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ABSTRACT Background/Objective Search Strategy Selection Criteria Data Collection/Analysis Results Conclusions Current guidelines recommend biopsychosocial‐informed treatment for chronic pelvic pain (CPP). The objective of this systematic review was to describe the available biopsychosocial approaches for the treatment of CPP, and the outcomes reported, to understand how guideline‐recommended treatments can be applied.MEDLINE, CINAHL, PsycINFO, EMBASE, Emcare, AMED and Cochrane trial registries were searched (inception to 17 November 2023).CPP Studies in women where the principal treatment modality was a biopsychosocial approach were included. Prospero registration: CRD42022374256.Data extraction included study setting, population, study design, intervention characteristics and outcome measures and is described via a narrative synthesis.The review included 14 RCTs (871 patients) and identified four broad intervention categories (Acceptance Commitment Therapy n = 2, Cognitive Behavioural Therapy n = 6, Mindfulness‐based approaches n = 2, and Physiotherapy‐based interventions n = 4). Pain science education (PSE) and, exposure/engagement with valued activity were recognised as important aspects of treatment regardless of intervention type. The most utilised outcomes were pain reduction and emotional functioning, with all studies reporting improvements in these domains. Heterogeneity in outcomes prevented efficacy comparison. High risk of bias was identified in six studies (1/4 physiotherapy‐based approaches, 2/6 CBT, 1/2 ACT and 2/2 mindfulness‐based interventions).CBT and ACT‐based biopsychosocial approaches were found effective in reducing pain and improving psychometric outcomes for CPP. Evaluation indicated PSE, and exposure/engagement in valued activity are important components of biopsychosocial management. Outcome heterogeneity needs to be addressed in future trials. [ABSTRACT FROM AUTHOR]

Key points Testosterone, the major androgen, influences the reproductive and non‐reproductive systems in males and females via binding to the androgen receptor (AR). Both circulating endogenous testosterone and muscle AR protein content are positively associated with muscle mass and strength in males, but there is no such evidence in females. Here, we tested whether circulating testosterone levels were associated with muscle mass, function, or the muscle anabolic response to resistance training in pre‐menopausal females. Twenty‐seven pre‐menopausal, untrained females (aged 23.5 ± 4.8 years) underwent a 12‐week resistance training programme. Muscle strength, size, power, and plasma and urine androgen hormone levels were measured. Skeletal muscle biopsies were collected before and after the training programme to quantify the effect of resistance training on AR content and nuclear localisation. Primary muscle cell lines were cultured from a subset (n = 6) of the participants’ biopsies and treated with testosterone to investigate its effect on myotube diameter, markers of muscle protein synthesis and AR cellular localisation. Physiological levels of total testosterone were not associated with muscle mass or strength at baseline or with the changes in muscle mass and strength that occurred in response to resistance training in our cohort of pre‐menopausal females. In contrast, bioavailable testosterone and the proportion of nuclear‐localised AR were positively associated with skeletal muscle mass and strength in pre‐menopausal females. In vitro, supra‐physiological doses of testosterone increased myocyte diameter, but this did not occur via the Akt/mTOR pathway as previously suggested. Instead, we show a marked increase in AR nuclear localisation with testosterone administration in vitro. Total circulating testosterone was not related to muscle mass or strength before or after resistance training in pre‐menopausal females. Bioavailable testosterone was positively related to exercise‐induced muscle hypertrophy in pre‐menopausal females. In vivo nuclear localisation of the androgen receptor was positively related to muscle mass in pre‐menopausal females at baseline, but not to resistance training‐induced hypertrophy. Testosterone treatment induced androgen receptor nuclear translocation but did not induce mTOR signalling in primary skeletal myocytes cultured from pre‐menopausal female muscle. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of a sexual rehabilitation program, SEXHAB, in improving sexual functioning, reducing sexual distress, and enhancing marital satisfaction for women after gynecological cancer treatment. Methods: This is a randomized controlled trial that included 150 women newly diagnosed with gynecological cancer from three public hospitals in Hong Kong. Participants were randomly assigned to the intervention group (n = 78) to receive the SEXHAB or to an attention control group (n = 72) to receive attention. The SEXHAB comprises four individual‐ or couple‐based sessions with three major components: information provision, cognitive‐behavioral therapy and counseling using motivational interviewing skills. The outcomes were measured at baseline (T0), upon completion of the program (T1) and 12‐month post‐treatment (T2). Semi‐structured interviews were also conducted with the SEXHAB group participants to explore their experiences with and opinions toward the program. Results: At both follow‐ups, there were no statistically significant differences between groups in improving sexual functioning, sexual distress and marital satisfaction. Nevertheless, participants in the SEXHAB group reported their partners having significantly greater sexual interest at T1 (76% vs. 52%, rate ratio: 1.46, 95% CI: 1.07 to 1.99, p = 0.024) and T2 (74% vs. 48%, rate ratio: 1.55, 95% CI: 1.11 to 2.10, p = 0.014). From the qualitative interviews, the interviewees who resumed sexual activity reported positive experiences in rebuilding sexuality and intimacy. Conclusions: Despite the quantitative results are negative, the qualitative findings suggest potential benefits of the SEXHAB for women resuming sexual activities after treatment for gynecological cancer. Further studies with longer intervention period and follow‐ups are needed to confirm the intervention effects. [ABSTRACT FROM AUTHOR]

Issue Addressed: Women are 'at‐risk' population for failing to meet muscle strengthening guidelines. Health benefits specific to this exercise mode include maintenance of muscle mass, which is associated with reduced risk of chronic disease and falls. Of significance is the progressive decline in muscle strength exercise participation in women aged 35–54 in Australia. This period is critical for maintaining muscle strength as it establishes foundations for older women's engagement. This integrative review examined available evidence regarding factors influencing muscle strength exercise participation, specifically in women aged 35–54. Methods: Seven databases were searched. Study inclusion criteria were: (1) peer reviewed, (2) English language, (3) sample populations of healthy female adults or general adult sample population differentiating females from males, (4) mean age between 35 and 54 years, (5) focused on muscle strength exercise and measured as the primary outcome factors of participation in muscle strength exercise. Findings: Five of 1895 studies met inclusion criteria. Five key factors were associated with participation in muscle strength exercise of women aged 35–54 years: perceived time constraints; knowledge and education; modality and intensity; social support and behavioural strategies. Conclusions: Focused education on strength exercise and guidelines, plus initiatives and strategies that suit the needs of this cohort, are necessary to achieve health and wellbeing benefits. Responsive approaches by health professionals to these women's circumstances can potentially address current low participation levels. So What?: Creating conditions where health professionals respect a woman's exercise preferences can positively impact these women's musculoskeletal health into older age. [ABSTRACT FROM AUTHOR]

The aim of this article is to examine female participation in farming and more specifically, the reasons for the low rate of female farm ownership in Ireland where only 13% of Irish farm owners are female. Females are excluded from the occupation of a farmer because land ownership is the key needed in most instances to being a farmer in one's own right. Females are farming, but too often, they are not owners of the farms they work on. We investigate the structural and cultural factors that alleviate or contribute to the inequality in Irish farm ownership. To address the research question, a qualitative study involving 35 semi‐structured interviews was carried out with both women and men in the Irish farming sector. This research recognises the positive role the state can play, as supported by cultural and institutional theory, by making legal and financial policy changes that can help effect change. [ABSTRACT FROM AUTHOR]

Women's football has grown in popularity, competitiveness and professionalism, increasing the demands placed on players and their injury risk. This study aimed to identify differences in the match workload and international travel between injured and non‐injured professional women's footballers. The study was conducted as an observational, retrospective, case‐control study over two football seasons (2021/2022 and 2022/2023) in four top‐tier European women's football leagues. Fifty‐eight professional women football players (81 injuries) formed the injury group and were matched with 81 elite women football players (162 non‐injuries), from the same league, to form the control group. For each injury, cumulative match workload (minutes played, appearances, days between matches, rest) and international travel (distances, time, time zones crossed) were calculated over a 28‐day period preceding the injury, for both the injured players and matched controls. The injured group had a higher number of instances of less than 5 days between matches compared to the controls (p = 0.03, effect size = 0.3, small). The anterior cruciate ligament injury group made more appearances (p = 0.09, effect size = 0.8, moderate), had more instances of less than 5 days between matches (p = 0.09, effect size = 0.8, moderate) and had less rest time (p = 0.12, effect size = 0.8, moderate) than the control group. No meaningful differences were observed between the hamstring injury group and the control group. These findings underscore the importance of careful consideration when developing match fixture schedules in elite women's football, particularly concerning the number of matches scheduled in a short period. Strategies to increase rest and recovery are recommended to safeguard players against injuries. Highlights: Instances of less than 5 days between matches in elite women's football were significantly higher in the injured group compared to the non‐injured group.Elite female footballers who sustained anterior cruciate ligament (ACL) injuries made more appearances, had more instances of less than 5 days between matches and had less rest time in the 28 days prior to the injury than the non‐injured players.Elite female footballers who sustained ACL injuries also travelled further, for longer and crossed more time zones than the non‐injured players. [ABSTRACT FROM AUTHOR]

