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To examine the association between cumulative exposure to neighborhood walkability (NW) and diabetes risk. A total of 11,037 women free of diabetes at enrollment were included. We constructed a 4-item NW index at baseline, and a 2-item average annual NW across years of follow-up that captured both changes in neighborhood features and residential moves. We used multivariable Cox PH regression models with robust variance to estimate the hazard ratios (HRs) of diabetes by NW scores. Compared with women living in areas with lowest NW (Q1), those living in areas with highest NW (Q4) had 33 % (26 %−39 %) reduced risk of incident diabetes, using baseline NW, and 25 % (95 % CI 11 %−36 %), using average annual NW. Analysis using time-varying exposure showed that diabetes risks decreased by 13 % (10 %−16 %) per -standard deviation increase in NW. The associations remained similar when using inverse probability of attrition weights and/or competing risk models to account for the effect of censoring due to death or non-response. The associations of average annual NW with incident diabetes were stronger in postmenopausal women as compared to premenopausal women. Long-term residence in more walkable neighborhoods may be protective against diabetes in women, especially postmenopausal women. • We constructed a 4-item baseline and a 2-item average annual walkability index. • Women living in the most walkable neighborhood had 25 %−33 % reduced risk in diabetes. • The protective associations remained apparent in older women and postmenopausal women. [ABSTRACT FROM AUTHOR]

Little is known about the time trends of postpartum depression (PPD) and whether they differ from time trends of depression among women in general. Using Danish health registers, we identified a postpartum population from all women who had a liveborn child from 2000-2022. We sampled a background population by matching five women for each delivery on age and date of childbirth. Depression and PPD were measured as incident depression diagnosis or redeemed antidepressant prescription within 180 days from childbirth/matching. We described incidence rates from 2000-2022 using Poisson regression with a restricted cubic spline. The study population included 1,133,947 postpartum women (669,101 unique), matched to 5,669,735 women (1,165,505 unique). Overall IR per 10,000 person-years of diagnoses was 34.3 (95% CI: 32.8–35.9) for PPD and 18.9 (95% CI: 18.3–19.4) for depression. Both IRs increased similarly over time in the main analyses, but more pronounced for PPD in primiparous and older mothers. Correspondingly, IR for prescriptions was 135.7 (95% CI: 132.7–138.8) for PPD and 209.8 (95% CI: 208.1–211.5) for depression, and both groups had fluctuating time trends. Depression measures were based on women who actively sought and received treatment, expectedly underestimating true disease incidence. Incidence rates of PPD and depression diagnoses increased over time, especially for PPD among primiparous and older mothers. These findings could suggest either increased vulnerability or increased awareness and detection over time in these groups. Fluctuating trends overserved from prescriptions could likely be driven by external factors and not a reflection of disease trends. • Incidence of postpartum depression diagnoses has increased over the past decades. • Time trends of postpartum depression and depression in women are overall similar. • Postpartum depression has increased particularly in primiparous and older mothers. • Using antidepressants as depression markers may not reflect disease time trends. [ABSTRACT FROM AUTHOR]

Higher diet quality scores are associated with a lower risk for many chronic diseases and all-cause mortality; however, it is unclear if diet quality is associated with aging biology. This study aimed to examine the association between diet quality and a measure of biological aging known as epigenetic aging. A cross-sectional data analysis was used to examine the association between three diet quality scores based on self-reported food frequency questionnaire data and five measures of epigenetic aging based on DNA methylation (DNAm) data from peripheral blood. This study included 4,500 postmenopausal women recruited from multiple sites across the United States (1993-98), aged 50 to 79 years, with food frequency questionnaire and DNAm data available from the Women's Health Initiative baseline visit. Five established epigenetic aging measures were generated from HumanMethylation450 Beadchip DNAm data, including AgeAccelHannum, AgeAccelHorvath, AgeAccelPheno, AgeAccelGrim, and DunedinPACE. Linear mixed models were used to test for associations between three diet quality scores (Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores) and epigenetic aging measures, adjusted for age, race and ethnicity, education, tobacco smoking, physical activity, Women's Health Initiative substudy from which DNAm data were obtained, and DNAm-based estimates of leukocyte proportions. Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores were all inversely associated with AgeAccelPheno, AgeAccelGrim, and DunedinPACE (P < 0.05), with the largest effects with DunedinPACE. A one standard deviation increment in diet quality scores was associated with a decrement (β ± SE) in DunedinPACE z score of –0.097 ± 0.014 (P = 9.70 x 10-13) for Healthy Eating Index, –0.107 ± 0.014 (P = 1.53 x 10-14) for Dietary Approaches to Stop Hypertension, and –0.068 ± 0.013 (P = 2.31 x 10-07) for the alternate Mediterranean diet. In postmenopausal women, diet quality scores were inversely associated with DNAm-based measures of biological aging, particularly DunedinPACE. [ABSTRACT FROM AUTHOR]

Type 2 diabetes is a major public health concern in the United States and worldwide. The dietary inflammatory index (DII) and the energy-adjusted DII (E-DII) are tools that assess dietary inflammation. Previous evidence suggests that obesity can modify the association between inflammation and disease. The aim of this study was to evaluate the association between the DII/E-DII and incident diabetes in self-identified Hispanic women from the Women's Health Initiative (WHI). The secondary aim was to evaluate whether obesity modifies the association between the DII/E-DII scores and incident diabetes. Participants were from the WHI Observational Study and the Clinical Trial Components (except women from the treatment arm in the Dietary Modification Trial) conducted among postmenopausal women in the United States. DII/E-DII scores were calculated from a self-administered food frequency questionnaire at baseline that included 122 food items, of which 12 are representative of Hispanic eating patterns. Participants included 3,849 postmenopausal women who self-identified as Hispanic that were recruited for the WHI from 1993 to 1998 at 40 US clinical centers. The outcome was incident diabetes. Cox regression models were used to assess the association between DII/E-DII and incident diabetes. Models were adjusted for age at baseline, lifestyle-related risk factors, known type 2 diabetes mellitus (T2DM) risk factors, and neighborhood socioeconomic status. Interaction was tested between the DII/E-DII scores and obesity. The incidence of diabetes was 13.1% after a median follow-up of 13 years. Higher E-DII scores were associated with a higher risk of incident diabetes (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.04–1.14). There was no interaction between E-DII scores and obesity (P = 0.73). Pro-inflammatory diets, as measured by higher E-DII scores, were associated with a higher risk of incident diabetes. Future research is needed for understanding how the inflammatory potential of diets can be decreased. [ABSTRACT FROM AUTHOR]

It is well known that women have been plagued by various skin problems. However, research on the characteristics of women's skin at different ages is still inadequate. In addition, there is a lack of research on the extent of women's skincare habits and skin care awareness. A cross-sectional survey on skin was carried out in Shanghai, China, which was conducted by means of a questionnaire. 3678 women, aged 18–59 years, participated in the study. The information collected focused on the importance they place on their skin, the skin problems they have, and their use and perception of skin care products. Before the age of 25, the most common skin problems that women face are dryness and oiliness, while after the age of 30, skin-ageing issues begin to appear and worsen with age. In addition, the higher the level of education, the higher the frequency of and compliance with sunscreen use, and the economy also affects women's use of sunscreen. Importantly, the importance women place on their skin and the level of sunscreen awareness affects women's use of sunscreen. This study was conducted to understand the skin characteristics of women of different age groups as well as to determine the factors that influence the use of sunscreens, which will not only promote women's skin care practices and product development, but also provide important clues for future activities on sunscreen use and health promotion. • This study examines the relationship and changing trends between various skin problems and age. • Women of different ages face different skin problems, the most common skin problems are dry, greasy and aging. • The higher the level of education, the higher the frequency of and compliance with sunscreen use, and the economy also affects women's use of sunscreen. • The importance women place on their skin and the level of sunscreen awareness affects women's use of sunscreen. [ABSTRACT FROM AUTHOR]

Menopause, characterized by a sudden decline in estrogen levels, has significant effects on women's health, especially when it occurs early. This study aimed to investigate the associations between menopausal age and incidence of metabolic dysfunction-associated fatty liver disease (MAFLD) using a large cohort and a long-term follow-up. Menopausal age was categorized into four groups (G1–4 [<40, 40–44, 45–49, and ≥50 years, respectively]). Cox proportional hazards regression analysis was used to assess the risk of developing MAFLD during the follow-up period according to the menopausal age categories. A total of 1,888 participants were included in the final analysis and followed for a median period of 12.3 years. The unadjusted hazard ratios (95 % CIs) for the incidence of new-onset MAFLD were 1.11 (0.93–1.32), 1.15 (0.90–1.47), and 1.52 (1.12–2.07) in G3, G2, and G1, respectively, compared with that in G4. After adjusting for confounders, the hazard ratio (95 % CIs) for the incidence of new-onset MAFLD was 1.40 (1.00–1.95) in G1 compared with that in G4. The risk of developing MAFLD was higher in women with premature menopause (<40 years) than in those with menopause aged ≥50 years. [ABSTRACT FROM AUTHOR]

