Gynecologic Health Research Articles

Shining a Light on Women’s Health: The Relationship Between Gynecological Cancer Awareness and Health Literacy

Shining a Light on Women’s Health: The Relationship Between Gynecological Cancer Awareness and Health Literacy

The Know-how of Polymeric Nanocarrier Based Vaginal Drug Delivery System: Pitfalls, Challenges and Trends.

Gynecological health is a global concern, and thus, the formulator researcher strives to improve the quality of life through innovative feminine pharmaceutical formulations. Vaginal delivery appears to be one of the vital strategies for local and systemic action of the therapeutically active agent. The rich vascular network, mucosal permeability, bypass of hepatic first-pass effect, and low enzymatic activity are the exclusive advantages of the vaginal route. But certain hindrances truncate the vaginal route, such as physiological factors including lower pH, self-cleansing mucus with constant secretion, and varying thickness of mucus layer due to menstrual cycle and microbiota. Significance of Review: This present review envisages the advances in the polymeric nanocarriers in the delivery to the vaginal route. Polymeric (mucoadhesive and PEGylated, etc.) nanocarriers have been recently utilized for drug delivery purposes. The modernized analysis of the updated advancements in the polymeric nanocarrier-based vaginal drug delivery system with the budding development is compiled in the present review. The literature search reveals that the novel polymeric nanocarrier design strategies currently being proposed to perk up the delivery of customary drugs through the vaginal route prove effective. Polymeric nanocarrier for vaginal delivery has provided better therapeutic efficacy due to higher drug residence, improved permeation, and sustained release of the active therapeutic agent. The polymeric nanocarriers can deliver different proteins, peptides, nuclear materials, hormones, etc., vaginally that are difficult for administration.

Acceptability of gynecologic e-health modalities by Hispanic/Latina women of reproductive age

IntroductionElectronic health (e-Health) modalities effectively address healthcare access limitations; however, there are limited data on their adoption by Hispanic/Latina women who are disproportionally affected by health disparities. MethodsWe conducted a cross-sectional study by disseminating an anonymous electronic questionnaire via social media to assess the perception of Hispanic/Latina women of reproductive age regarding facilitators and barriers for using e-Health modalities, including telemedicine and mobile apps, to monitor gynecologic health. ResultsThe questionnaire was completed by 351 Hispanic/Latina participants with high levels (98.3 %) of advanced technological expertise. Current use of a gynecologic mobile app was reported by 63.8 %, primarily for menstruation (85.1 %) and ovulation (46.3 %) tracking. While only 17.6 % of participants were offered the option of a gynecologic consultation via telemedicine, the majority (90.5 %) would agree to one. Higher education and advanced technological expertise correlated with acceptance of telemedicine for gynecological consults. Being younger (<29 y/o), a student, not having a preferred gynecologist and having a lower income significantly correlated with gynecologic mobile app acceptability. ConclusionsWe showed that e-Health modalities are highly acceptable for Hispanic/Latina women of reproductive age to facilitate gynecological care and documented factors that are significantly associated with e-Health acceptability. These findings are relevant to public health emergencies that cause access to care limitations disproportionally affecting this already underserved population. LAY SUMMARYElectronic health (e-Health) modalities, including telemedicine and mobile applications (apps) can effectively improve access to healthcare; however, there is limited data on their adoption by Hispanic/Latina women who are affected by health disparities. This study showed that e-Health modalities are acceptable for Hispanic/Latina women of reproductive age during public health emergencies highlighting opportunities to help facilitate access to gynecological care for this population.

Equitable Care for Patients With Disabilities: Considerations for the Gynecologic Health Care Professional.

All patients deserve high-quality health care. Patients with disabilities have historically experienced discrimination in health care and subsequently detrimental health outcomes. Health care professionals often lack confidence and preparedness in treating patients with disabilities effectively. Barriers such as communication difficulties, biased assumptions, and inadequate equipment hinder comprehensive care. These barriers to care lead to health inequalities and a diminished overall quality of life for individuals with disabilities. Existing clinical guidelines for care of this underserved population are lacking. This article establishes a comprehensive educational framework and accessible reference tools for gynecologic health care professionals to enhance their ability to offer inclusive and effective care to patients with disabilities. Insights in this article stem from expert consensus among clinicians experienced in this field and ongoing dialog with community-based disability care partners. We present actionable steps to cultivate an open, adaptable, and patient-centric method to actively engage patients and to provide suitable accommodations when needed.