Female development includes significant morphological changes across the breast. Yet, whether differences in breast surface area (BrSA) modify breast skin stiffness and tactile sensitivity at rest and after exercise in the heat remain unclear. We investigated the relationship between BrSA and skin stiffness and tactile sensitivity in 20 young to middle‐aged women (27 ± 8 years of age) of varying breast sizes (BrSA range: 147–502 cm2) at rest and after a submaximal run in a warm climatic chamber (32C${\mathrm{C}}$ ± 0.6C;${\mathrm{0}}{\mathrm{.6C;}}$ 53% ± 1.7% relative humidity). Skin stiffness above and below the nipple and tactile sensitivity from the nipple down were measured. Associations between BrSA and both skin stiffness and tactile sensitivity at rest were determined via correlation analyses. Effects of exercise and test site were assessed by a two‐way ANOVA. Skin stiffness was positively correlated with BrSA 3 cm above the areola edge (r = 0.61, P = 0.005) and at the superior areola border (r = 0.54, P = 0.016), but not below the nipple (P > 0.05). The area 3 cm below the areola was also significantly stiffer than all other test sites (P < 0.043). Tactile sensitivity did not vary with BrSA (P > 0.09), but it varied across the breast (i.e., the area 3 cm below the areola was more sensitive than the inferior areola edge; P = 0.018). Skin stiffness and tactile sensitivity across the breast decreased after exercise by ∼37% (P < 0.001) and ∼45% (P = 0.008), respectively. These findings expand our fundamental understanding of the mechanosensory properties of the female breast, and they could help to inform sportswear innovation to better meet the support needs of women of different breast sizes at rest and following exercise. What is the central question of this study?How do differences in breast surface area impact skin stiffness and tactile sensitivity in healthy women before and after running in the heat?What is the main finding and its importance?We found a new relationship between breast morphology and skin stiffness, such that skin stiffness increased linearly with breast surface area in the upper breast. Furthermore, skin stiffness and tactile sensitivity decreased after exercise in the heat. These findings expand our fundamental understanding of breast mechanosensory properties and they could help to inform sportwear innovation to meet the support needs of women of different breast sizes better. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions Treatment‐related weight gain and metabolic complications with antiretroviral integrase‐based regimens, especially among Black women, suggest the need for alternative options.We conducted a 48‐week, open‐label, single‐arm, single‐centre, phase IIIb switch study to evaluate the tolerability, safety and efficacy of switching from stable efavirenz‐ or dolutegravir‐based antiretroviral therapy to doravirine/lamivudine/tenofovir disoproxil fumarate in Black women.The 101 participants enrolled (median age 35 years; interquartile range 31–40) were on efavirenz (n = 46; mean duration on therapy 1.7 years) or dolutegravir‐based (n = 55; mean duration 1.5 years) antiretrovirals at screening. Retention at 48 weeks was 92/101 participants, and viral suppression was >90% throughout the study, with a single case of doravirine resistance (106 M, V108I and H221Y mutations). The mean weight percentage change at week 48 was 4.7% (95% confidence interval [CI] 3.0–6.5; p < 0.001), and the adjusted mean change was 2.7 kg (95% CI 1.50–3.98; p < 0.001); for efavirenz, the percentage change was 5.0% (95% CI 2.9–7.1; p < 0.001), and the adjusted weight gain was 3.5 kg (95% CI 1.93–5.13); for dolutegravir, the percentage change was 4.5% (95% CI 1.8–7.3; p < 0.001), and the adjusted weight gain was 2.1 kg (95% CI 0.26–3.90). Statistically significant decreases in lipid panel percent mean to week 48 included: total cholesterol −8.4% (95% CI −11.3 to −5.5; p < 0.001), triglycerides −10.4% (95% CI −16.4 to −4.4; p < 0.001) and high‐density lipoprotein −14.8% (95% CI −18.5 to −11.2%; p < 0.001), with minor differences when disaggregating the mean percent change in lipids between previous efavirenz/dolutegravir regimens. Adverse events due to doravirine were few and mild.Our findings suggest that a switch to doravirine from efavirenz or dolutegravir is safe and effective in Black women, with significant improvement in lipid profiles, but does not arrest progressive weight gain. [ABSTRACT FROM AUTHOR]

Most research on mass murderers to date has focused on perpetrators of male sex, while research on perpetrators of female sex has been relegated to case reports and series. We aimed to more fully examine the phenomenon of female‐perpetrated mass murder. We analyzed 1715 worldwide incidents of personal‐cause mass murder from 1900 to 2019, identifying 105 (6%) events perpetrated by females. We defined mass murder as any event involving at least three fatalities, not including the perpetrator, using any method. We identified cases of mass murder from English‐language databases of mass murder or murder in print or online. There were no significant differences in age and race between female and male perpetrators. Relative to males, female perpetrators were significantly less likely to employ firearms in their mass murders, using them in less than half of cases, compared to over 70% for males. The prevalence of psychotic signs and symptoms among female mass murderers was more than double that among males (25.7% vs. 12.5%, p < 0.01), while the rate of nonpsychotic psychiatric or neurological conditions was also much greater among female perpetrators (29.5% vs. 17.1%, p < 0.01). Over half of female perpetrators took or attempted to take their own lives. More than three‐quarters of mass murders by females involved at least one family member as a victim. This study underscores sex‐specific differences in the perpetration of mass murder and the need for further research to understand how insights about such dynamics might lead to the development of more effective and informed intervention policies. [ABSTRACT FROM AUTHOR]

Obesity has become a global epidemic and is associated with comorbidities, including diabetes, cardiovascular, and neurodegenerative diseases, among others. While appreciable insight has been gained into the mechanisms of obesity‐associated comorbidities, effects of age, and duration of obesity on the female brain remain obscure. To address this gap, adolescent and mature adult female mice were subjected to a high‐fat diet (HFD) for 13 or 26 weeks, whereas age‐matched controls were fed a standard diet. Subsequently, the expression of inflammatory cytokines, neurotrophic/neuroprotective factors, and markers of microgliosis and astrogliosis were analyzed in the hypothalamus, hippocampus, and cerebral cortex, along with inflammation in visceral adipose tissue. HFD led to a typical obese phenotype in all groups independent of age and duration of HFD. However, the intermediate duration of obesity induced a limited inflammatory response in adolescent females' hypothalamus while the hippocampus, cerebral cortex, and visceral adipose tissue remained unaffected. In contrast, the prolonged duration of obesity resulted in inflammation in all three brain regions and visceral adipose tissue along with upregulation of microgliosis/astrogliosis and suppression of neurotrophic/neuroprotective factors in all brain regions, denoting the duration of obesity as a critical risk factor for neurodegenerative diseases. Importantly, when female mice were older (i.e., mature adult), even the intermediate duration of obesity induced similar adverse effects in all brain regions. Taken together, our findings suggest that (1) both age and duration of obesity have a significant impact on obesity‐associated comorbidities and (2) early interventions to end obesity are critical to preserving brain health. [ABSTRACT FROM AUTHOR]

The article discusses attitudes towards urgent RhD-positive transfusions in female patients and the risk of hemolytic disease of the fetus and newborn (HDFN). Surveys show a preference for issuing RhD-negative blood products to women and girls, but due to supply constraints, some centers use RhD-positive products in life-threatening situations. Studies indicate that the public values survival in trauma over the risk of future pregnancy complications, supporting the acceptance of RhD-positive transfusions if RhD-negative products are unavailable. Efforts should still be made to provide RhD-negative products to females of childbearing potential, but the surveys demonstrate a willingness to accept lifesaving interventions when necessary. [Extracted from the article]

Sperm whales spatially segregate by sex and social behavior as they mature. In the North Atlantic, male whales move to higher latitudes as far as Svalbard at 80° N, while females and young whales typically remain around lower latitudes below 40–45° N. The Azores, Madeira, and the Canary Islands constitute important nursery grounds for female and young sperm whales. Irish waters represent a midpoint for this species' spatial segregation in the Northeast Atlantic, where the species occurs along the submarine canyon systems to the west of the country. Historically, just male whales were thought to be found in this region between 51 and 55° N, but one adult female was caught by commercial whalers in 1910, and a 5.49 m calf was found stranded in 1916. Between 1995 and 2023, 10 female sperm whales have been stranded around the coast of Ireland. Eight of these whales have been stranded since 2013, and there has been at least one stranding per year between 2019 and 2023. Four of these strandings have occurred in Donegal in the northwest of Ireland, indicating the presence of female whales along the continental shelf off this region. Two females were stranded within a day of each other and were found in similar states of decomposition in February 2022, indicating that they may have been part of the same group rather than being lone vagrant individuals. Sperm whale calves and juveniles were also sighted in Irish waters in 2001, 2004, and 2010 in the Rockall Trough, along the Porcupine Bank and Goban Spur, where between 1 and 3 individuals were observed on four occasions while one calf live stranded in 2004. These records indicate a historical presence of female and young sperm whales in this region but that an apparent increase in occurrence has taken place over the past decade. [ABSTRACT FROM AUTHOR]