Sofia Ionescu (1920–2008) was the first female neurosurgeon in the world, pioneering her field with skill, dedication, and humility. Born in Romania, she began her career amid the tumult of World War II, performing her first neurosurgical procedure in 1944. Despite initial skepticism, her talent and commitment earned her recognition, culminating in her acknowledgment as the first female neurosurgeon by the World Federation of Neurosurgical Societies in 2005. Throughout her illustrious career, she mentored colleagues, contributed to scientific literature, and innovated surgical techniques, all while maintaining a compassionate and composed demeanor. Her legacy serves as a beacon of inspiration for neurosurgeons worldwide, reminding them of the importance of diligence, empathy, and unwavering dedication to patient care. Even in retirement, her influence endures, as she continues to be revered for her remarkable contributions to the field of neurosurgery. We searched Google, PubMed, and others about Sofia Ionescu and compiled the data about her. We got very important information about her and compiled together for this article. Sofia Ionescu is regarded as the first female neurosurgeon of the world and she paved the way and encouraged many young female neurosurgeons in the field. [ABSTRACT FROM AUTHOR]

Les violences et maltraitances intrafamiliales concernent celles conjugales qui sont intimement liées aux violences faites aux femmes ainsi que les maltraitances et violences sur enfants et ascendants âgés. Le présent article a pour objectifs de définir juridiquement les notions de violences et de maltraitances, ces dernières étant quasi indissociables de la notion de vulnérabilité apparue dans le registre pénal en 1994. Il synthétise les données épidémiologiques actuelles en France et dans le monde et rapporte une sous-estimation évidente des violences intrafamiliale aussi bien en France que dans le monde au regard des problématiques liées au signalement des faits, ainsi qu'à une définition équivoque de la maltraitance. L'article souligne parallèlement que les faits à l'encontre des personnes âgées lorsqu'ils sont avérés sont moins judiciarisés que ceux à l'encontre des femmes et des enfants. Enfin, les auteurs proposent une approche psychopathologique, des éléments de compréhension issus des neurosciences, ainsi que des perspectives thérapeutiques concernant les violences et maltraitances intrafamiliales. Intra-familial violence and abuse includes domestic violence that is not specifically identified as violence against women, abuse and violence against children or elderly relatives. This article provides a legal definition of the notions of violence and abuse. Abuse is virtually inseparable from the notion of vulnerability, which appeared in the 1994 Penal Code in France. The present article summarizes current epidemiological data in France and worldwide and highlights the obvious underestimation of domestic violence both in France and in other parts of the world. One French survey reported that in 1997, 50,000 women were victims of rape and more recently, that 225,000 women had reported being victims of domestic violence. In 2021, there were 143 murders in the context of domestic violence, 85% of which involved women. The mechanisms of this violence are usually described as consisting of 4 cyclic phases alternating between a climate of tension, aggression, disempowerment, and remission (repentance on the part of the perpetrator). From a psychodynamic viewpoint, the phenomenon of ascendancy, initially conceptualized by Freud, makes it possible to understand the submission of the victim towards the aggressor. This phenomenon can lead to the inability of the perpetrator to recognize the otherness of the other (the victim). Systemic approaches recall the notion of circular causality, making the victim part of the system without denying the responsibility for his acts on the part of the perpetrator. The consequences are usually very negative representations of self for the victim and an increased dependence toward the aggressor. The judicial and clinical world has for several years advocated dealing with perpetrators of conjugal violence by issuing an injunction to submit to treatment. This can also include victims who consent to these therapeutic proposals. Child abuse in France involved more than 35,000 children in 2018. In 80% of the cases, the perpetrators were one of the victim's parents. The abuse ranged from psychological violence (about 30%) to sexual violence (3.6%). Globally, the prevalence of physical violence against children was estimated to concern from 5 to 35% of children in 2014. Fifteen to 30% of girls versus 5 to 15% of boys are thought to have suffered some form of sexual violence. The tender age of the child is the first risk factor, given that 50% of violent deaths in 2011 concerned subjects under the age of four months. From a psychodynamic perspective, child abuse and violence induce trauma with lasting effects on the personality. Several authors mention resulting attachment disorders and behaviors similar to the Stockholm syndrome. Furthermore, in the neurosciences, repeated trauma is considered to lead to disruption between warning neuroanatomical structures and memorization structures, preventing the memorization of events as representations in a space-time continuum, and retaining them only as a strong stress signal. In addition to violent deaths and immediate traumatic facial injuries, this abuse leads to precarious physical and mental health throughout life. The abuse of older people has become a fact of society worldwide. This phenomenon potentially affects 141,000,000 people worldwide and nearly 7000 people in France. The victims are most often women, widows, and dependents and with some financial resources. The perpetrators are often reported to be exhausted caregivers, but this does not explain the frequency of abuse involving money. Prosecutions after the facts are reported are rare. There is an obvious, underestimation of intra-familial violence both in France and globally, whether this relates to the problems involved in reporting such incidents, or to the ambiguous definitions attributed to abuse. This article underlines how violence against the elderly is less often reported to the courts than those against women and children. Finally, the authors propose a psychopathological approach, neuroscientific insights and therapeutic perspectives on intra-family violence and abuse. [ABSTRACT FROM AUTHOR]

This study explores the physiological changes associated with aging that lead to frailty syndrome, characterized by reduced vitality and degeneration across multiple bodily systems, increasing susceptibility to various pathologies. While established scales like the Fried Phenotype and Frailty Trait Scale (FTS) are commonly used for assessing frailty, incorporating biomarkers is crucial for accurate diagnosis and prognosis. Our research examines plasma oxylipin levels in frail elderly individuals to identify novel biomarkers. Diagnostic criteria for frailty included assessments using the Fried Phenotype and FTS-5, with blood samples collected from 71 elderly participants (50 women and 21 men) with mean ages of 73.6 ± 5.9 and 76.2 ± 6.2 years, respectively. Women exhibited elevated platelet counts (p-value 0.0035). The significant differences in oxylipin concentrations associated with the Fried Phenotype were particularly noteworthy, predominantly observed in women. Specifically, in women, decreased grip strength (<15 kg) and slow gait speed (<0.8 m/s) correlated with increased levels of thromboxane B 2 (TxB 2) and 7-HDoHE (p-values 0.0404, 0.0300, 0.0033, and 0.0033, respectively). Additionally, elevated 7-HDoHE levels correlated with a BMI exceeding 28 kg/m2 (p-value 0.0123) and Physical Activity Scale for the Elderly (PASE) scores surpassing 5 points (p-value 0.0134) in women. In summary, our findings emphasize that frail older individuals, particularly women, exhibit higher levels of TxB 2 and 7-HDoHE compared to their non-frail counterparts, aligning with established frailty classification and scale parameters, suggesting their potential as indicative biomarkers. [Display omitted] • The Fried Phenotype and Frailty Trait Scale (FTS) assess frailty, but biomarkers are essential for precise diagnosis and prognosis. • 71 donors (50 women, 21 men) assessed for oxylipin levels as frailty biomarkers, correlating with phenotypes from frailty scales. • Most of the evaluated phenotypes exhibited distinct behavior and correlation with frailty, particularly in the women's group. • High TxB2 and 7-HDoHE levels in elderly women may serve as frailty biomarkers compared to non-frail counterparts. [ABSTRACT FROM AUTHOR]

The reformer is an apparatus on which to perform the foot work and the body in a comfortable, nonweight-bearing supine position and keeps the muscles in balance. The aim of this randomized controlled and single-center study was to investigate the effect of reformer Pilates exercises on cognitive functions in sedentary women. A total of 44 sedentary women aged between 24 and 50 were randomized into two groups. The reformer Pilates group received a 6-week exercise program (45 min/twice per week), while the control group didn't receive any exercise program. Outcomes measured before and after the interventions were, right/left discrimination and scores of two questionnaires: Stroop Test and The Pittsburgh SleepQuality Index. Reformer pilates group showed significant improvement in terms of the Stroop Test (STROOP) "STROOP-B" (t0 = 156; p < 0.05; Cohen d = 0.12), "STROOP-C" (U = 144.5; p < 0.05; Cohen d = 1.13) and "STROOP-D" (U = 165; p < 0.05, Cohen d = 0.40) when compared to control group. In the comparison of the results of the right-left separation in both groups, the difference values were not statistically significant (p > 0.05). Similarly, in the both groups the sleep quality of the individuals improved, but the difference was not statistically significant (p > 0.05). The results of the current study suggest that Reformer Pilates exercises may be more effective on cognitive functions compared to no exercise intervention in sedentary women. Clinical Trial Number: NCT05932004. • Pilates aims to develop and maintain a perfect balance of mind and body. • Reformer pilates has positive effect on cognitive function in sedentary women. • Reformer pilates has positive effects on sleep quality in sedentary women. [ABSTRACT FROM AUTHOR]