Determination of microbiota awareness levels in women planning pregnancy.

It was recently discovered that the microbiota has a significant impact on pregnancy, gynecological, and neonatal health. However, studies indicate that people struggle to understand topics, such as microbiota, microbiome, probiotics, and prebiotics, or comprehend them inaccurately or incompletely. Understanding the human microbiota and probiotics that can regulate the microbiota helps women develop daily habits for both healthy nutrition and health protection. The aim of this study was to assess the microbiota awareness levels of women who are planning pregnancy. A cross-sectional descriptive study was carried out on 417 women who were planning pregnancy. Face-to-face interviews and questionnaires were used to collect research data. A microbiota awareness scale was used as a data collection tool. The study found a statistically significant difference in the subdimension scores related to microbiota awareness, general information, product knowledge, chronic disease, and probiotic and prebiotic knowledge based on the educational status of the participants. The study concluded that the participants had a confusion about microbiota awareness, general information, product information, chronic disease, and probiotic and prebiotic subdimensions. Furthermore, it was found that the participants had only a partial understanding of the relationship between microbiota and diseases. It is recommended that training programs focusing on the relationship between microbiota and health in women, such as "microbiota and its importance in women's health" and "microbiota and disease relationship," be organized and women would be encouraged to participate in these training programs.

Role of Serum Lactate Clearance as a Predictor of Mortality and Morbidity in Neonatal Sepsis: A Prospective Cohort Study

Introduction: Neonatal sepsis is a global healthcare concern, which is more prevalent in developing countries. However, surprisingly, biomarkers with good sensitivity and specificity to predict mortality and morbidity are lacking. Higher levels of serum lactate are observed in patients exposed to an inflammatory response, but its practical use remains limited. Therefore, the author aimed to investigate the relationship between serum lactate measurements and the severity of neonatal sepsis. Aim: To assess the role of serum lactate clearance as a marker to predict mortality and morbidity in neonatal sepsis. Additionally, the secondary aim was to evaluate the demographic profile of neonatal sepsis and understand the relationship between C-reactive Protein (CRP), Procalcitonin, and lactate clearance in neonatal sepsis. Materials and Methods: A prospective cohort study was conducted in the Sick Newborn Care Unit (SNCU) and Neonatal Intensive Care Unit (NICU) of Chittaranjan Seva Sadan, College of Obstetrics, Gynaecology, and Child Health in Kolkata, India, from June 2020 to May 2021. A total of 93 confirmed cases of neonatal sepsis were included in the study. Serum lactate levels were measured at the time of sepsis diagnosis and 48 hours after the first sample. Lactate clearance was calculated, and the neonates were followed till discharge or death. Various parameters, including complete blood count, CRP, Procalcitonin, culture, and Cerebrospinal Fluid (CSF), were assessed. The data obtained were statistically analysed using paired t-test, one-way Analysis of Variance (ANOVA), and Pearson’s Chi-square test. Results: A total of 93 neonates were included after meeting the inclusion and exclusion criteria. Among them, 10 neonates died, while 83 were successfully discharged. It was found that death was significantly associated (p&lt;0.0001) with lactate clearance. Total 9 (90%) of the deceased neonates had negative lactate clearance, while only 21 (25.3%) discharged neonates had negative lactate clearance. Lactate clearance was also significantly associated with the duration of hypoglycaemia (p=0.008), duration of Nil Per Mouth (NPM) (p=0.01), and need for reintubation (p=0.05). However, no association was found with the duration of hospital stay, duration of fluid therapy, duration of oxygen requirement, and need for ventilation. Conclusion: Lactate clearance showed a significant association with the risk of mortality in patients with neonatal sepsis. Therefore, lactate clearance can be used as a prognostic marker to identify sepsis. Early detection of sepsis can aid in proper management and subsequently reduce mortality

Reliability across content areas in progress tests assessing medical knowledge: a Brazilian cross-sectional study with implications for medical education assessments.