Problem: Predicting the impact of systemic inflammation on oocyte and embryonic development in unexplained infertile women using the new immunological indexes. Method of Study: This retrospective cohort study was conducted using the records of the In Vitro Fertilization Department of Ankara Gülhane Training and Research Hospital. After reviewing the records of patients who had undergone in vitro fertilization (IVF) for unexplained infertility (UI) and excluding all known factors that could cause systemic immune inflammation, the systemic immune response index (SIRI), and pan‐immune score were calculated from the pre‐treatment hemogram parameters between the embryo arrest (EA) group and the embryo transfer group. It was investigated whether there was a statistical difference between the two groups and whether an SIRI value affecting embryo quality was found. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut‐off values for inflammatory markers to predict EA. Results: The 108 EA group (embryos that were arrested during their development and could not be transferred) and the 140 embryo transfer group showed statistically significant differences in the parameters of systemic inflammatory index (SII), SIRI, pan‐immune inflammation value (PIV), and neutrophil/lymphocyte ratio (NLR) (p < 0.05). These inflammatory parameters, which were examined before ovulation induction, also correlated positively with the required total dose of gonadotropin and negatively with the ovarian sensitivity index (OSI). SII, SIRI, PIV, and NLR have specific cut‐off values with ROC analysis and determine the effect of the inflammatory status of the environment in which the oocyte develops on EA (p < 0.005). Conclusion: In women with UI, high levels of systemic immune inflammation have a negative impact on oocyte and embryo development, and treatments to suppress inflammation may improve IVF success. [ABSTRACT FROM AUTHOR]

Background: Sex‐based disparities in cardiovascular outcomes may be improved with appropriate hypertension management. Objective: To compare the evidence‐based evaluation and management of females with late‐onset hypertension compared to males in the contemporary era. Methods: Design: Retrospective population‐based cohort study. Setting: Ontario, Canada. Participants: Residents aged ≥66 years with newly diagnosed hypertension between January 1, 2010, and December 31, 2017. Exposure: Sex (female vs. male). Outcomes and Measures: We used Poisson and logistic regression to estimate adjusted sex‐attributable differences in the performance of guideline‐recommended lab investigations. We estimated adjusted differences in time to the prescription of, and type of, first antihypertensive medication prescribed between females and males, using Cox regression. Results: Among 111,410 adults (mean age 73 years, 53% female, median follow‐up 6.8 years), females underwent a similar number of guideline‐recommended investigations (adjusted incidence rate ratio, 0.997 [95% confidence interval [CI] 0.99–1.002]) compared to males. Females were also as likely to complete all investigations (0.70% females, 0.77% males; adjusted odds ratio, 0.96 [95% CI 0.83–1.11]). Females were slightly less likely to be prescribed medication (adjusted hazard ratio [aHR] 0.98 [95% CI 0.96–0.99]) or, among those prescribed, less likely to be prescribed first‐line medication (aHR, 0.995 [95% CI 0.994–0.997]). Conclusions: Compared to males, females with late‐onset hypertension were equally likely to complete initial investigations with comparable prescription rates. These findings suggest that there may be no clinically meaningful sex‐based differences in the initial management of late‐onset hypertension to explain sex‐based disparities in cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

Involvement of female genital track (FGT) by diffuse large B cell lymphoma (DLBCL) represents an extremely rare diagnosis. Especially data regarding early‐stage disease (i.e., IE, IIE) is very limited. Importantly, previous studies showed controversial results about the risk of central nervous system (CNS) relapse in this entity. Herein, we describe one of the largest reported real‐world series of patients with early‐stage FGT DLBCL aiming to investigate the clinicopathological characteristics, response to therapy and survival outcomes in the era of immunochemotherapy. We analyzed 21 consecutive patients with biopsy proven DLBCL from uterus or ovary classified as stage IE or IIE out of 1905 newly diagnosed DLBCL patients (1.1%). Uterine and ovarian localization was observed in 14 and seven patients, respectively. Median age was 66 years (range 33–96); 9/21 (43%) were <55 years. Regarding Cell of Origin DLBCL subtype, Germinal Center B‐cell subtype was found in seven patients, non‐GCB in 10 and non‐classified in 4 patients. Median follow‐up was 57 months and 5‐year overall survival, lymphoma specific survival and Freedom from Progression were 78%, 89% and 90%, respectively. There was no correlation of patients' characteristics with survival parameters. Interestingly, none of the patients experienced CNS relapse. Our results indicate that localized FGT DLBCL exhibits a good prognosis and may not increase the risk for secondary CNS involvement. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes is highly prevalent worldwide, with an estimated 536 million living with diabetes in 2021, and that number projected to increase to 783 million by 2045. Diabetic bladder dysfunction is thought to affect up to 60%–90% of individuals with diabetes and can significantly impact quality of life. Despite the prevalence of diabetic bladder dysfunction, the exact pathophysiological mechanism, and resulting clinical presentation, remains debated. Our objective was to compare urodynamic parameters between diabetic and nondiabetic women, assessing the impact of various markers of diabetes severity on bladder function. Methods: A retrospective chart review was conducted on female patients aged 18 and above who underwent urodynamic studies at a single tertiary care university hospital system from 2014 to 2020. Patients were categorized based on diabetes status, and diabetes severity including duration of disease, hemoglobin A1c levels, insulin dependence, and markers of end‐organ dysfunction. Urodynamic variables, including compliance, bladder voided efficiency, bladder contractility index, postvoid residual, maximum flow rate, capacity, voided volume, and detrusor overactivity, were assessed by two independent reviewers. Statistical analyses were performed to assess the impact of diabetes and diabetic severity on urodynamic parameters. Results: A total of 652 female patients were included in the study, of which, 152 (23.3%) had diabetes, with an average duration of diagnosis of 82.3 months. Diabetic women were older and had higher body mass index compared to nondiabetic women. Diabetic retinopathy and neuropathy were present in 18% and 54.6% of diabetic patients, respectively. Significant differences in urodynamic parameters were observed between diabetic and nondiabetic women, with diabetic women showing higher rates of detrusor overactivity (p = 0.01), particularly associated with increasing BMI (p = 0.03). However, classic markers of diabetes severity including duration, as well as markers of end‐organ damage, showed mixed associations with urodynamic changes. Conclusions: Despite the prevalence of diabetic bladder dysfunction and its impact on patient quality of life, the exact mechanisms and clinical presentation remain elusive. Our study highlights the significant differences in urodynamic parameters between diabetic and nondiabetic women, emphasizing the need for further research into the relationship between diabetes and diabetic bladder dysfunction. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Editors‐in‐Chief (EiC) play a key role as gatekeepers in academic medicine, often shaping research agendas. Women have historically been underrepresented in editorial leadership roles in academic medicine. The purpose of this study was to examine gender representation among EiC of contemporary transplantation and nephrology journals.This cross‐sectional study evaluated gender disparities among EiC of transplantation and nephrology medical journals. The study population was drawn from journals in two subject categories (1) ‘Transplantation’ and (2) ‘Urology and Nephrology’ in the 2023 Journal Citation Reports. Binary gender classification (woman/man) was determined by the names/pronouns used to describe the EiC on the journal or institutional webpage. The primary outcome was the proportion of women EiC. Secondary outcome was the proportion of women EiC based on journal topic, location and metrics. Descriptive statistics were used. Gender differences were compared using students t‐test or Fisher's exact test.A total of 79 EiC were identified of which 16 (20%) were women and 63 (80%) were men (p < .001). Transplantation and nephrology journals had 21% and 20% women EiC, respectively. The proportion of women to men EiC was not impacted by journal category (p = .93), journal location (p = .61), journal impact factor (p = .71) or quartile (p = .59).There was a disparity in gender representation in EiC in nephrology and transplantation journals, with men holding 80% of all positions. These findings, among growing evidence of gender disparity, highlight a need for targeted efforts to promote gender equity in academic medicine. [ABSTRACT FROM AUTHOR]

Background: Usage of immune checkpoint inhibitors (ICIs) has prolonged the overall survival (OS) of patients with extensive‐stage small‐cell lung cancer (ES‐SCLC). In clinical trials, males accounted for a large proportion, leading to the uncertainty of its efficacy in female patients. We therefore conducted this study to explore the efficacy and safety of using ICIs in female patients with ES‐SCLC. Methods: We retrospectively enrolled female SCLC patients and subdivided them into two groups. Group A (n = 40) was defined as ES‐SCLC patients who received first‐line standard chemotherapy with or without ICIs. Group B (n = 47) included relapsed SCLC patients who were administered with second‐line therapies. Kaplan–Meier methodology was used to calculate survival analysis. Chi‐squared tests were used to analyze the incidence of adverse events (AEs). Results: Median progression‐free survival (PFS) and median OS favored the ICI‐contained cohorts (Group A PFS: 8.3 vs. 6.1 months; OS: not reached vs. 11.3 months; Group B PFS: 15.1 vs. 3.3 months; OS: 35.3 vs. 8.3 months), especially in those patients who received second‐line immunotherapies. Patients who received immunotherapy had a slightly higher incidence rate of grade ≥3 AEs (Group A: 71.4% vs. 46.2%; Group B: 44.5% vs. 13.2%). Those who developed grade ≥3 AEs in first‐line ICIs cohort had a more favorable survival (PFS: 8.3 vs. 3.2 months; OS: not reached vs. 5.1 months). Conclusions: Our study suggested that female ES‐SCLC patients treated with immunotherapy tended to achieve a relatively longer survival. The incidence of AEs (grade ≥3) was higher in women patients receiving ICIs, which requires monitoring more closely. [ABSTRACT FROM AUTHOR]