Osteoporosis, a significant public health concern, affects millions of adult women globally, leading to increased morbidity and fracture risk. Antidepressant use, prevalent in this demographic, is suggested to influence bone mineral density (BMD), yet evidence remains limited across antidepressant classes. We investigated the association between antidepressant use and osteoporosis in a representative sample of adult women in the United States, focusing on different classes of antidepressants and their potential associations with BMD and fracture risk. We conducted a cross-sectional analysis using data from ten cohorts of the National Health and Nutrition Examination Survey (NHANES) spanning 1999–2000 to 2017–2020. The sample included adult women, with data collected on antidepressant use, BMD scores, and reported fractures. Statistical models adjusted for potential confounders such as Major Depressive Disorder (MDD), age, physical activity, and comorbidities. Antidepressant use was associated with a 44 % increase in the odds of osteoporosis. Phenylpiperazines showed the highest association, followed by miscellaneous antidepressants and tricyclic antidepressants (TCAs). Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) also demonstrated significant, though comparatively lower associations. The odds of fractures were elevated by 62 % among antidepressant users, particularly with phenylpiperazines and miscellaneous antidepressants. A dose-response analysis indicated that both the number and duration of antidepressants were associated with increased odds of osteoporosis. Our findings underscore the need for heightened awareness of the adverse effects of antidepressants on bone health, particularly in adult women. Careful consideration is necessary when prescribing these medications, especially in populations at risk for osteoporosis and MDD. • Osteoporosis and fracture risk significantly associated with antidepressant use. • Antidepressant classes affect bone health by varying magnitudes. • Duration of antidepressant use increase osteoporosis risk in adult women. • Concurrent antidepressant use exacerbates osteoporosis in adult women. • Findings urge bone health consideration in antidepressant prescriptions. [ABSTRACT FROM AUTHOR]

To examine (i) if depression and anxiety are prospectively associated with subsequent lower urinary tract symptoms (LUTS) and (ii) if LUTS are prospectively associated with subsequent depression. The study is based on data from parous middle-aged women from the Avon Longitudinal Study of Parents and Children. LUTS were assessed using the Bristol Female LUTS Questionnaire and the International Consultation on Incontinence Questionnaire on Female LUTS. Depression was assessed using the Edinburgh Postnatal Depression Scale and anxiety was assessed using the Crown Crisp Experiential Index. We used multivariable logistic regression to examine (i) associations between depression and anxiety at baseline in 2002–04 and subsequent LUTS at follow-up in 2011–2012 (n = 5291) and (ii) associations between LUTS at baseline in 2002–04 and subsequent depression at follow-up in 2010–11 (n = 6147). Analyses were adjusted for age, socioeconomic factors, stressful life events, social support, smoking, weekly alcohol consumption, BMI, physical activity, obstetric/reproductive factors, and menopausal status. We found evidence of prospective associations between depression and subsequent mixed urinary incontinence [odds ratio = 1.97, 95 % confidence interval = 1.16, 3.33], any urinary incontinence [1.68 (1.21, 2.31)], and urgency [1.90 (1.28, 2.83)]. Anxiety was only associated with subsequent nocturia [1.84 (1.04, 3.26)]. Only stress urinary incontinence was associated with subsequent depression [1.37 (1.03, 1.83)]. We find evidence that mental health problems could be contributing factors, as well as consequences, of LUTS. Research is needed to determine if these observed associations are causal and to identify underlying mechanisms. • Bidirectional relationships exist between affective symptoms and urinary incontinence. • Depression was prospectively associated with incontinence at follow-up. • Anxiety was prospectively associated with subsequent nocturia. • Stress UI was associated with subsequent depression at follow up. [ABSTRACT FROM AUTHOR]

Radiology Interest Groups (RIGs) in medical education are a catalyst for enhancing the appeal of the discipline and catapulting professional development of medical students. Despite the growing number of women amongst medical school graduates, a significant gender disparity persists in radiology, partly due to obstacles including limited exposure, lack of role models and mentors. This article evaluates the role of RIGs in bridging the gender gap and highlights the challenges women medical students face and proposes targeted initiatives to promote their participation in RIGs. [ABSTRACT FROM AUTHOR]

The percentage of women in radiology has remained at 25 % for decades. Our institutions identified the need to recruit, support and retain women in our departments in order to change this status quo. Our institutions created two different frameworks for Women in Radiology (WIR) programs in order to meet the needs of each distinct department. The organizational structure (trainee led vs faculty led and hybrid), the need for departmental chair support, and types of events and speakers are outlined with unique programs provided by each institution. Collaboration with established programs for women within the institutions and within the region was utilized to support the developing programs. Each of the (WIR) programs has been successful in creating community, impact and sustainable programming, including a peer and faculty mentoring programs for all genders, improvements in gender equity in the workplace, the implementation of trainee parental support programs, and an overall increase in the percentage of women trainees and faculty. Over the last 3 years, the integration of the two programs into a single Women in Radiology program, also encompassing the new enterprise radiology group, has led the way during the initiation of a large institutional merger from two institutions to one large institution. We have provided two frameworks for developing a successful women in radiology program as well as a roadmap for combining best practices in a time of change and institutional merger at a major academic institution. [ABSTRACT FROM AUTHOR]

Coronary artery disease remains a leading cause of morbidity and mortality globally, with chronic total occlusions (CTOs) representing a particularly challenging subset. Percutaneous coronary intervention (PCI) for CTOs has evolved significantly over the years, driven by advancements in equipment, techniques, and operator expertise. However, women have historically been underrepresented in clinical trials and guidelines, leading to a gap in an evidence-based management tailored to their specific needs, including in CTO-PCI. This review aims to explore the nuances of CTO-PCI in women, including anatomic considerations, procedural strategies, and clinical outcomes, with the goal of optimizing their care. [ABSTRACT FROM AUTHOR]

Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention is necessary for preventing stent thrombosis and ensuring long-term cardiovascular protection. It is important to be thoughtful in balancing thrombotic and bleeding risk when deciding therapy regimen and duration. Revascularization randomized trials have studied many specific, at-risk populations; however, women remain underrepresented. Although there is evidence to support shortened DAPT duration in women, especially those at higher bleeding risk or on chronic oral anticoagulation, we need trials specifically enrolling and focusing on women. [ABSTRACT FROM AUTHOR]

Women with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) have a higher burden of symptoms, are older at the time of the TAVR procedure, and have unique anatomic features that increase the periprocedural risk. However, long-term outcomes including mortality are favorable for women compared with men. Careful attention is needed in considering the vascular access route and choice of valve platform to mitigate complications. Large prospective trials dedicated to women undergoing TAVR are needed to investigate individual female-specific factors determining outcomes. [ABSTRACT FROM AUTHOR]

Women with cardiogenic shock have a higher risk of mortality compared with men. There is an increasing need to identify existing barriers to care and formulate tailored strategies to improve outcomes in women. [ABSTRACT FROM AUTHOR]

• Eating low-fat yogurt for 4 weeks had a minor impact on circulating immune markers. • The isocaloric nondairy control food increased regulatory T cells but lowered interleukin-10. • Yogurt consumption maintained the regulatory T and helper T-cell proportions. Yogurt consumption may help reduce chronic inflammation associated with obesity. However, the underlying mechanism(s) by which yogurt consumption modulates the immune system have not been validated in human intervention studies. We hypothesized that 4-week yogurt consumption (12 oz/day) attenuates systemic inflammation by modulating the proportion of circulating T helper (Th) 17 and regulatory T (Treg) cells in adult women with elevated body mass index (BMI). To test the hypothesis, we conducted a randomized crossover dietary intervention study consisted of a 4-week dietary intervention in which participants consumed 12 oz of either low-fat dairy yogurt or a soy pudding control snack per day, with a 4-week washout between treatments. Thirty-nine healthy adult women with a BMI between 25 and 40 kg/m2 were enrolled and 20 completed the study. Changes in the biometrics, circulating T cells, and markers of systemic and colonic inflammation were assessed between the 2 treatment groups, as well as 24-hour diet recalls were conducted at baseline and following each treatment. The primary study outcome, the change in the proportion of circulating Th17 cells, was unaffected by the treatments. Secondary outcome measures, circulating Treg, Th17, and markers of chronic inflammation, were maintained by yogurt treatment, whereas circulating Treg was increased and interleukin-10 was reduced by control snack treatment. However, circulating Treg changes were not associated with changes to other biomarkers of inflammation, implying other immune cells and/or tissues may mediate circulating biomarkers of chronic inflammation. This study was approved by the University of Wisconsin-Madison institutional review board and registered at ClinicalTrials.gov NCT04149418. We hypothesized that 4-week low-fat yogurt consumption (12 oz/day) attenuates systemic inflammation by modulating the proportion of circulating Th17 and Treg cells in adult women with elevated BMI. We conducted a randomized crossover dietary intervention study. Yogurt consumption had a minor impact on the immune cell and cytokine profiles, whereas IL-10 was reduced and Treg was increased by control intervention. Th17, T helper 17; Treg, regulatory T cell; BMI, body mass index; IL, interleukin. [Display omitted] [ABSTRACT FROM AUTHOR]