Brazilian medical schools equitably divide their medical education assessments into five content areas: internal medicine, surgery, pediatrics, obstetrics and gynecology, and public health. However, this division does not follow international patterns and may threaten the examinations' reliability and validity. To assess the reliability indices of the content areas of serial, cross-institutional progress test examinations. This was an analytical, observational, and cross-sectional study conducted at nine public medical schools (mainly from the state of São Paulo) with progress test examinations conducted between 2017 and 2023. The examinations covered the areas of basic sciences, internal medicine, surgery, pediatrics, obstetrics and gynecology, and public health. We calculated reliability indices using Cronbach's α, which indicates the internal consistency of a test. We used simple linear regressions to analyze temporal trends. The results showed that the Cronbach's α for basic sciences and internal medicine presented lower values, whereas gynecology, obstetrics, and public health presented higher values. After changes in the number of items and the exclusion of basic sciences as a separate content area, internal medicine ranked highest in 2023. Individually, all content areas except pediatrics remained stable over time. Maintaining an equitable division in assessment content may lead to suboptimal results in terms of assessment reliability, especially for internal medicine. Therefore, content sampling of medical knowledge for general assessments should be reappraised.

Algorithm of management actions for the formation and implementation of a resilient health care quality system.

Aim: Development of an algorithm of management actions for the formation of a resilient system of quality of medical care in health care institutions of obstetric and gynecological profile and formalization of its closed structural and logical scheme. Materials and Methods: A set of theoretical approaches of social medicine and methods of business process reengineering is used, taking into account the dominant ones: systemic and integrated approach and alarm and process approaches; the concept of resilience; quality of medical care; reproductive health care using business ecosystem methods. Results: The algorithm of management actions for the formation of a resilient system of quality of medical care in obstetric and gynecological health care institutions, which is formalized in nine stages: analysis of needs and identification of problems; substantiation of performance requirements; development of a health care quality strategy; involvement of stakeholders; formation of a system of relative indicators; development of an action plan; implementation of a set of measures; monitoring and evaluation; improving the quality of health care. Conclusions: The results made it possible: construction of a closed structural and logical scheme of management actions, taking into account the combination of factors of influence, harmonized with the main functions of the resilient system, which determine the peculiarities of its functioning; justification of the boundaries of managerial and social responsibility of management entities according to the binary components of the medical and social justification of the process of improving the quality of medical care.

LncRNA STARD7-AS1 suppresses cervical cancer cell proliferation while promoting autophagy by regulating miR-31-5p/TXNIP axis to inactivate the mTOR signaling.

Cervical cancer (CC) is a serious gynecologic health issue for women worldwide. Long non-coding RNA (lncRNA) has been well-documented in controlling malignant behavior of various cancer cells. The role of lncRNA STARD7-AS1 in regulating CC cell proliferation and autophagy and its possible mechanism were investigated in this work. RNA expression and protein levels were quantified by reverse transcription quantitative polymerase chain reaction and western blotting. The location of STARD7-AS1 in CC cells was examined using subcellular fraction assays. Cell Counting Kit-8 assays and colony forming assays were performed to measure CC cell viability and proliferation. Autophagy in CC cells was evaluated using macrophage-derived chemokine (MDC) staining and transmission electron microscopy. The binding between microRNA (miR)-31-5p and STARD7-AS1 (or thioredoxin-interacting protein [TXNIP]) was determined by performing luciferase reporter, RNA pull-down or RNA immunoprecipitation assays. STARD7-AS1 overexpression significantly suppressed CC cell viability and proliferation while notably inducing autophagy. STARD7-AS1 upregulated TXNIP expression via interaction with miR-31-5p. In addition, the effects of STARD7-AS1 on CC cell proliferation and autophagy were reversed by TXNIP silencing. The suppressive effect of STARD7-AS1 overexpression on phosphorylated levels of mTOR and S6K1 was countervailed by TXNIP deficiency. In conclusion, lncRNA STARD7-AS1 inhibits CC cell proliferation and promotes cell autophagy by targeting the miR-31-5p/TXNIP axis to inactivate the mTOR signaling.

Projeto de extensão Mulher Saudável: ações educativas no ambiente ocupacional e sua interface com a saúde ginecológica

The study focuses on the importance of cervical and breast cancer as public health issues for working women, highlighting the Woman Healthy Extension Project in a pediatric hospital in Curitiba-PR. The project conducts screenings and educational activities to prevent these cancers, raising the central question: "Do educational activities in the workplace impact gynecological health?" Using an integrative literature review, the study analyzed seven articles from November 2022 to March 2023. It emphasizes that extension projects contribute to academic development, promoting a critical perspective. The lack of preventive practices in gynecological health is related to various factors, underscoring the importance of discussing exams such as Pap smears and mammography. The study concludes that integrating extension projects into the curriculum promotes health education, benefiting female workers through the prevention and early diagnosis of gynecological cancers.

