles (salamanders, newts) or caecilians (limbless amphibians) are extremely limited. Evidence from laboratory studies has shown that a wide range of chemicals have the ability to alter hormone systems and affect reproductive development and function in anurans, but for the most part only at concentrations exceeding those normally found in natural environments. Exceptions can be found for exposures to the herbicide atrazine and polychlorinated biphenyls in leopard frogs (Rana pipiens) and perchlorate in African clawed frogs (Xenopus laevis). These contaminants induce feminising effects on the male gonads (including 'intersex' - oocytes within testes) at concentrations measured in some aquatic environments. The most extensive data for effects of an EDC in wild amphibian populations are for feminising effects of atrazine on male gonad development in regions across the USA. Even where strong evidence has been provided for feminising effects of EDCs, however, the possible impact of these effects on fertility and breeding outcome has not been established, making inference for effects on populations difficult. Laboratory studies have shown that various chemicals, including perchlorate, polychlorinated biphenyls and bromodiphenylethers, also act as endocrine disrupters through interfering with thyroid-dependent processes that are fundamental for amphibian metamorphosis. Perchlorate has also been shown to induce these effects in wild anuran populations from perchlorate-contaminated environments. Overall, the published data available suggest that some health effects observed in wild anuran populations, most notably intersex, likely have a chemical aetiology; however they derive only from very few anuran species and for a few pesticides at field sites in the USA. To understand better the impacts of EDCs on wild anuran populations, as well as other amphibian groups, assessment of fertility in exposed animals are required. Development of non-destructive biomarkers that are indicative of specific EDC-effect mechanisms are also needed to allow the study of vulnerable populations. This will help to distinguish the effects of EDCs from other environmental and/or genetic influences on development and reproduction., (© 2014 The Authors. Biological Reviews © 2014 Cambridge Philosophical Society.)

Sexual disruption is reported in wild fish populations living in freshwaters receiving discharges of wastewater treatment works (WwTW) effluents and is associated primarily with the feminisation of males by exposure to oestrogenic chemicals. Antiandrogens could also contribute to the feminisation of male fish, but there are far less data supporting this hypothesis and almost nothing is known for the effects of oestrogens in combination with antiandrogens in fish. We conducted a series of in vivo exposures in two fish species to investigate the potency on reproductive-relevant endpoints of the antiandrogenic antimicrobials triclosan (TCS), chlorophene (CP) and dichlorophene (DCP) and the resin, abietic acid (AbA), all found widely in WwTW effluents. We also undertook exposures with a mixture of antiandrogens and a mixture of antiandrogens in combination with the oestrogen 17α-ethinyloestradiol (EE2). In stickleback (Gasterosteus aculeatus), DCP showed a tendency to reduce spiggin induction in females androgenised by dihydrotestosterone (DHT), but these findings were not conclusive. In roach (Rutilus rutilus), exposures to DCP (178 days), or a mixture of TCS, CP and AbA (185 days), or to the model antiandrogen flutamide (FL, 178 days) had no effect on gonadal sex ratio or on the development of the reproductive ducts. Exposure to EE2 (1.5ng/L, 185 days) induced feminisation of the ducts in 17% of the males and in the mixture of antiandrogens (TCS, CP, AbA) in combination with EE2, almost all (96%) of the males had a feminised reproductive ducts. In stickleback androgen receptor (ARα and ARβ) transactivation assays, the model antiandrogens, FL and procymidone inhibited 11-ketotestosterone (11-KT) induced receptor activation, but none of the human antiandrogens, TCS, CP, DCP and AbA had an effect. These data indicate that antimicrobial antiandrogens in combination can contribute to the feminisation process in exposed males, but they do not appear to act through the androgen receptor in fish., (Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.)

Feminisation of amphipod crustaceans is associated with the presence of at least three microsporidian parasites and one paramyxean parasite, suggesting that the ability to feminise has evolved multiple times in parasites of amphipods. Co-infection by a paramyxean with one of the putative microsporidian feminisers, Dictyocoela duebenum, has inspired the alternative hypothesis that all feminisation of amphipods is caused by paramyxea and that all microsporidian associations with feminisation are due to co-infection with paramyxea (Short et al., 2012). In a population of the amphipod Gammarus duebeni, breeding experiments demonstrate that the microsporidia D. duebenum and Nosema granulosis are associated with feminisation in the absence of paramyxea. Co-infection of the two microsporidia is no more frequent than expected at random and each parasite is associated with feminisation in the absence of the other. These findings support the original hypothesis that the ability to feminise amphipods has evolved in microsporidia on multiple occasions. Additionally, the occurrence of a non-feminising strain of D. duebenum in Gammarus pulex suggests that different strains vary in their feminising ability, even within microsporidian species. The presence or absence of feminising ability in a particular microsporidian strain should not therefore be generalised to the species as a whole., (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Little information is available on the public health workforce. This study contributes to the gap in the literature and examines the demographic characteristics, career destinations and earnings of Masters in Public Health (MPH) graduates in Australia, using data from the 1999-2009 waves of the Graduate Destination Survey. It was found that public health graduates had a high amount of female representation and very low proportions of indigenous representation. Public health graduates experienced a relatively low unemployment rate and 85% were employed within 120 days of graduation. However, close to half of the graduates did not work in the health industry or in health-related roles. The mean salaries of public health graduates working in public health roles were relatively low compared to those in other occupations, but they had a range comparable to that observed for public health professionals in the USA and were higher than those of other Masters graduates in some other health fields. The results indicate strong demand and positive employment prospects for public health graduates in Australia. Strategies to target recruitment and/or retention of female or indigenous graduates in the public health workforce should be a priority. Mapping of public health graduate destinations and employment prospects should might be prioritised, given its strong potential to facilitate workforce planning and provide potential public health workers with more comprehensive career trajectories., (© Royal Society for Public Health 2013.)

Introduction: At present the topic "feminisation" in medicine, in other words the increasing number of female staff members is under heavy discussion; however, there are only few data upon the basis of which a scientific discussion can be held. The question arises as to the possibility of problems arising therefrom for the specialty gynaecology and obstetrics. Methods: With the help of a questionnaire the directors of departments of gynaecology and obstetrics were questioned about the various aspects of the topic feminisation in gynaecology and obstetrics. Results: Among current applications the proportion of female applicants is estimated to be 84.2 %. Reasons given most frequently for the feminisation in the specialty include low income, loss of face of the medical profession and the poor career chances. Among the spontaneously mentioned reasons were the increasingly female dominated image of gynaecology and the working conditions in hospitals. Whereas the taking on of surgical duties and of directing functions was less markedly desired by women than by men, the questioned directors found that male and female staff members were equally motivated to take on duties outside of their working hours or to engage in research work. Discussion: Feminisation in medicine represents a challenge. It seems to be important to evaluate and investigate the motivation of staff members with regard to their wishes in professional life and thus to be able to offer an appropriate working environment based on the survey results.