This study reports on gender differences in psychosocial symptoms and suicidal thoughts and behaviors from the first longitudinal, national survey of veterans with a recent nonfatal suicide attempt to inform women-tailored suicide prevention. We recruited all female veterans with a documented nonfatal suicide attempt between October 2018 and September 2019 and a stratified matched sample of males. Surveys were administered at baseline, month 6, and month 12; 968 veterans completed the baseline survey with valid gender data. Surveys assessed psychosocial constructs, suicidal ideation severity, and suicidal behavior. Administrative datasets provided healthcare and suicide attempt data during the one year follow up. Women retained higher social rejection and institutional betrayal, and lower self-compassion and autonomy than men over follow up. Higher overall self-compassion was associated with lower baseline suicide ideation for both women and men; however, this association was stronger for women (Δ = −0.19; 95 % CI = -0.31, −0.07; d = −0.15). Individuals with higher overall psychological distress had greater odds of a subsequent suicide attempt (AOR = 2.20, 95 % CI = 1.56, 3.11). Social rejection had the strongest association with worsening psychological distress, both within individuals (b = 0.18; 95 % CI = 0.14, 0.23; d = 0.23) and between individuals (b = 0.07; 95 % CI = 0.04, 0.10; d = 0.09). Results may not generalize beyond a VHA-utilizing veteran population. Findings from this study inform potential therapeutic targets and topics for future research on tailoring suicide prevention for women veterans. While all veterans may need support reducing distress, women may need additional support in multiple other areas. • Tailored suicide prevention strategies for women veterans are needed. • Psychological distress is a core contributor to suicide risk among veterans. • Women veterans carry higher psychosocial risk and lower resilience than men. • Chronic illness approaches are warranted for veterans with recent suicide attempts. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is a complex, heterogeneous disease. Categorizing the disorder into phenotypes can help us better understand its pathology and guide us toward more personalized treatment approaches. Nevertheless, most of the previous cluster analysis (CA) studies in OSA predominantly included middle-aged to older men and may not adequately represent the heterogeneity of OSA phenotypes in women. Our aim is to identify these phenotypes in women using an extensive, exclusively female cohort. Cross-sectional study of 1886 women diagnosed with OSA (apnea-hypopnea index >5 events/h) by PSG (polysomnography) and RP (respiratory polygraphy) at a tertiary hospital Sleep Unit. A CA was performed including general data, clinical variables, comorbidities and sleep study results. Four phenotypic subtypes were identified: Cluster 1 "Middle-aged paucisymptomatic women without cardiovascular risk factors" (507 patients, 27 %); Cluster 2 "Older paucisymptomatic women with established cardiovascular disease and severe OSA" (228 patients, 12 %); Cluster 3 "Middle-aged women with "classic" symptoms and cardiovascular risk factors" (892 patients, 47 %), and Cluster 4 ″Middle-aged women with mood disorders, nonrestorative sleep and cardiovascular risk factors" (259 patients, 14 %). Conducting a CA exclusively within a female cohort reveals a heterogeneous presentation of OSA in women, similar to what has been previously reported in the literature for men. The "classical" presentation is notably the most prevalent, while the "atypical" presentation, which was previously more frequently associated with women, is less prevalent. Additionally, paucisymptomatic presentations, with or without associated comorbidities, are also present. [Display omitted] • Cluster analysis in mainly male cohorts may not reflect female OSA diversity. • Analyzing a female cohort reveals a heterogeneous presentation of OSA in women. • The "classical" OSA phenotype characterized by marked sleepiness is the most common. • The "atypical" presentation previously associated with women is less prevalent. • Paucisymptomatic presentations, with or without comorbidities, are also observed. [ABSTRACT FROM AUTHOR]

• PFMT and MPE have similar effects on the frequency of SUI and the level of exposure to symptoms on elderly women. • PFMT and MPE can be used in combination because they provide improvement on elderly women with SUI through different mechanism. • MPE can be seen as alternative treatment for elderly women with SUI who do not want ro receive PFMT for various reasons. The aim of this study was to compare the effects of pelvic floor muscle training (PFMT) and modified pilates exercises (MPE) in elderly women with stress urinary incontinence (SUI). Both randomized groups [Group 1: PFMT (n = 17), Group 2: MPE (n = 17)] performed their exercises twice a week for 12 weeks. Incontinence Severity Index (ISI), Urogenital Distress Inventory-Short Form (UDI-6) and Incontinence Impact Questionnaire-Short Form (IIQ-7) were used to assess SUI frequency and level of exposure from symptoms, electromyography (EMG) device was used to assess PFM activation response and a stabilizer was used to assess transversus abdominis (TrA) muscle strength. The assessments were performed at baseline and at week 12. While in-group assessment there were statistically significant differences in ISI, UDI-6, IIQ-7 in both groups at week 12 (p < 0.05); in the assessment between groups, there were statistically significant difference for EMG-work avarage (U = 60.00, P = 0.02), EMG-work peak (U = 62,50, P = 0.03) and EMG-rest peak (U = 61,50, P = 0.03) in favor of Group 1 and TrA muscle strength (U = 61.00, P = 0.02) in favor of Group 2 from baseline to week 12 (p < 0.05). In summary, MPE can be considered alternative and safe exercise in clinic for elderly women with SUI who do not want to receive PFMT for various reasons. [ABSTRACT FROM AUTHOR]

• Grand multiparous women showed a significantly higher rate of postpartum hemorrhage only from parity eight. • Increasing parity is associated with an increased risk for obstetrical complications, such as PPH, placental abruption and LGA neonates, but with a decrease for some others obstetrical complications such as unplanned cesarean and preterm deliveries. • It seems that any additional delivery has an impact on obstetric outcomes, in a dose dependence matter. To assess the effect of each additional delivery among grand multiparous (GMP) women on maternal and neonatal outcomes. A multi-center retrospective cohort study that examined maternal and neonatal outcomes of GMP women (parity 5–10, analyzed separately for each parity level) compared to a reference group of multiparous women (parity 2–4). The study population included grand multiparous women with singleton gestation who delivered in one of four university-affiliated obstetrical centers in a single geographic area, between 2003 and 2021. We excluded nulliparous, those with parity > 10 (due to small sample sizes), women with previous cesarean deliveries (CDs), multifetal gestations, and out-of-hospital deliveries. The primary outcome of this study was postpartum hemorrhage (PPH, estimated blood loss exceeding 1000 ml, and/or requiring blood product transfusion, and/or a hemoglobin drop > 3 g/Dl). Secondary outcomes included unplanned cesarean deliveries, preterm delivery, along with other adverse maternal and neonatal outcomes. Univariate analysis was followed by multivariable logistic regression. During the study period, 251,786 deliveries of 120,793 patients met the inclusion and exclusion criteria. Of those, 173,113 (69%) were of parity 2–4 (reference group), 27,894 (11%) were of parity five, 19,146 (8%) were of parity six, 13,115 (5%) were of parity seven, 8903 (4%) were of parity eight, 5802 (2%) were of parity nine and 3813 (2%) were of parity ten. GMP women exhibited significantly higher rates of PPH starting from parity eight. The adjusted odds ratios (aOR) were 1.19 (95 % CI: 1.06–1.34) for parity 8, 1.17 (95 % CI: 1.01–1.36) for parity 9, and 1.39 (95 % CI: 1.18–1.65) for parity 10. Additionally, they showed elevated rates of several maternal and neonatal outcomes, including placental abruption, large-for-gestational age (LGA) neonates, neonatal hypoglycemia, and neonatal seizures. Conversely, they exhibited decreased risk for other adverse maternal outcomes, including preterm deliveries, unplanned cesarean deliveries (CDs), vacuum-assisted delivery, and third- or fourth-degree perineal tears and small-for-gestational age (SGA) neonates. The associations with neonatal hypoglycemia, and neonatal seizure were correlated with the number of deliveries in a dose-dependent manner, demonstrating that each additional delivery was associated with an additional, significant impact on obstetrical complications. Our study demonstrates that parity 8–10 is associated with a significantly increased risk of PPH. Parity level > 5 correlated with increased odds of placental abruption, LGA neonates, neonatal hypoglycemia, and neonatal seizures. However, GMP women also demonstrated a reduced likelihood of certain adverse maternal outcomes, including unplanned cesarean, preterm deliveries, vacuum-assisted deliveries, SGA neonates, and severe perineal tears. These findings highlight the importance of tailored obstetrical care for GMP women to mitigate the elevated risks associated with higher parity. [ABSTRACT FROM AUTHOR]

• Urinary incontinence creates both physical and mental burdens that need adaptation. • Identifying barriers is critical first step to building successful adaptation. • Being neglected is a main barrier for older women in adapting to urinary incontinence. • Beliefs formed in older women led them to remain silent about urinary incontinence. Urinary incontinence affects the physical, psychological, social and well-being of older adult women and requires adaptation. This study aimed to explain the inhibiting factors of adaptation to urinary incontinence in community-dwelling older adult women. A qualitative content analysis approach was adopted. Participants were 15 older women with urinary incontinence, three family members, and three healthcare team members. Data were collected by individual, in-depth semistructured interviews and analysed using the Graneheim and Lundman approach. The data analysis yielded the theme of neglecting urinary incontinence and the older adult , with four categories of "s silence-inducing beliefs", "worthlessness for the family", "non-adaptation of urban spaces", and "deficiencies in the healthcare service structure". Elucidating the inhibiting factors for older women's adaptation to urinary incontinence will lead to a change in the attitude of social policymakers and healthcare officials. This changes will then facilitate the establishment and adjustment of the necessary infrastructure to overcome these barriers. [ABSTRACT FROM AUTHOR]