Women After Solid Organ Transplantation: An Overview of Gynecological Health

The increase in survival after transplantation and the growth of the female organ recipient population underscore the importance of carefully considering the reproductive and gynecological health of these women. One of the main concerns is the increased risk of cancer after transplantation, partly attributed to the use of immunosuppressive therapy. Gynecological cancers with a high association with viral infections, such as cervical cancer, should receive specific care and screening, especially among younger women. Additionally, the preventable nature of cervical cancer makes vaccination mandatory before undergoing transplantation. Breast cancer, another gynecological cancer of special interest due to its high prevalence, should be screened in the transplant population following guidelines for the general population. Fertility and family planning are also important considerations, as most women experience the return of ovulation and menstruation after transplantation. Contraception strategies, such as reversible long-acting methods, are recommended due to their effectiveness and low failure rate. The use of hormonal contraceptives and immunosuppressants should also be evaluated, emphasizing the need to carefully monitor potential drug interactions. An integrated approach to the gynecological health of women after solid organ transplantation enables better outcomes for both graft health and the gynecological health of the woman, resulting in improved outcomes for the patient. Ongoing follow-up, careful surveillance, cancer prevention, and effective management of fertility and contraception are crucial to ensure their quality of life and well-being.

Abstract C091: Newly identified Fannyhessea species contributions in HPV infection, cervical dysplasia, and cancer in two Arizonan cohorts

Abstract The vaginal microbiome can impact gynecologic health and disease. It is still unclear the extent to which the microbiome plays in the progression and development of gynecologic cancers. Fannyhessea vaginae is a key vaginal bacterium linked to bacterial vaginosis, HPV acquisition, and cervical cancer. F. vaginae was recently proposed for reclassification as three species: F.vaginae, Fannyhessea massiliense, and Fannyhessea species type 2. We hypothesize that these Fannyhessea species vary in terms of their host-microbe interactions which contribute to cancer progression/severity. We investigated the prevalence of Fannyhessea species in two of our Arizona-based HPV and cervical cancer cohorts recruited in Phoenix or Flagstaff area. The Phoenix (Phx) cohort included: women diagnosed with invasive cervical cancer (ICC=9), high-grade squamous intraepithelial lesion (HSIL=27), and low-grade squamous intraepithelial lesion (LSIL=11), as well as controls who were either HPV-positive=20 or HPV-negative without dysplasia=31. While the Flagstaff cohort (Flg) consisted of 31 women that were HPV-positive=7 or HPV-negative=24. The 16S rDNA sequencing information was analyzed with DADA2 and QIIME2 to identify the microbial composition of the cervicovaginal profiles of these patients. Statistical analyses are ongoing, utilizing survey data on these species to decipher their clinical associations with factors such as HPV status and genotype. The cohorts had a prevalence of 59.2% of Atopobiaceae bacteria in Phx and 38.7% prevalence in Flg cohort. We observed F. vaginae (50% and 38.7%, respectively), Fannyhessea species type 2 (16.4% and 25.0%, respectively), F. massiliense (21.0% and 18.8%, respectively) in these cohorts. Interestingly, in both dysplasia groups of the Phx cohort these species had an increased abundance, but it did not reach significance. Other clinical and demographic factors in both cohorts, vaginal pH (p = 0.0005 and 0.47, respectively), Native American race (p=0.002) and Hispanic ethnicity (p= 0.013 and 0.63, respectively), indicated significant species-specific differences in the prevalence of Atopobiaceae. Additionally, genital inflammation scores were higher in profiles that contained Atopobiaceae species (p= 0.05) in Phoenix cohort. In addition, microbial co-occurrence analysis identified that Fannyhessea species highly co-occurred with one another. Sneathia amnii, Sneathia sanguinegens, and other BV-associated bacteria also co-occurred with Fannyhessea species, indicating an association between multiple Fannyhessea species and a potential link to cancer that requires further investigation. This research highlights potential associations of BV-associated bacteria and their role in HPV infection and cervical cancer and investigates the relationship of underexplored Fannyhessea species in historically understudied populations that have the highest disease burden. The overall data from our study provide foundational knowledge on putative oncogenic bacteria that could be exploited to modulate the microbiome and improve cancer outcomes. Citation Format: Nicole R. Jimenez, Paweł Łaniewski, Naomi R. Lee, J. Gregory Caporaso, Melissa M. Herbst-Kralovetz. Newly identified Fannyhessea species contributions in HPV infection, cervical dysplasia, and cancer in two Arizonan cohorts [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C091.