Background and aim Method Results Conclusion Evidence suggests there has been an increase in anabolic‐androgenic steroid (AAS) use among women, driven by the evolving landscape of women's participation in sport. However, the extent of use is unknown. This systematic review aimed to estimate the prevalence of women's AAS use.We conducted a systematic review of peer‐reviewed articles in English, focusing on AAS use among women aged 18 and above. We excluded grey literature and studies that measured doping through some form of analysis (e.g. urine or hair). Searched databases were MEDLINE, CINAHL, PsycINFO, SocINDEX, SPORTDiscus, Embase and Cochrane Library. Titles and abstracts for all articles were screened, followed by full‐text assessment and data extraction of included articles by multiple authors for accuracy. The pooled prevalence of lifetime use was determined using a random effects model and the risk of bias was assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool.Based on 18 studies, participant numbers averaged 669 per study (median = 189; range = 16 to 7051). The overall pooled AAS use prevalence was 4% (95% confidence interval [CI] = 2–9%) with high heterogeneity overall (I2 = 95%). In the subgroup analysis, AAS use prevalence was 16.8% (95% CI = 11.0–24.9%, I2 = 44%) in the bodybuilder subgroup, 4.4% (95% CI = 1.2–15.1%, I2 = 93%) in athletes/recreational gym user subgroup, and 1.4% (95% CI = 0.4–4.7%, I2 = 96%) in the general population/other subgroup. Meta‐regression demonstrated significantly higher AAS use in bodybuilders compared with the other subgroup (P = 0.011).Anabolic‐androgenic steroid use among women appears to be substantially higher among bodybuilders and athletes/recreational gym users than the general female population. [ABSTRACT FROM AUTHOR]

Objective: The study evaluated the anatomical and functional outcomes, as well as the safety data of laparoscopic sacrocolpopexy (LSC) for pelvic organ prolapse (POP) using a lightweight macroporous mesh. Methods: A multicentric observational study was developed including five expert centers between March 2011 and December 2019. Inclusion criteria were female patients with symptomatic ≥stage II POP (POP‐Q classification), who underwent a LSC. A lightweight and macroporous mesh device (Surelift Uplift) was used. Baseline anatomical positions were evaluated using POP‐Q stage. The anatomical outcomes and procedural complications were assessed during the postoperative period. Primary outcomes were anatomical success, defined as POP‐Q stage ≤I, and subjective success, defined as no bothersome bulge symptoms, and no repeat surgery or pessary use for recurrent prolapse. Results: A total of 325 LSCs were analyzed with a median patient age of 66 (interquartile range [IQR] 61–73). After a median follow‐up of 68 months (IQR 46.5–89), anatomical success was found in 88.9%, whereas subjective success was seen in 98.5% of the patients. Recurrent prolapse presented as cystocele (1.5%). Reported complications were bladder (4.6%) or rectum lesions (0.6%), de novo urinary incontinence (12.9%), and mesh extrusion (1.2%). Conclusions: LSC provides significant clinical improvement and excellent anatomical results, with a low risk of serious complications for women with ≥2 grade POP in a real clinical practice setting. [ABSTRACT FROM AUTHOR]

Background: Pityriasis versicolor (PV), a cutaneous fungal infection, most commonly affects adolescents and young adults and is associated with hyperhidrosis and humid weather. Understanding other factors associated with PV might help improve diagnostic and treatment practices. Objectives: PV's associations with patient demographics, comorbidities and medication exposures were assessed using the All of Us Database, a large, diverse, national database from the United States. Methods: A case–control study with multivariable analysis was performed. Results: We identified 456 PV case‐patients and 1368 control‐patients. PV case‐patients (vs. control‐patients) were younger (median age [years] (standard deviation): 48.7 (15.4) vs. 61.9 (15.5); OR: 0.95, CI: 0.94–0.96) and more likely to be men versus women (42.8% vs. 33.9%, OR: 1.45, CI: 1.16–1.79) and Black (19.5% vs. 15.8%, OR: 1.35, 95% CI: 1.02–1.80) or Asian (4.6% vs. 2.7%, OR: 1.86, CI: 1.07–3.24) versus White. PV case‐patients more frequently had acne (5.3% vs. ≤1.5%, OR: 5.37, CI: 2.76–10.48) and less frequently had type 2 diabetes mellitus (T2DM) (14.7% vs. 24.7%, OR: 0.52, CI: 0.39–0.70) and hypothyroidism (OR: 10.3% vs. 16.4%, OR: 0.59, CI: 0.42–0.82). In multivariable analysis, PV odds were significantly higher in those with acne and lower in those with T2DM, older age and female sex. Conclusions: Our results may be used as a basis for future studies evaluating whether acne treatment may decrease PV risk. Physicians could educate patients with acne about PV, including strategies to control modifiable PV risk factors, such as avoidance of hot and humid environments and avoidance of use of topical skin oils. [ABSTRACT FROM AUTHOR]

We examined performance across one menstrual cycle (MC) and 3 weeks of hormonal contraceptives (HC) use to identify whether known fluctuations in estrogen and progesterone/progestin are associated with functional performance changes. National Rugby League Indigenous Women's Academy athletes [n = 11 naturally menstruating (NM), n = 13 using HC] completed performance tests [countermovement jump (CMJ), squat jump (SJ), isometric mid‐thigh pull, 20 m sprint, power pass and Stroop test] during three phases of a MC or three weeks of HC usage, confirmed through ovulation tests alongside serum estrogen and progesterone concentrations. MC phase or HC use did not influence jump height, peak force, sprint time, distance thrown or Stroop effect. However, there were small variations in kinetic and kinematic CMJ/SJ outputs. NM athletes produced greater mean concentric power in MC phase four than one [+0.41 W·kg−1 (+16.8%), p = 0.021] during the CMJ, alongside greater impulse at 50 ms at phase one than four [+1.7 N·s (+4.7%), p = 0.031] during the SJ, without differences between tests for HC users. Among NM athletes, estradiol negatively correlated with mean velocity and power (r = −0.44 to −0.50, p < 0.047), progesterone positively correlated with contraction time (r = 0.45, p = 0.045), and both negatively correlated with the rate of force development and impulse (r = −0.45 to −0.64, p < 0.043) during the SJ. During the CMJ, estradiol positively correlated to 200 ms impulse (r = 0.45, p = 0.049) and progesterone to mean power (r = 0.51, p = 0.021). Evidence of changes in testing performance across a MC, or during active HC use, is insufficient to justify "phase‐based testing"; however, kinetic or kinematic outputs may be altered in NM athletes. Highlights: Evidence of changes in testing performance across a menstrual cycle, or during active hormonal contraceptives use, is insufficient to justify "phase‐based testing" at a group or team‐based level among female rugby league athletes.Kinetic or kinematic outputs in jumping movements may be altered in naturally menstruating athletes; however it could not be determined if the observed alterations exceeded between‐day variability. [ABSTRACT FROM AUTHOR]

Female development includes significant morphological changes across the breast. Yet, whether differences in breast surface area (BrSA) modify sweat gland density and output remains unclear. The present study investigated the relationship between BrSA and sweat gland density and output in 22 young to middle‐aged women (28±$\ \pm \ $10 years) of varying breast sizes (BrSA range: 147–561 cm2) during a submaximal run in a warm environment (32 ±$ \pm \ $0.6°C; 53 ±$ \pm \ $1.7% relative humidity). Local sweat gland density and local sweat rate (LSR) above and below the nipple and at the bra triangle were measured. Expired gases were monitored for the estimation of evaporative requirements for heat balance (Ereq, in W/m2). Associations between BrSA and (i) sweat gland density; (ii) LSR; and (iii) sweat output per gland for the breast sites were determined via correlation and regression analyses. Our results indicated that breast sweat gland density decreased linearly as BrSA increased (r = −0.76, P < 0.001), whereas sweat output per gland remained constant irrespective of BrSA (r = 0.29, P = 0.28). This resulted in LSR decreasing linearly as BrSA increased (r = −0.62, P = 0.01). Compared to the bra triangle, the breast had a 64% lower sweat gland density (P < 0.001), 83% lower LSR (P < 0.001) and 53% lower output per gland (P < 0.001). BrSA (R2 = 0.33, P = 0.015) explained a greater proportion of variance in LSR than Ereq (in W/m2) (R2 = 0.07, P = 0.538). These novel findings extend the known relationship between body morphology and sweat gland density and LSR, to the female breast. This knowledge could innovate user‐centred design of sports bras by accommodating breast size‐specific needs for sweat management, skin wetness perception and comfort. What is the central question of this study?How do differences in breast surface area impact sweat gland density and output across the breast of healthy women during running in the heat?What is the main finding and its importance?There was a novel relationship between breast morphology and sweat gland density and output such that gland density and local sweat rates decreased linearly as breast surface area increased. Furthermore, the breast had lower sweat gland density and output than the bra triangle. This knowledge could inform user‐centred design of sports bras through a better understanding of breast size‐specific thermal needs. [ABSTRACT FROM AUTHOR]