• As expected, a higher volume of physical activity was associated with reduced odds of both hypertension and obesity. • When considering the volume of physical activity, the frequency or intensity of physical activity did not significantly impact the odds of hypertension. • An increased proportion of vigorous physical activity relative to the total volume was associated with a small additional reduction in the odds of obesity. • Overall, physical activity volume seems to be more important than specific patterns of accumulation for preventing hypertension and obesity in women. Optimal patterns of accrual of recommended levels of physical activity (PA) for prevention of hypertension and obesity are not known. The overall aim of this study was to investigate whether different patterns of accumulation of PA are differentially associated with hypertension and obesity in Australian women over 21 years. Specifically, we investigated whether, for the same weekly volume of PA, the number of sessions (frequency) and vigorousness of PA (intensity) were associated with a reduction in the occurrence of hypertension and obesity in women. Data from the 1973–1978 and 1946–1951 cohorts of the Australian Longitudinal Study on Women's Health were analyzed (n = 20,588; 12%–16% with a Bachelor's or higher degree). Self-reported PA, hypertension, height, and weight were collected using mail surveys every 3 years from 1998/2000 to 2019/2021. Generalized Estimating Equation models with a 3-year lag model were used to investigate the association of PA volume (metabolic equivalent min/week) (none; 33–499; 500–999; ≥1000, weekly frequency (none; 1–2 times; 3–4 times; 5–7 times; ≥8 times), and the proportion of vigorous PA to total volume of PA (none; 0%; 1%–33%; 34%–66%; 67%–100%) with odds of hypertension and obesity from 2000 to 2021. The cumulative incidence of hypertension was 6% in the 1973–1978 and 23% in the 1946–1951 cohort; 27% of women in the 1973–1978; and 15% in the 1946–1951 cohort developed obesity over the period. Overall, a higher volume of PA was associated with reduced odds of hypertension and obesity. When the volume of PA was considered, the odds of hypertension did not vary according to the frequency or intensity of PA. However, increased proportion of vigorous PA to the total volume of PA was associated with a small additional reduction in the risk of obesity. PA volume appears to be more important than the pattern of accumulation for the prevention of hypertension and obesity. Incorporating more sessions, particularly of vigorous-intensity PA, may provide extra benefits for the prevention of obesity. [Display omitted] [ABSTRACT FROM AUTHOR]

To gather knowledge and experiences from Squamish Nation citizens to codevelop a model of foraging walks for Indigenous women's heart health. Qualitative study (sharing circles). Vancouver, Canada (virtual). Squamish Nation community members (n = 9), Elders or Knowledge Keepers (n = 5), and researchers (n = 2). Community-led foraging walks as a culturally safe nutrition education strategy. Perspectives and experiences. Content analysis and narrative synthesis. Personal experiences of foraging walks or knowledge of traditional plants were limited for most participants, and all desired to learn more about traditional foods using land-based activities. Participants identified a lack of nutrition education surrounding heart health and common mistreatment and judgment from health professionals. Participants identified important elements of a future Squamish program, including who should be involved, how to implement it, and the most effective temporal and physical setting. All agreed foraging walks help promote 5 dimensions of heart health (physical, emotional, spiritual, mental, and social) through physical activity, purposeful nutrition, and connection to community and culture. Findings from the sharing circles were used in the creation of a template for future foraging sessions and contributed to plant identification cards for the whole community. Community-based pilot studies to test foraging walks as a culturally safe and environmental approach to nutrition education and cardiovascular health awareness for Indigenous communities are warranted. Research to examine the similarities and differences across Indigenous groups related to understanding heart health and land-based practices for nutrition education and heart health awareness is needed. [ABSTRACT FROM AUTHOR]

The efficacy and availability of contraception have changed in the last several decades; however, unintended pregnancies continue to be an issue in Australia. This study aimed to describe trends in contraception in women attending a sexual health service over 9 years. Repeated cross-sectional study. Women aged 16–49 years attending Melbourne Sexual Health Centre between 2011 and 2020 were included. Women were asked what methods of contraception they currently use. Contraception were categorised into long-acting reversible contraception (LARC; e.g. intrauterine devices and implants classified as highly effective), moderately effective contraception (e.g. oral contraception pill), less effective contraception (e.g. condom and withdrawal) and no contraception, as defined by US Centers for Disease Control and Prevention guidelines. Multivariable logistic regression was used to examine the factors associated with the use of moderate-high-efficacy contraception. A total of 38,288 women were included with a median age of 25 (interquartile range: 22–29). Between 2011 and 2020, there was a decreasing trend in condom (63.3%–56.1%; P trend <0.001) and oral contraception (27.2%–20.5%; P trend <0.001) use, whilst there was an increasing trend in the use of LARCs: implant (4.6%–6.0%; P trend = 0.002) and intrauterine device (2.8%–11.8%; P trend <0.001). Increasing age was associated with decreased odds of using moderate-high-efficacy contraception (P trend <0.001). Compared with Oceanian-born women, Asian (adjusted odds ratios [aOR] = 0.63, 95% confidence interval [CI]: 0.56–0.72) and Middle Eastern-born women (aOR = 0.60, 95% CI: 0.48–0.74) had lower odds of using moderate-high-efficacy contraception, whilst European (aOR = 1.23, 95% CI:1.07–1.41) and North American-born women (aOR = 1.51, 95% CI: 1.22–1.87) had higher odds of using moderate-high-efficacy contraception. Between 2011 and 2020, LARC use has increased, whilst less effective contraceptives, such as condom and oral contraception, have decreased among women at Melbourne Sexual Health Centre. Further research is required to understand age and ethnic disparities in contraception methods for future family planning programmes. [ABSTRACT FROM AUTHOR]

Enhancing gender diversity at academic conferences is critical for advancing women's representation and career trajectories in spine surgery. To discover trends in women's representation at major spine conferences over a 15-year period. Conference records from the 2007–2021 annual meetings of the Congress of Neurological Surgeons, North American Spine Society, and Scoliosis Research Society (SRS). Authors of spine-related presentations. Authorship by gender. Retrospective bibliometric analysis with univariate and multivariate modeling to identify trends and predictors of gender diversity. Among 8,948 presentations, 750 (8.4%) had female first authors and 618 (6.9%) had female senior authors. There was no change in rates of female first authorship (p=.41) or senior authorship (p=.88) over time. The strongest predictors of female first authorship were having a female senior author (OR 7.32, p<.001), and delivering presentations at SRS (OR 1.95, p=.001). Factors negatively associated with female first authorship included poster format (OR 0.82, p=.039) and conference location in the United States/Canada (OR 0.76, p=.045). Similar trends were encountered for senior authorship. Productivity per senior author was similar between genders (p=.160); whereas a gender gap in productivity per first author during 2007 to 2011 (p=.020) equalized by 2017 to 2021 (p=.300). Among the 10 most productive authors of each gender, male authors delivered more presentations, but all authors shared similar format, content, and location. Women's representation in spine-related presentations did not increase at three major conferences over a 15-year period. Our findings regarding the positive effects of female mentorship, and international or virtual venues merit further investigation to address the gender gap. The upstream pipeline of recruiting women into academic spine surgery also needs to be addressed. 3 [ABSTRACT FROM AUTHOR]

• Smoking is a major risk factor for cardiovascular diseases. • Despite the benefits of smoking cessation (SC) the abstinence rate remains low. • Factors associated to success and failure of quit attempts differ according to sex. • Tailored SC interventions according to sex might help to improve smoking abstinence. • More intensive SC strategies in needed for smokers with diabetes, regardless of sex. Smoking is a major risk factor for cardiovascular diseases (CVD), in particular in women, but smoking cessation (SC) reduces or even cancels the risk for both sexes. Using a nationwide SC services database, we aimed to determine the predictive factors of SC in men and women smokers with CV risk factors (CVRF) or CVD. A retrospective study from the French CDTnet database was conducted. Inclusion criteria were age ≥ 18 years, and ≥ 1 CVRF (Body Mass Index ≥ 25 kg/m2, hypertension, diabetes, hypercholesterolemia) or CVD (myocardial infarction (MI) or angina pectoris, stroke, peripheral arterial disease [PAD]). Self-reported smoking abstinence (≥ 28 consecutive days) was confirmed by exhaled carbon monoxide < 10 ppm. Logistic regression analysis assessed the association between SC and sociodemographic, medical characteristics, and smoking profile. Among the 36,864 smokers at high CV risk, abstinence rate was slightly lower in women than in men, (52.6% [ n = 8,102] vs 55.0% [ n = 11,848], P < 0.001). For both sexes, factors associated with the lowest abstinence rates were diabetes, respiratory and psychiatric diseases, anxiolytic/antidepressant use, and cannabis consumption. In women, the factors associated with smoking abstinence were suffering from MI or angina and taking contraceptive pill and the factors associated with persistent smoking were alcohol disorder and high cigarette consumption. In men, there was a positive relationship between overweight and abstinence while being dual users of cigarettes and electronic cigarettes at first visit, having tobacco-related diseases (cancer and PAD) and taking opioid substitution treatment were associated with persistent smoking. Finally, in both sexes, the factors associated with abstinence were: age ≥ 65 years, having a diploma, being employed, self-referred or encouraged by entourage, ≥ 1 previous quit attempt, ≤ 20 cigarettes per day consumption, benefiting from SC medication prescription and ≥ 4 follow-up visits. In conclusion, our results suggest the relevance of SC intensive management in smokers at high CV risk, based on sociodemographic, medical, and smoking behaviour characteristics, as well as a gender-specific SC approach. [ABSTRACT FROM AUTHOR]