The Role of Government in Reducing Stunting in Indonesia, Case Study: Optimization of BKKBN in Sukoharjo District

Indonesia is included in the list of countries with poor nutritional status, according to the World Health Organization (WHO). In 2019, the stunting rate in Indonesia was 27.6%. As a multidimensional problem, stunting requires cross-sectoral solutions. At the regional level, Indonesia has a Population and Family Planning Agency (BKKBN), which is specifically tasked with solving this problem. One area with a history of success in overcoming stunting in Indonesia is Sukoharjo Regency. This research examines the role of the government in Sukoharjo Regency, through the BKKBN, in making various efforts to reduce stunting rates. The research method is qualitative research with an empirical approach. Research data was collected through in-depth interviews, observation, and documentation, then analyzed using interactive analysis techniques. The research results found that the main steps taken were: deploying family cadres to socialize about gynecological health with prospective brides and grooms. The government utilizes technical and strategic regulations and carries out budgetary interventions to maximize the reduction in stunting rates.

Perceptions of Gynecologic Health and Health Care in Females Living with CKD: A Survey Protocol

Perceptions of Gynecologic Health and Health Care in Females Living with CKD: A Survey Protocol

Gynaecological cancer resources for Aboriginal and Torres Strait Islander women: A resource audit.

Aboriginal and Torres Strait Islander women experience considerable disparities in gynaecological cancer outcomes. Accessible and culturally appropriate health promotion resources about gynaecological cancers may support health literacy in this area. This study aimed to determine the understandability, actionability, readability, and cultural relevance of gynaecological cancer health literacy resources for Aboriginal and Torres Strait Islander consumers, families, and caregivers. We conducted a general Google search and targeted searches of Australian gynaecological cancer organisation websites in January and February 2022. Resources were assessed for understandability, actionability and cultural relevance to Aboriginal and Torres Strait Islander audiences. We found 16 resources. The resources were generally understandable, actionable, readable, and culturally relevant, however, most resources were focused on cervical cancer prevention through vaccination and screening. Few resources focused other gynaecological cancer types or aspects of the cancer care continuum. While many resources contained elements that made them culturally relevant, areas for improvement were identified. These included: greater transparency relating to the Aboriginal and Torres Strait Islander leadership, governance, and involvement in the development of the resources as well as availability of different resource formats with an emphasis on visual aids. This study highlighted a need for the development of resources relating to a wider range of gynaecological cancer types and different stages of the cancer care continuum for Aboriginal and Torres Strait Islander women. SO WHAT?: The development of a broader range of culturally appropriate gynaecological cancer health literacy resources, ideally developed through co-design with Aboriginal and Torres Strait Islander peoples, may contribute to addressing the disparities in gynaecological cancer outcomes for Aboriginal and Torres Strait Islander women.

Longitudinal analysis of vaginal microbiota during IVF fresh embryo transfer and in early pregnancy.