Aims: To explore UK healthcare professionals' practice and attitudes towards asking women with diabetes about sexual health problems, including symptoms of female sexual dysfunction (FSD). Methods: An online questionnaire to address the study aims was developed, piloted by ten healthcare professionals (HCPs) and completed by 111 eligible HCPs, recruited via professional networks and social media. Free text data were analysed and reported thematically. Two questions were analysed to test the hypothesis of differences between men's and women's responses. Results: The majority of respondents did not ask women with diabetes about sexual problems. Multiple barriers to inquiry were reported, including inadequate training, time constraints, competing priorities, the perceived likelihood that questions will cause surprise or distress (especially for certain groups of women), the belief that sexual problems are to be expected as women age, and the belief that FSD is complex or untreatable, with unclear management pathways. Exploratory findings indicated significant differences in men and women's responses (men disagreed more strongly with prioritisation, and fewer reported routine inquiry about sexual problems in their usual practice). Conclusions: HCPs reported not asking women with diabetes about sexual problems during routine care. They described multiple factors reinforcing the silence about sexual health, including inadequate education and perceived social risk for individual HCPs who deviate from the patterns of topics usually discussed in diabetes consultations. [ABSTRACT FROM AUTHOR]

Background: Subarachnoid hemorrhage (SAH) represents a severe stroke subtype. Our study aims to develop gender‐specific prognostic prediction models derived from distinct prognostic factors observed among different‐gender patients. Methods: Inclusion comprised SAH‐diagnosed patients from January 2014 to March 2016 in our institution. Collected data encompassed patients' demographics, admission severity, treatments, imaging findings, and complications. Three‐month post‐discharge prognoses were obtained via follow‐ups. Analyses assessed gender‐based differences in patient information. Key factors underwent subgroup analysis, followed by univariate and multivariate analyses to identify gender‐specific prognostic factors and establish/validate gender‐specific prognostic models. Results: A total of 929 patients, with a median age of 57 (16) years, were analyzed; 372 (40%) were male, and 557 (60%) were female. Differences in age, smoking history, hypertension, aneurysm presence, and treatment interventions existed between genders (p < 0.01), yet no disparity in prognosis was noted. Subgroup analysis explored hypertension history, aneurysm presence, and treatment impact, revealing gender‐specific variations in these factors' influence on the disease. Screening identified independent prognostic factors: age, SEBES score, admission GCS score, and complications for males; and age, admission GCS score, intraventricular hemorrhage, treatment interventions, symptomatic vasospasm, hydrocephalus, delayed cerebral ischemia, and seizures for females. Evaluation and validation of gender‐specific models yielded an AUC of 0.916 (95% CI: 0.878–0.954) for males and 0.914 (95% CI: 0.885–0.944) for females in the ROC curve. Gender‐specific prognostic models didn't significantly differ from the overall population‐based model (model 3) but exhibited robust discriminative ability and clinical utility. Conclusion: Variations in baseline and treatment‐related factors among genders contribute partly to gender‐based prognosis differences. Independent prognostic factors vary by gender. Gender‐specific prognostic models exhibit favorable prognostic performance. [ABSTRACT FROM AUTHOR]

Female hypogonadism (FH) is a relatively common endocrine disorder in women of premenopausal age, but there are significant uncertainties and wide variation in its management. Most current guidelines are monospecialty and only address premature ovarian insufficiency (POI); some allude to management in very brief and general terms, and most rely upon the extrapolation of evidence from the studies relating to physiological estrogen deficiency in postmenopausal women. The Society for Endocrinology commissioned new guidance to provide all care providers with a multidisciplinary perspective on managing patients with all forms of FH. It has been compiled using expertise from Endocrinology, Primary Care, Gynaecology and Reproductive Health practices, with contributions from expert patients and a patient support group, to help clinicians best manage FH resulting from both POI and hypothalamo‐pituitary disorders, whether organic or functional. [ABSTRACT FROM AUTHOR]

Several quantitative studies have shown a negative relationship between fitspiration content (appearance‐idealized pictures related to a fit and healthy lifestyle) in social media and mental health. The current study aimed to gain a deeper understanding of fitspiration users by qualitatively assessing their perception of fitspiration content and how it affects their health‐related behaviour and well‐being. A further research question was whether fitspiration as a form of public pedagogy was addressed in participants' physical education (PE) in schools. Thirteen female students from Austria who follow fitspiration content (14–19 years) were interviewed using semi‐structured interviews. Positive effects in health behaviour, such as a higher reported physical activity, exercise motivation and conscious eating (e.g., reducing junk food) were reported. However, participants further described potentially negative consequences on mental and physical health resulting from social comparisons with influencers. As none of the students reported addressing social media fitness content in PE, including or adapting a critical media pedagogy in PE should be considered to enhance awareness of the negative effects of social media but use the positive influence on health behaviour. [ABSTRACT FROM AUTHOR]

Aims: Existing questionnaires provide limited information on the nature, severity and context surrounding lower urinary tract symptoms (LUTS) experienced during running, jogging and brisk walking. The aims of this study were to develop a theoretical model of the experience of LUTS by females participating in gait‐based exercise activities and to use this model to generate a questionnaire to evaluate the presence, symptoms and bother associated with LUTS experienced by females during gait‐based activities. Methods: A theoretical model was developed through a review of the literature and refined through a focus group consultation including pelvic health physiotherapists, females who experienced leakage during exercise and academic researchers who studied female LUTS. A draft questionnaire was developed using key constructs identified in the model by the focus group. A new expert panel was recruited, which included physiotherapists, women with self‐reported gait‐induced LUTS and urogynecologists. This panel followed a DELPHI process to evaluate the relevance and completeness of the constructs within the questionnaire. Results: Two rounds of consultation were required to reach consensus on the completeness of included constructs as well as the inclusion and wording of questions. The resulting questionnaire contains questions related to five key constructs: physical activity characteristics, symptoms of urgency, urgency urinary incontinence, stress urinary incontinence experienced during exercise and management/mitigation strategies adopted by respondents. Conclusions: The content validity of the brisk walking‐ and running‐induced lower urinary tracts symptoms questionnaire has been established. The next steps are to ensure that the questionnaire has adequate comprehensibility, followed by adequate measurement properties. [ABSTRACT FROM AUTHOR]

Objectives: Women represent >50% of people with HIV globally but have historically been underrepresented in clinical trials. We evaluated the efficacy and safety of switching to dolutegravir/lamivudine (DTG/3TC) vs continuing their current antiretroviral regimen (CAR) by sex assigned at birth (female and male) in virologically suppressed adults with HIV‐1 without prior virological failure in a pooled analysis of two randomized controlled trials. Methods: This analysis included 48‐week data from the phase 3 TANGO and SALSA studies. Primary and key secondary endpoints included proportions of participants with HIV‐1 RNA ≥50 and <50 copies/mL at week 48, respectively. Safety was also assessed. Results: Of 1234 participants, 250 (DTG/3TC, n = 133; CAR, n = 117) were female at birth. Week 48 proportions of participants with Snapshot HIV‐1 RNA ≥50 copies/mL were similar regardless of sex at birth (DTG/3TC vs CAR: female, <1% [1/133] vs 2% [2/117]; male, <1% [1/482] vs <1% [3/502]). Proportions with HIV‐1 RNA <50 copies/mL were high across sexes and treatment groups (DTG/3TC vs CAR: female, 91% [121/133] vs 89% [104/117]; male, 94% [455/482] vs 94% [471/502]). Immunological response with DTG/3TC was slightly higher in female participants. Incidences of adverse events leading to withdrawal and serious adverse events were low and comparable between treatment groups and across sexes. Weight gain was higher with DTG/3TC than with CAR among female participants aged ≥50 years (treatment difference 2.08 kg [95% confidence interval 0.40–3.75]). Conclusions: Results confirm the robustness of DTG/3TC as a switch option in virologically suppressed females with HIV‐1, with outcomes similar to those in males. [ABSTRACT FROM AUTHOR]

Introduction: Females of childbearing age with hepatitis C virus (HCV) face increased marginalisation with intersecting, sex‐specific barriers to direct acting antiviral (DAA) therapy. We assessed the factors associated with uptake of DAA therapy among females of childbearing age, including those with evidence of recent drug dependence. Methods: HCV notifications in New South Wales, Australia (1995–2017) were linked to opioid agonist therapy (OAT), hospitalisations, incarcerations, perinatal, HIV notifications, deaths and prescription databases. Recent drug dependence was defined as hospitalisation due to injectable drugs or receipt of OAT occurring in the DAA era (2016–2018). Logistic regression was used to analyse factors associated with DAA uptake among females of childbearing age (18–44), including those with recent drug dependence. Results: Among 57,467 people with evidence of chronic HCV in the DAA era (2016–2018), 20,161 (35%) were female, including 33% (n = 6563/20,161) of childbearing age (18–44). Among all females of childbearing age (n = 6563) and those with evidence of recent drug dependence (n = 2278/6563, 35%), DAA uptake was lower among those who had given birth in the DAA era (vs. no birth record, all females of childbearing age; aOR: 0.74, 95% CI 0.61, 0.89; those with recent drug dependence; aOR 0.69, 95% CI 0.51, 0.93) and Aboriginal and Torres Strait Islander peoples (all females of childbearing age; aOR 0.81, 95% CI 0.71, 0.93; those with recent drug dependence aOR 0.75, 95% CI 0.62, 0.90). Conclusion: Females of childbearing age should be considered a key population for DAA therapy. Enhancing antenatal and postnatal HCV care may be critical in the pursuit towards elimination. [ABSTRACT FROM AUTHOR]