To identify what coaches, support staff, and athletes believe should be considered when implementing menstrual cycle tracking in sport. Concept mapping (mixed-methods participatory approach). Participants brainstormed statements in response to the focus prompt "What should be considered when tracking menstrual cycles in sport?" Participants then sorted the statements into groups according to meaning and rated each statement on its importance and feasibility to address. Twenty-six participants (12 athletes and 14 coaches/support staff) generated 53 ideas that the research team synthesised to 57 unique statements. Sixteen participants sorted the statements into an average of 8 (± 4) groups. Six clusters were identified as the most appropriate representation of the sorting data following multidimensional scaling and hierarchical cluster analysis: 1) Ethics , 2) Tracking Tools and Methods , 3) Performance and Health , 4) Education , 5) Interpretation and Framing and 6) Communication. Participants rated each statement based on their importance (n = 12) and feasibility (n = 10), respectively. The most important (mean = 3.88 out of 5) and feasible (mean = 3.85 out of 5) cluster was Ethics , whilst the least important (mean = 3.17) and feasible (mean = 3.04) was Communication. Ethical considerations pertaining to privacy, consent, and scope of practice should be prioritised when tracking menstrual cycles in sport. A low burden method of tracking, which allows for some individualisation based on athletes' preferences or needs, and menstrual health education should also be undertaken to improve the uptake and impact of menstrual cycle tracking. [ABSTRACT FROM AUTHOR]

Cardiorespiratory fitness has been postulated to lower chronic inflammation in obesity. We assessed sex-specific associations of inflammation with cardiorespiratory fitness in overweight and obese persons. Peak oxygen uptake (VO 2max) was measured by treadmill in 566 participants (age 48 ± 9 years, 60% women) with body mass index >27.0 kg/m2 in the FAT associated CardiOvasculaR dysfunction (FATCOR) study. Fitness was identified from age- and sex specific reference levels of VO 2max. The inflammatory markers C-reactive protein (CRP), serum amyloid A (SAA), kynurenine:tryptophan ratio (KTR) and pyriodoxic acid ratio (PAr) were measured by mass spectrometry. In the total study population 63% had obesity and 74% were cardiorespiratory unfit. Unfit women had the highest fat percentage and the highest serum levels of CRP and SAA (p < 0.05). In multivariable linear regression analyses in women, higher CRP (β −0.15, p = 0.001), SAA (β −0.10, p = 0.03) and PAr (β −0.09, p = 0.03) were associated with lower VO 2max after adjusting for confounders. In multivariable analyses in men, higher PAr (β −0.14, p = 0.02) was associated with lower VO 2max. In multivariable analyses in obese women, higher CRP and PAr remained associated with lower VO 2max (p < 0.05), while in obese men there was no significant association. When normalizing VO 2max for fat-free mass (VO 2maxFFM) higher CRP, SAA and PAr index were associated with lower VO 2maxFFM in women, while only higher PAr index was associated with lower VO 2maxFFM in men. The association of inflammation with lower cardiorespiratory fitness was more pronounced in women than men, in particular when obesity was present. URL: http://www.clinicaltrials.gov NCT02805478. • Inflammation is central in the development of atherosclerotic cardiovascular disease. • Fitness has been postulated to counter the negative effects of obesity-associated inflammation. • Sex-specific associations of inflammation andcardiorespiratory fitness is little studied in overweight and obese subjects. • Women with poor fitness had the highest levels of inflammatory markers, especially when obesity was present. [ABSTRACT FROM AUTHOR]

Psychosocial stress can affect cardiovascular health through multiple pathways. Certain stressors, such as socioeconomic disadvantage, childhood adversity, intimate partner violence, and caregiving stress, are especially common among women. The consequences of stress begin at a young age and persist throughout the life course. This is especially true for women, among whom the burden of negative psychosocial experiences tends to be larger in young age and midlife. Menarche, pregnancy, and menopause can further exacerbate stress in vulnerable women. Not only is psychosocial adversity prevalent in women, but it could have more pronounced consequences for cardiovascular risk among women than among men. These differential effects could reside in sex differences in responses to stress, combined with women's propensity toward vasomotor reactivity, microvascular dysfunction, and inflammation. The bulk of evidence suggests that targeting stress could be an important strategy for cardiovascular risk reduction in women. • Psychosocial stress contributes to cardiovascular disease through multiple pathways, and young and midlife women, especially those from marginalized groups, are particularly vulnerable to the adverse effects of psychosocial stress. • A multipronged approach to psychosocial adversity at the individual and community levels is needed to reduce the impact of stress on women's cardiovascular health. • Clinical trials should explore the benefits of targeting psychosocial stress to improve women's cardiovascular health. [ABSTRACT FROM AUTHOR]

Malang has become the city that reached the highest rate of early marriage in the Province of East Java. Many data had stated that Malang remained on the first rank for two years straight which is 2021 until 2022. This issue became the main cause of students dropping out of school and hampered in achieving higher education. Some of the factors that cause early marriage to remain unresolved are society's distorted perception of early marriage. Due to this issue, this study aimed to observe how (research output) can reduce the rate of early marriage especially in Malang. To acknowledge the problem, this study uses literature review and qualitative methods for data processing. Sources of this literature review are extracted from various journals that come from trusted sources. Based on the research results, it can be sensed that the influence of early marriage has a negative impact on educational attainment of adolescents especially on women. Due to high number of early marriages in Malang and the impact on educational attainment of female adolescents, this research resulting in social media campaign to educate adolescents about how early marriage impacts quality education. Therefore, it is hoped that this Instagram Platform Based Campaign will help to spread awareness among adolescents about how early marriage impacts their education and life goals. [ABSTRACT FROM AUTHOR]

Women have worse outcomes after coronary artery bypass surgery (CABG) than men. This study aimed to determine the incidence of CABG graft failure in women, its association with cardiac events, and whether it contributes to sex-related differences in outcomes. A pooled analysis of individual patient data from randomized clinical trials with systematic imaging follow-up was performed. Multivariable logistic regression models were used to assess the association of graft failure with myocardial infarction and repeat revascularization between CABG and imaging (primary outcome) and death after imaging (secondary outcome). Mediation analysis was performed to evaluate the effect of graft failure on the association between female sex and risk of death. Seven randomized clinical trials (N = 4,413, 777 women) were included. At a median imaging follow-up of 1.03 years, graft failure was significantly more frequent among women than men (37.3% vs 32.9% at the patient-level and 20.5% vs 15.8% at the graft level; P = 0.02 and P < 0.001, respectively). In women, graft failure was associated with an increased risk of myocardial infarction and repeat revascularization (OR: 3.94; 95% CI: 1.79-8.67) and death (OR: 3.18; 95% CI: 1.73-5.85). Female sex was independently associated with the risk of death (direct effect, HR: 1.84; 95% CI: 1.35-2.50) but the association was not mediated by graft failure (indirect effect, HR: 1.04; 95% CI: 0.86-1.26). Graft failure is more frequent in women and is associated with adverse cardiac events. The excess mortality risk associated with female sex among CABG patients is not mediated by graft failure. [ABSTRACT FROM AUTHOR]

• Among Korean adults ≥65y, 25% of men and 36% of women had low muscle strength. • Only 16% of Korean adults met the recommended nutrient intake of dietary vitamin C. • Dietary vitamin C intake was correlated with handgrip strength in Korean women. • Korean women ≥65y with low dietary vitamin C had a higher risk of possible sarcopenia. Although vitamin C is one of the most important antioxidants, its effect on muscle quality is not fully understood. Therefore, we hypothesized that low dietary vitamin C intake is associated with low muscle strength. To test the hypothesis, a single 24-h dietary recall and handgrip strength test of 10,883 younger adults 19-64 y and 3,961 older adults ≥65 y from the seventh Korea National Health and Examination Survey (KNHANES VII 2016-2018) was analyzed by multivariable linear and logistic regression models, and low muscle strength was defined as handgrip strength <28 kg for men and <18 kg for women. Approximately 15.5% of Korean adults met the recommended intake of dietary vitamin C, and those with higher dietary vitamin C intake had higher total energy and protein intake. After adjusting for confounding variables, including age, body mass index, total energy intake, household income, alcohol consumption, smoking, resistance exercise, medical condition, and dietary intake of protein, vitamin E, and β-carotene, dietary vitamin C was correlated with maximal handgrip strength in younger women 19-64 y (β = 0.002; SE = 0.001; P -value =.026) and older women ≥65 y (β = 0.005; SE = 0.002; P -value =.013). Among older women ≥65 y, those in the lowest quartile of dietary vitamin C intake had a higher risk of low muscle strength compared to those in the highest quartile after adjustment of confounding factors (odds ratio, 2.16; 95% confidence interval, 1.49-3.15). These results imply that adequate dietary vitamin C intake may reduce the risk of sarcopenia in older Korean women. Dietary vitamin C was shown to be inversely associated with the risk of low muscle strength in older Korean women. Although no association between the two variables among younger men 19-64 y, older men ≥65 y, and women 19-64 y was observed, older Korean women ≥65 y in the lowest quartile of vitamin C intake had significantly higher odds of low muscle strength compared to those in the highest quartile with adjustment for confounding variables (OR, 2.16; 95% CI, 1.49-3.15). [Display omitted] [ABSTRACT FROM AUTHOR]