Non-Lactobacillus-dominated vaginal microbiota has been associated with poor gynecologic health and complications during pregnancy. Lactobacilli and especially Lactobacillus crispatus associate with good reproductive health and dominate the microbiota during healthy pregnancy. We examined whether the composition of vaginal microbiota at the time of fresh embryo transfer (ET) has an impact on the success of in vitro fertilization (IVF) and whether vaginal microbiota changes from IVF-ET to early pregnancy within individuals. Vaginal swab samples were collected from subfertile women at the time of IVF-ET (n = 76) and at the eighth gestational week (n = 21) from those who achieved clinical pregnancy. The microbiota composition was analyzed using 16S rRNA gene amplicon sequencing. L. crispatus was more abundant among the 30 women who achieved clinical pregnancy (46.9% vs. 19.1%, q = 0.039) and the 26 women who had live birth (43.3% vs. 23.1%, q = 0.32) compared to those who did not. Lactobacilli, mainly L. crispatus (76.2%), dominated all early pregnancy samples. Microbiota remained the same, i.e., Lactobacillus-dominated type in 52% (11/21), shifted from one Lactobacillus-dominated type to another in 24% (5/21), or shifted from mixed community to Lactobacillus-dominated type in 24% (5/21) women, but never from Lactobacillus dominance to non-lactobacilli dominance. Our results emphasize the role of L. crispatus in the success of IVF-ET and in early pregnancy. During pregnancy, the microbiota shifted toward L. crispatus dominance even if it was undetectable before pregnancy, indicating that most women hold a reservoir of this beneficial Lactobacillus in their reproductive tract.IMPORTANCEInfertility is a global public health issue which leads many couples to seek fertility treatments, of which in vitro fertilization (IVF) is considered to be the most effective. Still, only about one-third of the women achieve live birth after the first IVF embryo transfer (IVF-ET). Factors affecting embryo implantation are poorly known, but the female reproductive tract microbiota may play a key role. Our study confirms the beneficial role of vaginal lactobacilli, especially Lactobacillus crispatus, in the probability of achieving clinical pregnancy and live birth following IVF-ET. Our findings regarding the intra-individual shift of vaginal microbiota between non-pregnancy and pregnancy states are novel and provide new information about the dynamics of microbiota in the early steps of human reproduction. These findings may help clinicians in their attempts to optimize the conditions for ET by microbiota screening or modulation and timing the ET when the microbiota is the most favorable.

Parity, mode of birth, and long-term gynecological health: A follow-up study of parous and nonparous women in the Australian Longitudinal Study on Women's Health cohort.

Although gynecological health issues are common and cause considerable distress, little is known about their causes. We examined how birth history is associated with urinary incontinence (UI), severe period pain, heavy periods, and endometriosis. We studied 7700 women in the Australian Longitudinal Study on Women's Health with an average follow-up of 10.9 years after their last birth. Surveys every third year provided information about birth history and gynecological health. Logistic regression was used to estimate how parity, mode of birth, and vaginal tears were associated with gynecological health issues. Presented results are adjusted odds ratios (OR) with 95% confidence intervals. UI was reported by 16%, heavy periods by 31%, severe period pain by 28%, and endometriosis by 4%. Compared with women with two children, nonparous women had less UI (OR 0.35 [0.26-0.47]) but tended to have more endometriosis (OR 1.70 [0.97-2.96]). Also, women with only one child had less UI (OR 0.77 [0.61-0.98]), but more severe period pain (OR 1.24 [1.01-1.51]). Women with 4+ children had more heavy periods (OR 1.42 [1.07-1.88]). Compared with women with vaginal birth(s) only, women with only cesarean sections or vaginal birth after cesarean section had less UI (ORs 0.44 [0.34-0.58] and 0.55 [0.40-0.76]), but more endometriosis (ORs 1.91 [1.16-3.16] and 2.31 [1.25-4.28]) and heavy periods (ORs 1.21 [1.00-1.46] and 1.35 [1.06-1.72]). Vaginal tear(s) did not increase UI after accounting for parity and birth mode. While women with vaginal childbirth(s) reported more urinary incontinence, they had less menstrual complaints and endometriosis.

OR16-01 A Common WNT4 Polymorphism Drives Gynecologic Cancer Phenotypes And Health Disparities