Inclusive education has been widely accepted as a useful policy to offer equal access to education to all children. However, practices have stalled in many countries, including the United Arab Emirates (UAE), necessitating support for system strengthening to enhance the existing practices in schools. While leadership is at the heart of effective practices, there is little discussion on the leadership required to leverage inclusive practices. In the UAE, little information is available regarding inclusive education leadership at early school levels, which is dominated by female teachers. This study examined the structural validity of the heuristic leadership framework, which focuses on leadership tenets (transaction, transformation and instruction) controlled by school leaders, to explain female leadership practices in the implementation of inclusive education in early education schools in the UAE. A scale based on the study framework (heuristics leadership framework) was used to collect data from 151 school leaders, including principals, vice principals, faculty heads and lead teachers, working at early school levels across the UAE. The results of this study provide theoretical support for the heuristic leadership framework and some demographics, providing valuable insights into leadership practices among female education leaders in the UAE. [ABSTRACT FROM AUTHOR]

Highlights We investigated the effects of resistance exercise (RE), hydrolysed collagen (HC) ingestion and circulating oestrogen concentration on collagen synthesis in a naturally menstruating female CrossFit athlete. In a double‐blind, randomised cross‐over design, the participant (36 years; height 1.61 m; mass 82.6 kg) consumed 0 or 30 g HC prior to performing back‐squat RE when endogenous circulating oestrogen concentration was low (onset of menses, OM) and high (late follicular phase, LF) during two consecutive menstrual cycles. Ten 5‐mL blood samples were collected during each of the four interventions to analyse concentrations of serum 17β‐oestradiol, and biomarkers of type I collagen turnover, that is serum procollagen type I N‐terminal propeptide (PINP, a biomarker of collagen synthesis) and plasma β‐isomerised C‐terminal telopeptide of type I collagen (β‐CTX, a biomarker of collagen breakdown), as well as the serum concentration of 18 collagen amino acids. 17β‐Oestradiol concentration was 5‐fold higher at LF (891 ± 116 pmol L−1) than OM (180 ± 13 pmol L−1). The PINP concentration × time area under the curve (AUC) was higher in the 30 g HC OM intervention (201 μg L−1 h) than the 30 g HC LF (144 μg L−1 h), 0 g HC OM (151 μg L−1 h) and 0 g HC LF (122 μg L−1 h) interventions. β‐CTX concentration decreased 1.4‐fold from pre‐RE to 6 h post‐RE in all interventions. Thus, high circulating oestrogen concentration was associated with lower collagen synthesis following RE in this female athlete. Ingesting 30 g HC, however, augmented the collagen synthesis response at LF and particularly at OM. What is the central question of this study? Does resistance exercise‐induced collagen synthesis vary according to circulating oestrogen concentration in a naturally menstruating female athlete, and if so, does hydrolysed collagen ingestion have any impact? What is the main finding and its importance? Exercise‐induced collagen synthesis was low when circulating oestrogen concentration was high and vice versa. However, ingesting 30 g hydrolysed collagen prior to exercise reduced the negative effect of oestrogen on collagen synthesis. As high circulating oestrogen has been associated with greater injury risk in females, supplementing exercise with hydrolysed collagen may help protect these tissues from injury. What is the central question of this study?Does resistance exercise‐induced collagen synthesis vary according to circulating oestrogen concentration in a naturally menstruating female athlete, and if so, does hydrolysed collagen ingestion have any impact?What is the main finding and its importance?Exercise‐induced collagen synthesis was low when circulating oestrogen concentration was high and vice versa. However, ingesting 30 g hydrolysed collagen prior to exercise reduced the negative effect of oestrogen on collagen synthesis. As high circulating oestrogen has been associated with greater injury risk in females, supplementing exercise with hydrolysed collagen may help protect these tissues from injury. [ABSTRACT FROM AUTHOR]

Previous studies have investigated the association between reproductive factors and lung cancer risk; however, findings have been inconsistent. In order to assess this association among Asian women, a total of 308,949 female participants from 11 prospective cohorts and four Asian countries (Japan, Korea, China, and Singapore) were included. Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs). A total of 3,119 primary lung cancer cases and 2247 lung cancer deaths were identified with a mean follow‐up of 16.4 years. Parous women had a lower risk of lung cancer incidence and mortality as compared with nulliparous women, with HRs of 0.82 (95% CI = 0.70–0.96) and 0.78 (95% CI = 0.65–0.94). The protective association of parity and lung cancer incidence was greater among ever‐smokers (HR = 0.66, 95% CI = 0.49–0.87) than in never‐smokers (HR = 0.90, 95% CI = 0.74–1.09) (P‐interaction = 0.029). Compared with age at first delivery ≤20 years, older age at first delivery (21–25, ≥26 years) was associated with a lower risk of lung cancer incidence and mortality. Women who ever used hormone replacements had a higher likelihood of developing non‐small cell lung cancer (HR = 1.31, 95% CI = 1.02–1.68), compared to those who never used hormone replacements. Future studies are needed to assess the underlying mechanisms, the relationships within these female reproductive factors, and the potential changes in smoking habits over time. [ABSTRACT FROM AUTHOR]

Background: Sexual violence remains a persistent and devastating issue in eastern Democratic Republic of Congo (DRC). Aim: To elucidate the sociodemographic, sexual, and obstetrical characteristics associated with the experiences of victims of sexual violence (VSV) among women in the region. Materials and Methods: A cross‐sectional study was conducted involving 625 women from eastern DRC. Participants provided self‐reported data, collected through interviews conducted by trained female interviewers in secure environments. Associations between VSV and various sociodemographic and reproductive health factors were examined. Results: Of the respondents, 26.1% reported experiences of sexual violence. VSV were predominantly younger, with 56.44% aged between 15 and 24 years. Single women comprised 57.67% of VSV, and 37.42% identified as farmers. There were 33.13% of VSV who were illiterate, and 81.60% belonged to the low socio‐economic stratum. Early physiological and reproductive milestones characterised VSV: 52.15% experienced menarche at or before 13 years, 34.97% initiated sexual intercourse before age 15, and 18.70% reported their first pregnancy before age 15. Higher nulliparity was observed in VSV (29.45%) compared to non‐VSV (9.31%). A lower prevalence of HIV infection was found among VSV (11.04%) relative to non‐VSV (25.76%). Conclusion: Sexual violence in the eastern DRC exhibits multifactorial associations. Younger women, those in certain occupations, and those with specific reproductive histories appear more vulnerable. The findings underscore the urgency for targeted interventions, enhanced access to education, and improved reproductive health services. Addressing these pressing issues should remain a primary focus in both societal and public health spheres. [ABSTRACT FROM AUTHOR]

Background: Adolescents with psychiatric disorders have high rates of unintended pregnancy and experience barriers to accessing sexual and reproductive health (SRH) care. Outpatient psychiatry visits are potential opportunities to connect adolescents to SRH care. This study informs the development of the Link2BC intervention which links adolescents in outpatient psychiatry care to SRH care. Methods: We conducted group interviews with adolescents (3 groups, 7 total participants) and caregivers (3 groups, 9 total participants) and individual interviews with 8 psychiatry providers who received or provided outpatient psychiatric treatment in clinics in a pediatric hospital in a city in the Midwestern United States. We asked questions about the acceptability of Link2BC, potential implementation needs, and implementation determinants. Using consensus‐building techniques, two coders analyzed transcriptions using a codebook informed by the Consolidated Framework for Implementation Research 2.0. Results: Participants agreed on the need for interventions that expand access to SRH care. Adolescents emphasized that services should be confidential and accessible and were open to their psychiatrists introducing SRH topics during appointments. Providers expressed preference for training and clear workflows. Participants agreed that psychiatry providers could serve as liaisons between adolescents and their caregivers to facilitate conversations about contraception. Participants had concerns about time constraints during visits but mentioned few other barriers to the intervention. Conclusion: This study demonstrates the acceptability of connecting adolescents in outpatient psychiatry care to contraceptive counseling and informs the refinement and implementation of Link2BC. Integrating contraception counseling in outpatient psychiatry settings is an innovative approach to prevent unintended pregnancy among adolescents by increasing access to SRH care services. [ABSTRACT FROM AUTHOR]

Background: Controversies remain on the diagnostic strategy in suspected AA, considering the different settings worldwide. Material and Methods: A prospective observational international multicentric study including patients operated for suspected AA with a definitive histopathological analysis was conducted. Three groups were analyzed: (1) No radiology; (2) Ultrasound, and (3) Computed tomography. The aim was to analyze the performance of three diagnostic schemes. Results: Three thousand and one hundred twenty three patients were enrolled; 899 in the no radiology group, 1490 in the US group, and 734 in the CT group. The sex ratio was in favor of males (p < 0.001). The mean age was lower in the no radiology group (24 years) compared to 28 and 38 years in US and CT‐scan groups, respectively (p < 0.001). Overall, the negative appendectomy rate 3.8%: no radiology group (5.1%) versus US (2.9%) and CT‐scan (4.1%) (p < 0.001). The sensitivity and specificity analysis showed the best balance in clinical evaluation + score + US. These data reach the best results in those patients with an equivocal Alvarado score (4–6). Inverse probability weighting (IPW), showed as the use of ultrasound, is significantly associated with an increased probability of formulating the correct diagnosis (p 0.004). In the case of a CT scan, this association appears weaker (p 0.08). Conclusion: The association of clinical scores and ultrasound seems the best strategy to reach a correct preoperative diagnosis in patients with clinical suspicion of AA, even in those population subgroups where the clinical score may have an equivocal result. This strategy can be especially useful in low‐resource settings worldwide. CT‐scan association may improve the detection of patients who may potentially be submitted to conservative treatment. [ABSTRACT FROM AUTHOR]