Varying patterns in eating disorder (ED) classification are evident and may impact ED treatment and prevention. However, investigations of patterns of heterogeneity in ED presentations have been limited to civilian samples, despite the high prevalence of EDs in military personnel and veterans. The present study aimed to explore ED-related symptom patterns, including emotional overeating, in women veterans. Participants were 407 women veterans using health care services at a large Veterans Affairs health care system who completed mental health measures via surveys. Latent profile analyses were used to explore distinct ED symptom patterns (binge eating, purging, heavy exercise, positive and negative emotional overeating, dietary restraint, and shape/weight concerns). Subsequent auxiliary models explored associations with mental health concerns (depressive symptoms, posttraumatic stress disorder, anxiety, alcohol misuse, substance misuse), adjusting for age, race and ethnicity, and service branch. A four-class solution demonstrated the best model fit, characterized as follows: 1) Low ED Concerns, 2) Moderate Dietary Restraint/Negative Emotional Eating, 3) High Binge/Emotional Eating, and 4) High ED Concerns. Although all profiles had moderate or higher levels of negative emotional overeating, the High Binge/Emotional Eating and High ED Concerns profiles were distinct in levels of dietary restraint and had the highest probabilities of positive emotional overeating. The High ED Concerns profile also had the most severe mental health concerns relative to the other profiles. The identification of unique ED symptom patterns in women veterans can inform prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Women's mortality at a reproductive age has been a global concern, and its decrease has been incorporated as a target of the UN Sustainable Development Goals. The aim of this study was to describe the spatial–temporal evolution of mortality rates among women of reproductive age in Brazilian municipalities by groups of causes and socioeconomic indicators from 2000 to 2018. Ecological analysis. This work was an ecological, descriptive study that analyzed estimates of mortality rates among women of reproductive age (15–49 years) by main groups of causes of death from the Global Burden of Disease (GBD) study in three consecutive trienniums, T1 (2000–2002), T2 (2009–2011), and T3 (2016–2018). To quantify the temporal evolution in mortality rates, the present study calculated the percentage change for each triennium. The spatial analysis of mortality rates was carried out using Moran's index. The Pearson coefficient was used to analyze the correlation between the data. A significant decline in mortality rates was found for all groups of causes in all regions of the country. Despite the downward trend, the percentage change from 2009 to 2011 to 2016 to 2018 showed a decrease in the group of Noncommunicable Diseases (NCDs) and external causes. The decline in mortality rates of women due to external causes showed only a minimal change in the North and Northeast regions from T2 to T3, whereas a cluster of neighboring municipalities with high mortality rates persisted in the municipalities of the South region and in the state of Roraima. The ranking of the main causes of death in Brazilian municipalities showed an increase in neoplasms in detriment to cardiovascular diseases (CVDs). The main causes of death in women of reproductive age at a more local level could be used to recognize inequalities and to develop interventions aimed at tackling premature and preventable deaths. [ABSTRACT FROM AUTHOR]

• Investigated the clinical efficacy of acupuncture and moxibustion therapies for women with stress urinary incontinence (SUI) using a network meta-analysis approach. • Identified the combination of moxibustion, electromyographic biofeedback (EB), and pelvic floor muscle training (PFMT) as a potent non-surgical intervention for SUI. • Found a relatively low risk of side effects during acupuncture treatments, emphasizing its safety profile. Stress urinary incontinence (SUI) significantly impacts women's health and imposes substantial mental and socio-economic burdens. Acupuncture and moxibustion, either alone or in combination with other non-surgical therapies, are recognized as effective treatments for SUI. This study aimed to assess the efficacy of various treatments for women with SUI using network meta-analysis (NMA). We systematically searched databases up until June 30, 2022, to identify relevant randomized controlled trials (RCTs) focusing on SUI in women. Subsequently, the quality of the included studies was assessed. NMA was performed using STATA 14.0 software. A total of 31 RCTs involving 2922 participants were included in the analysis. A total of 18 treatment plans were identified. The treatment plan consisting of Moxibustion + PFMT + EB demonstrated the most significant reduction in ICIQ-UI-SF. Due to lack of consistency across studies, a NMA was not performed for the outcomes of effectiveness and the 1 h pad test. The combined intervention of Moxibustion + PFMT + EB appears to be the most effective in reducing patients' reported symptoms and improving their quality of life. However, due to the limitations of the included studies, further high-quality RCTs are necessary to reinforce the current evidence. [ABSTRACT FROM AUTHOR]

We evaluated the outcomes of pregnancy in women with congenital heart disease (CHD) and their offspring in Taiwan. We also investigated how different severity levels may influence the outcomes. We used data (2009–2017) from the Birth Certificate Application database in Taiwan, which is linked to the National Health Insurance Research Database and Taiwan Maternal and Child Health Database. We identified 2990 women with CHD who had 4227 births. Based on the CHD subtypes, patients were further divided into "severe CHD" and "simple CHD" groups. Women with CHD have a significant risk of stillbirth. In maternal cardiac events, they had the highest risk of heart failure, followed by arrhythmia. The severity of CHD had a significant effect on the outcomes as well. The neonatal birth event that mothers with CHD have the highest risk of is preterm birth at < 32 weeks of gestation. The prominent difference in neonatal morbidities between mothers with severe and simple CHD is recurrent CHD in the offspring. The offspring of the severe CHD group had a higher risk of severe CHD, whereas those of the simple CHD group had a higher risk of simple CHD. During pregnancy, the monitoring of heart function and cardiac rhythm could be more intensive in mothers with CHD. In addition to accurately assessing fetal growth and development during antenatal care, mothers with severe CHD should be provided with careful fetal heart structure assessment and genetic testing along with counseling. [ABSTRACT FROM AUTHOR]

To understand the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) counselor experiences discussing responsive bottle feeding during counseling and WIC participants' knowledge, understanding, and use of responsive bottle feeding. Qualitative descriptive, semistructured interviews with 23 participants (8 WIC counselors and 15 WIC participants) were conducted online via Zoom. The WIC counselors and mothers of WIC-enrolled bottle-fed infants were recruited through a network of WIC clinics in North Carolina. Interviews were recorded, transcribed, and collaboratively analyzed using content analysis. The WIC participants received responsive infant feeding support from WIC counselors but often in the context of breastfeeding. WIC counselors provided valuable support for families but were challenged by limited training on responsive bottle feeding, balancing promoting breastfeeding with supporting mothers' feeding decisions, and time constraints. Findings provide preliminary support for the need to develop and pilot an intervention focused on promoting responsive feeding for parents of bottle-fed infants. [ABSTRACT FROM AUTHOR]

Neurosurgery is a specialty that has been dominated by males. Although there has been an increase in the number of women in the field, it is not yet close to being equal. Some noteworthy women who have carved the path for other women to follow in their footsteps include Drs. Sofía Ionescu and Diana Beck, the first and second female neurosurgeons worldwide, respectively. However, there are limited publications on Dr. María Cristina García-Sancho, the first Latina neurosurgeon. The purpose of this review was to illuminate the neurosurgical community on the life of Dr. García-Sancho. A thorough literature was performed on medical and non-medical publications that were either authored by Dr. García-Sancho or mentioned her directly. Dr. García-Sancho earned her medical degree at the School of Medicine of the National Autonomous University of Mexico under the guidance of Dr. Clemente Robles, who founded Mexico's first neurosurgical department. Her training took her worldwide. Her expertise allowed her to pioneer a revolutionary advancement known as the one-step bilateral cordotomy. Her perseverance led her to becoming the head of the Department of Neurosurgery at the National Cancer Institute of Mexico and co-found the Mexican Society of Neurological Surgery, where she served on the board of directors. This review aims to advocate for an equitable environment in the field of neurosurgery with Dr. García-Sancho's story. [ABSTRACT FROM AUTHOR]

Endometriosis may be linked to the risk of iron deficiency through chronic systemic inflammation or heavy menstrual bleeding. No longitudinal studies, however, have examined the relationship between endometriosis and the risk of iron deficiency. This study included 3,294 participants born from 1973 to 1978 and followed as part of the Australian Longitudinal Study on Women's Health from 2000 to 2018. Participants with endometriosis were identified using self-reported longitudinal surveys linked to administrative health records. During each survey, participants were also asked to report the diagnosis of iron deficiency, and we validated diagnoses using an administrative health database. Generalized estimating equations for binary responses with an autoregressive correlation matrix were used to examine the association between endometriosis and the risk of iron deficiency over the seven time points. We found that women with endometriosis had a significantly higher risk of iron deficiency than those without endometriosis after adjusting for sociodemographic, lifestyle, reproductive, and nutrition factors (adjusted odds ratio [aOR] = 1.46; 95% confidence interval [CI] [1.29, 1.66]; p <.0001). Women with a surgically confirmed diagnosis and those with clinically suspected endometriosis had a higher risk of iron deficiency (aOR = 1.38; 95% CI [1.17, 1.64] and aOR = 1.53; 95% CI [1.30, 1.81]), respectively. These associations, however, were slightly attenuated (by 8%) when adjusted for the presence of heavy menstrual bleeding. Women with endometriosis are at a higher risk of developing iron deficiency than those without endometriosis. The findings suggest that iron deficiency should be concomitantly addressed during initial diagnosis and successive management of endometriosis. [ABSTRACT FROM AUTHOR]