Abstract Disclosure: B.G. Bitler: None. M.T. Shackleford: None. L.S. Treviño: None. L.S. Cook: None. M.J. Sikora: None. Gynecologic cancers such as ovarian cancer (OvCa) are among the deadliest affecting women due to therapy resistance and limited understanding of disease etiology and risk. An underexplored risk factor is Wnt ligand WNT4, which is central to ovarian and uterine organogenesis. A single nucleotide polymorphism at a key WNT4 regulatory site (rs3820282) is associated with 10-25% increased risk for gynecologic pathologies including OvCa but the mechanism is unknown. Our prior work links WNT4 signaling to cancer cell growth, metabolism, and therapy resistance, suggesting the rs3820282 variant activates WNT4 to drive cancer phenotypes. Importantly, rs3820282 variant allele frequency (VAF) is ∼0% in African populations, ∼15% in Caucasians, 20-40% in Latinx populations, and 45-55% in Asian populations, paralleling increased incidence of aggressive OvCa subtypes in Asian populations. We hypothesize the rs3820282 variant drives OvCa health disparities by aberrant activation of WNT4, mediating distinct cancer etiology, therapy resistance, and poor patient outcomes. Supporting this hypothesis, we found WNT4-overexpression in an ID8 murine OvCa model drove cisplatin resistance in vitro, and resistance and metastatic outgrowth in vivo (n=5 mice/model; post-treatment metastatic nodule mass: empty vector = 5±8mg; WNT4 = 42±18mg; p=0.0078). In paired OvCa tumors pre-/post-treatment with neoadjuvant chemotherapy (n=18 pairs), we found WNT4 in the top 10 most-strongly induced genes post-chemotherapy (&amp;gt;4-fold, p =0.0005). In OvCa cell lines, WNT4 siRNA only suppressed growth in WNT4 variant lines (60% reduced growth in n=4 variants, vs n=4 wild-type p=0.010). WNT4 siRNA dysregulated mitochondrial function only in WNT4 variant lines, linking the rs3820282 variant to WNT4-driven metabolic remodeling. We next performed protein array analysis on 103 gynecologic tumors (52% heterozygote+variant); this is one of the largest proteomic studies on gynecologic tissues and the first enriched for patient diversity (47% from non-White patients). We identified differential metabolic signaling; AMPK activation was increased in variant tumors (AMPKα1-pT172 + AMPKα2-pS345; p=0.031) along with AMPK signaling targets. Conversely, glucose metabolism proteins were increased in wild-type tumors, and inversely correlated with AMPK activation (Spearman ρ=-0.34, p=0.0005), suggesting that WNT4 genotype underpins AMPK activation and metabolic remodeling. Taken together, the rs3820282 variant permits aberrant activation of WNT4, driving AMPK-mediated metabolic remodeling and therapy resistance. As the rs3820282 VAF differs widely across populations, WNT4 polymorphism may drive disparities in gynecologic cancer risk and outcomes. Understanding WNT4 signaling and regulation via the rs3820282 variant can lead to precision treatments exploiting cellular dependencies on WNT4 signaling. Presentation: Friday, June 16, 2023

Introduction to Vaginal Microbiota and its Relevance in Gynecological Health

This article provides an introductory exploration into the vaginal microbiota and its significance in maintaining gynecological health. The vaginal microbiota plays a crucial role in sustaining a balanced and harmonious vaginal ecosystem, influencing various aspects of reproductive well-being. By examining the composition and dynamics of the vaginal microbiota, this article highlights its impact on preventing dysbiosis and associated infections. A deeper understanding of the intricate interactions within the vaginal microbiota can pave the way for targeted therapeutic interventions aimed at promoting and preserving gynecological health.

Patient evaluation of gynaecological information provision and preferences.

To evaluate gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. A descriptive cross-sectional survey design was used. A total of 293 women accessing gynaecological services responded to the survey. Quantitative analysis included descriptive and inferential statistics. Content analysis was conducted on qualitative data. Health professionals were the most common and preferred sources of gynaecological health information. Enablers to information provision included positive communication strategies by health professionals, participants having prior knowledge and doing their own research. Despite its widespread availability, only 24.2% of women preferred the internet as an information source. Poor communication and inadequate information provision were identified as barriers to information access. Statistically significant associations were identified between location of residence, education level, year of birth, diagnostic group and health information preferences. Recommendations from women included improved communication strategies, system changes and provision of individualized information. Health professionals are central to women accessing information about gynaecological diagnoses. Areas for improvement include communication strategies, facilitating access to internet-based resources for information and consideration of women's preferences when providing health information. Consumer co-design of gynaecological health information and communication training for health professionals is recommended. Improved communication and facilitated use of internet-based resources may improve women's understanding of information. This study explored gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. It was found that gynaecological patients preferred individualized information provided to them directly by health professionals and despite its widespread availability, the internet is an underutilized health information resource. These findings are applicable to health professionals and patients utilizing tertiary gynaecological health services in Australia but may be generalized if demographic data aligns with other jurisdictions. The STROBE reporting method was used in the preparation of the manuscript. No patient or public contribution.