Patients with chronic liver disease (CLD) experience health‐related quality of life (HRQoL) and patient‐reported outcomes (PROs) impairments. We assessed and identified predictors of HRQoL and PROs in CLD patients from Saudi Arabia (SA), Turkey and Egypt. Patients enrolled in Global Liver Registry™ with chronic hepatitis B (CHB), chronic hepatitis C (CHC) and non‐alcoholic fatty liver disease (NAFLD) or non‐alcoholic steatohepatitis (NASH) were included. Clinical data and PRO questionnaires (FACIT‐F, CLDQ and WPAI) were compared across countries. Linear regression identified PRO predictors. Of the 4014 included patients, 26.9% had CHB, 26.9% CHC and 46.1% NAFLD/NASH; 19.2% advanced fibrosis. Compared across countries, CHB patients were younger in Egypt (mean age [years] 41.2 ± 11.4 vs. 45.0 ± 10.3 SA, 46.1 ± 12.0 Turkey), most often employed in SA (64.8% vs. 53.2% Turkey) and had the lowest prevalence of obesity in Turkey (26.7% vs. 37.8% SA, 38.5% Egypt). In SA, CHB patients had lowest prevalence of fibrosis and comorbidities (all p <.01). There was a higher frequency of males with NAFLD/NASH in SA (70.0% vs. 49.6% Turkey, and 35.5% Egypt). Among NAFLD/NASH patients, CLDQ‐NAFLD/NASH scores were highest in SA (mean total score: 5.3 ± 1.2 vs. 4.8 ± 1.2 Turkey, 4.1 ± 0.9 Egypt, p <.01). Independent predictors of worse PROs included younger age, female sex, advanced fibrosis, non‐hepatic comorbidities and lack of regular exercise (all p <.05). Clinical presentation and PRO scores of CLD patients vary across SA, Turkey and Egypt. Impairment of HRQoL is associated with demographic factors, lack of regular exercise, advanced fibrosis and non‐hepatic comorbidities. [ABSTRACT FROM AUTHOR]

Background: Little is known about factors that influence footwear selection by field hockey players. Methods: An online survey was used to collect data on participant demographics and physical characteristics, factors influencing footwear selection, perceptions regarding footwear design features on injury and performance, and experiences regarding usability. Nominal and ordinal data were described as absolute frequencies and relative frequencies. Free text responses were analysed using content analysis. Sex‐related differences in quantitative and qualitative data were explored. Results: A total of 401 hockey players completed the survey. Participants reported that fit, comfort, support, and cushioning were the most important factors when selecting hockey footwear. Most hockey players believed that stud design could influence athletic performance (65%) and injury risk (63%) but reported having no preference on outsole design or stud shape. Most participants (63%) used hockey‐specific footwear, but 46% of female hockey players did not, with 40% using trail running footwear instead. Qualitative analysis revealed that hockey players, particularly female participants, encounter difficulties finding properly fitting footwear. They desire more options for wide or narrow feet and face challenges in accessing suitable hockey shoes due to limited choices and availability. Conclusions: With over a third of field hockey players not using hockey‐specific footwear, future research should attempt to understand the reasons and assess the impact of different footwear features on comfort, performance, injury risk, and usability. [ABSTRACT FROM AUTHOR]

Considering the importance of promoting gender equality, Microfinance Institutions (MFIs) have emerged to reduce the gender gap by supplying credit opportunities to women. However, the microfinance literature has largely focused on the role of women in the client base while devoting less attention to their representation in the organizational structure of MFIs. This study aims to fill this gap. Using ANOVA and random effects models, our purpose is to investigate which types of MFIs more intensively promote gender equality within their workforce, at any of the organizational ladders. We analyze data from 1222 MFIs across 102 developing countries from 2010 to 2018. Empirical evidence reveals that the presence of females in both the workforce and the client base is significantly lower in commercially motivated MFIs (e.g., banks and other for‐profit institutions) compared to non‐government organizations (NGOs), and —to a lesser extent— credit unions, cooperatives and rural banks. Our results suggest that the microfinance sector would benefit from a stronger emphasis on NGO‐driven initiatives to promote female representation in terms of both employment opportunities and access to credit. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion To examine gender differences in Australian football (AF)‐related concussion presentations to EDs in regional Australia.A prospective observational study of patients presenting to 1 of the 10 EDs in Western Victoria, Australia, with an AF‐related concussion was conducted. Patients were part of a larger study investigating AF injuries over a complete AF season, including pre‐season training and practice matches. Information regarding concussion injuries was extracted from patient medical records, including clinical features, concurrent injuries, mechanism and context of injury. Female and male data were compared with chi‐squared and Fisher's exact tests. P < 0.05 was considered significant.From the original cohort of 1635 patients with AF‐related injuries (242 female and 1393 male), 231 (14.1%) patients were diagnosed with concussion. Thirty‐eight (15.7%) females had concussions versus 193 (13.9%) males (P > 0.05). Females over the age of 16 were more likely to be concussed than males in the same age range (females n = 26, 68.4% vs males n = 94, 48.7%; P = 0.026). Neurosurgically significant head injury was rare (one case). Similar rates of concurrent injury were found between females 15 (39.5%) and males 64 (33.2%), with neck injury the single most common in 24 (10.3%) concussions. Sixty‐nine patients (29%) were admitted for observation or to await the results of scans. The majority of concussions occurred in match play (87.9%). Females were more likely injured in contested ball situations (63.2% vs 37.3%; P < 0.05).Concussion rates for community‐level AF presentations to regional EDs were similar between genders. Serious head injury was rare, although hospital admission for observation was common. Concurrent injuries were common, with associated neck injury most often identified. Match play accounted for the majority of head injuries. [ABSTRACT FROM AUTHOR]

We undertook a retrospective observational review of patients referred to a tertiary dermatology department with vulval complaints over 12 months. The most common provisional diagnoses made by the referrer and final dermatology diagnoses were lichen sclerosus (54% and 38%), dermatitis (12.7% and 16.5%) and psoriasis (5.1% and 6.3%). Referrers may benefit from further education about skin diseases of the vulva, topical steroids for vulval complaints and the importance of clinical photography. [ABSTRACT FROM AUTHOR]

Aim: It remains unclear whether the newly defined concept of metabolic dysfunction‐associated steatotic liver disease (MASLD) appropriately includes patients with nonalcoholic fatty liver disease with significant liver fibrosis. Methods: A total of 4112 patients in whom nonalcoholic fatty liver disease was diagnosed by ultrasonography during medical checkups were enrolled. We defined a fibrosis‐4 index ≥1.3 in patients aged <65 years and ≥2.0 in patients aged ≥65 years as significant liver fibrosis. Results: The numbers of patients with a low, intermediate, and high probability of advanced fibrosis based on the fibrosis‐4 index were 3360 (81.7%), 668 (16.2%), and 84 (2.0%). There were 3828 (93.1%) and 284 (6.9%) patients diagnosed with MASLD and non‐MASLD. The non‐MASLD group, compared with the MASLD group, was significantly younger (44 vs. 55 years) and had a higher percentage of women (62.3% vs. 27.7%). Significant fibrosis, defined based on the fibrosis‐4 index, was present in 18.5% of the MASLD group and 15.5% of the non‐MASLD group. In a multivariable analysis, female sex (OR 6.170, 95% CI 3.180–12.000; p < 0.001) was independently associated with non‐MASLD in patients with a significant fibrosis. Among non‐MASLD patients with a significant fibrosis (n = 44), body mass index was significantly lower in females than in males (p < 0.001). In a multivariable analysis of patients aged <65 years, female sex (OR, 7.700; 95% CI, 3.750–15.800; p < 0.001) remained independently associated with non‐MASLD in patients with a significant fibrosis. Conclusions: MASLD may inappropriately exclude patients with significant fibrosis, especially lean females with nonalcoholic fatty liver disease. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effectiveness of a media literacy‐based smoking prevention program based on Ajzen's theory of planned behavior in female adolescents. Methods: This quasi‐experimental study was conducted with female high school students aged 16–17 years in Seoul, Republic of Korea. The program provided eight sessions over 4 weeks. Quantitative data were collected before and after online surveys in an intervention (n = 21) and control (n = 21) groups, and analyzed using mixed analysis of variance. Qualitative data on participation experiences was collected by requesting the participants to answer open‐ended questions once a week during the intervention and performing co‐occurrence analysis of specific terms in the responses was conducted through text mining. Results: Although the program decreased smoking intention and increased smoking media literacy in the intervention group, there were no significant differences between the groups. Qualitative results obtained from the intervention group showed cognitive and behavioral changes in the perception of the harmfulness of e‐cigarettes in the media and the expression of a willingness to overcome the temptation to smoke. Conclusions: Our findings show that the enhancement of smoking media literacy, specifically by correcting misconceptions regarding e‐cigarettes promoted by the new media, contributes smoking prevention in female adolescents. It supports calls for an expanded role of public health professionals in health education at the school level. [ABSTRACT FROM AUTHOR]