To investigate associations between perceived childhood neighborhood safety and sleep over the life course. Among a cohort of 1693 Black/African American women aged 23–35 years at enrollment (2010–2012), participants recalled neighborhood safety (safe vs. unsafe) when they were 5, 10, and 15 years old. Participants' mothers/caregivers and participants reported sleep-related health behaviors at age 5. We used ordinal logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sleep-related health behaviors (i.e., rarely/never or sometimes vs. mostly/always going to bed by 8:00 p.m., bed in a quiet room, bed in a dimly lit or unlit room), separately. Adulthood sleep duration and insomnia symptoms were reported at enrollment and over three follow-up periods. We applied generalized estimating equations to log binomial regression models to estimate relative risks (RR) for adulthood sleep characteristics. Four percent of participants reported an unsafe neighborhood at age 5 years, only, and 12% reported an unsafe neighborhood at all ages. Participants in perceived unsafe vs. safe neighborhoods at age 5 had higher odds of poor sleep-related health behaviors (e.g., rarely/never or sometimes going to bed in a quiet room: OR = 1.73 [1.27–2.35]). Participants in perceived unsafe vs. safe neighborhoods throughout childhood had higher risk of short sleep (RR = 1.10 [1.02–1.18]) and insomnia symptoms (RR = 1.07 [1.00–1.15]) during adulthood after adjustment for life course socioeconomic characteristics and adulthood health behaviors and characteristics. Perceived unsafe childhood neighborhood was associated with poorer sleep over the life course and may serve as an early intervention target. • We assessed perceived childhood neighborhood safety and life course sleep. • Perceived unsafe childhood neighborhood was associated with poor sleep in childhood. • Perceived unsafe childhood neighborhood was associated with poor sleep in adulthood. • Living in unsafe neighborhoods during childhood may impact life course sleep health. [ABSTRACT FROM AUTHOR]

In Australia, one in two women have experienced sexual harassment in their lifetime and one in five women has experienced sexual violence since the age of 15. Public facing organizations, such as public transport providers, have a role to play in providing safe environments and preventing violence. Our study examined the experiences and views of those working in public transport delivery organizations about the organizational challenges and opportunities to provide safe transport for women. Using Normalization Process Theory (NPT), our analysis of 19 semi-structured in-depth interviews with stakeholders focused on three key areas: making sense of safety of women on public transport; working towards women's safety on public transport; and monitoring the progress of safety initiatives. We found that public transport is delivered by multiple stakeholders, with individual and combined organizational and relational complexity. Participants highlighted the importance of leadership and the need for an overarching strategy for women's safety. Macro-level organizational and environmental barriers to implementing safety initiatives include a lack of proactive, consistent, and collaborative approaches. Differing understandings of what women's safety means can lead to conflicting strategies among organizations, but there are opportunities to develop and integrate enhanced and conceptually consistent training and policies in response to women's safety. At the micro-level, providers recognize the need to prioritize safety for women across public transport. Our findings indicate key opportunities to inform the development of interventions and policies for public transport, and public facing organizations more broadly, to provide for and sustain women's safety. • Complex solutions needed to address sexual assault & harassment against women on public transport. • Solutions require overarching leadership and a collaborative and consistent strategy. • Public transport planning and delivery still requires a gender-lens. [ABSTRACT FROM AUTHOR]

A large body of scientific research accumulated over the past twenty years documents the cardiovascular (CV) benefits of estradiol (E2) and progesterone (P4) in reproductive aged women. In contrast, accelerated development of CV disease (CVD) occurs in the absence of ovarian produced E2 and P4. Hormone replacement therapy (HRT) with E2 and P4 has been shown to cause no harm to younger menopausal women. This robust scientific data supports a reconsideration of the prescriptive use of E2 and P4 as preventative therapeutics for the reduction of CVD, even without additional large-scale studies of the magnitude of the Women's Health Initiative (WHI). With the current expanded understanding of the critical modulatory role played by E2 on a multitude of systems and enzymes impacting CVD onset, initiation of HRT shortly after cessation of ovarian function, known as the "Timing Hypothesis", should be considered to delay CVD in recently postmenopausal women. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death in women worldwide and the lifetime risk of CVD in women is similar to men. However, the pathophysiology of CVD varies between women and men necessitating a sex-specific understanding of cardiovascular (CV) risk. A belief that women have a lower CVD risk than men, and an underrepresentation in clinical research for many years has led to a paucity of evidence in the prevention and management of CVD in women. Many recent efforts have tried to bridge the gap. As a result, we now know that traditional risk factors impact CVD risk differently in women when compared with men. There are also numerous sex-specific and pregnancy related risk factors that modify the risk and can predict the future development of CVD in women. This is important as risk calculators, in general, tend to misclassify risk in young women with nontraditional CVD risk factors. To address this, guidelines have introduced the concept of risk enhancers that can suggest a higher risk. The use of coronary artery calcium score can further accurately delineate risk in these women, leading to an appropriate matching of therapy to underlying risk. This review discusses implementation strategies that are essential to mitigate disparities in CVD outcomes and optimizing CVD risk in women. Central illustration: Identification and management of CV risk in women. [Display omitted] [ABSTRACT FROM AUTHOR]

• The rate of opioid use disorder (OUD) among women in the U.S. is increasing and medications for OUD (MOUD) do not prevent drug seeking and relapse. • There is a critical need for adjunctive therapies capable of improving long-term clinical outcomes in women with OUD. • Eight-week Mindfulness-Oriented Recovery Enhancement (MORE) intervention as an adjunct to MOUD may improve emotional regulation and brain function to assist in recovery for women with OUD. • A 10-minute guided MORE meditation may improve immediate mood in women with OUD. Mindfulness-Oriented Recovery Enhancement (MORE) is an efficacious intervention to aid recovery from substance use disorder. This study in a pilot sample of individuals in treatment for opioid use disorder (OUD) characterizes longer-term changes after the MORE intervention and immediate effects of a brief MORE guided meditation session. Twelve female participants in residential treatment for OUD completed an 8-week MORE intervention. Participants completed two sessions: one before and one after the 8-week MORE intervention. Each session included an emotional regulation questionnaire outside an MRI scanner first and then a 10-minute guided MORE meditation inside the scanner during which functional magnetic resonance imaging (fMRI) data were collected. Emotional regulation was measured after 8-weeks of MORE intervention. In addition, functional connectivity (i.e. correlated fMRI signal) between regions in a hypothesized affect regulation network was measured during the meditation state to assess change in brain network function due to 8-weeks of MORE. For each 10-min guided meditation, we also assessed their mood and opioid craving. Nine participants completed all measurements. Participants' emotional regulation difficulty significantly decreased after 8-weeks of MORE intervention. Furthermore, after 8-weeks of MORE, there was significantly increased connectivity between left ventromedial prefrontal cortex and left amygdala and between left ventrolateral prefrontal cortex and left nucleus accumbens captured during a meditation state. In both sessions, positive mood significantly increased after 10-min of guided mediation, however opioid craving was not significantly influenced. This pilot study characterizes potential benefits of 8-week MORE intervention in improving emotional regulation difficulty and brain function. A 10-min guided MORE meditation may immediately improve mood, with potential to reduce acute stress- or cue-provoked craving. These results warrant future studies with larger sample size. [ABSTRACT FROM AUTHOR]

Studies suggest an interplay between maternal metabolome and mental health. We investigated the association of maternal serum metabolome at pregnancy with anxiety scores during pregnancy and throughout the first year postpartum. A prospective cohort of Brazilian women collected 119 serum metabolome at pregnancy (28–38 weeks) and anxiety scores measured by the State-Trait Anxiety Inventory (STAI) at pregnancy (n = 118), 1 (n = 83), 6 (n = 68), and 12 (n = 57) months postpartum. Targeted metabolomics quantified metabolites belonging to amino acids (AA), biogenic amines/amino acid-related compounds, acylcarnitines, lysophosphatidylcholines, diacyl phosphatidylcholines, alkyl:acyl phosphatidylcholines, non-hydroxylated and hydroxylated sphingomyelins [SM(OH)], and hexoses classes. Linear mixed-effect models were used to evaluate the association of metabolites and STAI scores. Hierarchical clustering and principal component analyses were employed to identify clusters and metabolites, which drove their main differences. Multiple comparison-adjusted p -values (q -value) ≤ 0.05 were considered significant. AA (β = −1.44) and SM(OH) (β = −1.49) classes showed an association with STAI scores trajectory (q- value = 0.047). Two clusters were identified based on these classes. Women in cluster 2 had decreased AA and SM(OH) concentrations and higher STAI scores (worse symptoms) trajectory (β = 2.28; p -value = 0.041). Isoleucine, leucine, valine, SM(OH) 22:1, 22:2, and 24:1 drove the main differences between the clusters. The target semiquantitative metabolome analysis and small sample size limited our conclusions. Our results suggest that AA and SM(OH) during pregnancy play a role in anxiety symptoms throughout the first year postpartum. • Amino acids (AA) and hydroxylated sphingomyelins [SM (OH)] classes showed associations with anxiety scores trajectory. • Two clusters were identified based on AA and SM (OH) concentrations. • Women in cluster 2 had decreased AA and SM (OH) and higher anxiety scores (worse symptoms) trajectory. • Isoleucine, leucine, valine, SM (OH) 22:1, 22:2, and 24:1 drove the main differences between the clusters. [ABSTRACT FROM AUTHOR]