Background: Using low titer group O whole blood (LTOWB) is increasingly popular for resuscitating trauma patients. LTOWB is often RhD‐positive, which might cause D‐alloimmunization and hemolytic disease of the fetus and newborn (HDFN) if transfused to RhD‐negative females of childbearing potential (FCP). This simulation determined the number of life years gained by the FCP and her future children if she was resuscitated with LTOWB compared with conventional component therapy (CCT). Methods: The model simulated 500,000 injured FCPs of each age between 0 and 49 years with LTOWB mortality relative reductions (MRRs) compared with components between 0.1% and 25%. For each surviving FCP, number of life years gained was calculated using her age at injury and average life expectancy for American women. The number of expected future pregnancies for FCPs that did not survive was also based on her age at injury; each future child was assigned the maximum lifespan unless they suffered perinatal mortality or serious neurological events from HDFN. Results: The LTOWB group with an MRR 25% compared with CCT had the largest total life years gained. The point of equivalence for RhD‐positive LTOWB compared to CCT, where life years lost due to severe HDFN was equivalent to life years gained due to FCP survival/future childbearing, occurred at an MRR of approximately 0.1%. Conclusion: In this model, RhD‐positive LTOWB resulted in substantial gains in maternal and child life years compared with CCT. A >0.1% relative mortality reduction from LTOWB offset the life years lost to HDFN mortality and severe neurological events. [ABSTRACT FROM AUTHOR]

Artificial light at night (ALAN) widely affects wildlife by blurring light‐dark differences, including transitions such as sunrise and sunset, thereby affecting regulation of diel rhythms. As a result, activity onsets in many wild diurnal songbirds advance under ALAN. From chronobiological studies, it is known that the direction and strength of the response to light depends on when during the night exposure takes place. However, these experiments are mostly done under continuous light conditions, when animals have free‐running rhythms. It remains unclear whether phase‐dependence also holds in entrained, wild songbirds; i.e., does the effect of ALAN on activity patterns differ between exposure in the morning compared to the evening? This information is essential to assess the effects of mitigation measures by limiting ALAN to selected times of the night. We exposed incubating great tits (Parus major) inside the nest‐box to 4 h of dim light, of which 1 h overlapped with dawn before sunrise or dusk after sunset. We found a small advancing effect of morning‐light on activity onset and of evening‐light on offset compared to dark controls but not vice versa. Breeding success and chick condition were unaffected by the light treatments. However, light‐treated females had lower weights 9–18 days after the end of the treatment compared to the controls, independent of whether ALAN occurred in the morning or the evening, indicating possible costs of ALAN. Despite the weak behavioral response, ALAN might have affected the females' circadian clock or physiology resulting in lower body condition. Research Highlights: Part‐night lighting alters natural shifts in incubation activity patterns. Thus, onset advanced by light in the early morning and offset by light in the early evening compared to dark controls, and led to lower body weights. [ABSTRACT FROM AUTHOR]

The article titled "A call for action to stop sexual violence against women in the Democratic Republic of Congo: A brief report" highlights the urgent need to address the issue of sexual violence against women in the country. The authors emphasize the importance of taking action to prevent and respond to these atrocities. The report calls for increased support and resources to protect women and hold perpetrators accountable. The article was published in the International Journal of Gynecology and Obstetrics in 2024. [Extracted from the article]

Aims Methods Results Conclusion We hypothesise that PTNS is a safe and effective treatment for OAB. Overactive bladder (OAB) is estimated to affect 11.8% of women worldwide, causing diminished quality of life. Lifestyle modifications, muscarinic receptor antagonist and beta‐adrenoreceptor agonist remain the mainstay of treatment but are limited by their efficacy and adverse effects. Access to third‐line therapies of intravesical botulinum toxin type A or sacral neuromodulation is limited by their invasive nature. Percutaneous tibial nerve stimulation (PTNS) has emerged as a non‐invasive treatment option for OAB.This study was a single‐arm trial of women requesting third‐line treatment for OAB. The primary treatment outcome was patient‐reported visual analogue score (VAS) improvement of at least 50%. Secondary outcome measures were Urinary Distress Inventory Short Form (UDI‐6) score and two‐day bladder diary. Patients also provided feedback on adverse effects encountered.In the 84 women recruited, initial treatment protocol showed a success rate of 77.2% among those who completed treatment based on VAS, with a statistically significant improvement in mean UDI‐6 score of 20.13 (P < 0.01, standard deviation: 12.52). Continued success following tapering protocol of 60.8% and a mean maintenance protocol of 14.2 months was achieved. No adverse effects were reported.The results from this study are in concordance with previously published literature on the effectiveness and safety of PTNS as a treatment modality for OAB. Further randomised controlled trials to evaluate the optimal treatment protocol are warranted to establish a standardised regime. [ABSTRACT FROM AUTHOR]

Background: Persistent pelvic pain (PPP) is a complex and often debilitating condition. While widely accepted to be multifactorial in nature, the precise aetiology of PPP remains elusive. In many cases, women who undergo laparoscopy for PPP will have no visible pathology identified (a 'negative' laparoscopy). Currently, there are no consensus guidelines which outline the recommended management following a negative laparoscopy, and the woman's experiences and outcomes are not widely known. Aims: This review aims to identify and summarise the literature surrounding the experiences of women with PPP who have a negative laparoscopy; specifically, their outcomes of pain, quality of life (QoL), satisfaction with care, and their overall management. Materials and Methods: A systematic search of the electronic databases Ovid Medline, PubMed and Embase was performed. Studies in English exploring the outcomes of women with PPP following a negative laparoscopy were included. Results: Four studies consisting of a total of 200 women were included. Results were inconsistent. Three studies concluded that the majority of women with PPP had persistent pain following a negative laparoscopy. A single study found that pain significantly improved after negative laparoscopy. QoL outcomes varied, with two studies reporting a positive impact and two studies reporting a deleterious impact on QoL following a negative laparoscopy. Conclusions: The impact on pain outcomes and QoL following a laparoscopy that does not diagnose pathology remains unknown, and the available evidence is insufficient to guide evidence‐based practice. This review highlights a significant gap in our understanding of surgical management for PPP. [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence, incidence, and burden of groin injuries in the Norwegian women's premier football league and to describe their clinical and imaging characteristics. Methods: During the 2020 and 2021 seasons, players in the Norwegian women's premier league reported groin injuries weekly, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC‐H2). We calculated weekly prevalence, incidence, and burden of groin injuries. The team physical therapists classified the player‐reported injuries based on the Doha classification system. Injuries with more than 3 days' time loss or reported in 2 consecutive weeks were eligible for magnetic resonance imaging (MRI). Results: On average, 3.9% (95% CI: 3.4–4.4) of players reported a groin injury at any time; of which 78% caused time loss. The incidence rate was 1.6 injuries/1000 h (95% CI: 1.3–2.0) and their burden was 11 days lost/1000 h. The physical therapists examined 67 of 124 player‐reported groin injuries (53%). Adductor‐related injury was most common (55%) followed by iliopsoas (15%) and rectus femoris‐related (12%). Pubic‐related injuries caused most time loss (median: 24 days, IQR: 5–133). In this study, 42 injuries were investigated with MRI; 8 (19%) showed no changes, 6 (14%) an acute musculotendinous lesion, and 32 (76%) a nonacute finding (e.g., central symphyseal disc protrusion, tendinopathies). Conclusion: The incidence rate and burden of groin injuries were high. Adductor‐related injuries were most common, but pubic‐related injuries caused most time loss. Most MRI examinations demonstrated nonacute findings. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical characteristics of male adolescents and young adults hospitalized for medical complications of atypical anorexia nervosa (atypical AN) and to compare their clinical characteristics with females with atypical AN and males with anorexia nervosa (AN). Method: A retrospective review of electronic medical records for patients with atypical AN and AN aged 9–25 admitted to the UCSF Eating Disorders Program from May 2012 to August 2020 was conducted. Results: Among 21 males with atypical AN (mean age 15.1 ± 2.7, mean %mBMI 102.0 ± 11.8), medical complications evidenced by admission laboratory values included anemia (52.9%), vitamin D insufficiency/deficiency (52.6%), and zinc deficiency (31.6%). Compared with females with atypical AN (n = 69), males with atypical AN had longer length of stay (11.4 vs 8.4 days, p =.004), higher prescribed kcal at discharge (4114 vs 3045 kcal, p <.001), lower heart rate nadir (40.0 vs 45.8, p =.038), higher aspartate transaminase (AST, 37.9 vs 26.2 U/L, p =.032), higher alanine transaminase (ALT, 30.6 vs 18.3 U/L, p =.005), and higher rates of anemia (52.9% vs 19.4%, p =.005), with no differences in vitamin D, zinc, and vital signs. Compared with males with AN (n = 40), males with atypical AN had no significant differences in vital signs or laboratory assessments during the hospitalization. Discussion: Atypical AN in males leads to significant medical comorbidity, and males with atypical AN require longer hospital stays compared to females with atypical AN. Rates of abnormal vital signs and abnormal serum laboratory values during hospital admissions do not differ in males with atypical AN compared to AN. Public Significance: Adolescent and young adult males with atypical anorexia nervosa experience significant medical complications. Males with atypical anorexia nervosa had longer hospitalizations and higher prescribed nutrition at discharge than females. Medical complications of atypical anorexia nervosa in male adolescents and young adults were generally equal to those of male adolescents and young adults with anorexia nervosa. Clinicians should be aware of unique medical complications of males with atypical anorexia nervosa. [ABSTRACT FROM AUTHOR]