Indices In Women Research Articles

Association of HOMA-IR with Ovarian Sensitivity Index in Women Undergoing IVF/ICSI: A Retrospective Cohort Study.

Insulin resistance (IR) may adversely impact the in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) outcomes. However, the association of IR with ovarian sensitivity during controlled ovarian hyperstimulation (COH) remains controversial. We aimed to explore the association between homeostasis model assessment of insulin resistance (HOMA-IR) and ovarian sensitivity index (OSI). In this retrospective cohort study, 7836 patients aged between 20 and 39 years with good ovarian reserve were included consecutively between June 2018 and May 2022. HOMA-IR was calculated to evaluate the degree of IR and OSI was used to measure ovarian sensitivity. Owing to skewed distribution, HOMA-IR and OSI were log e transformed to Ln HOMA-IR and Ln OSI. Smoothing splines were generated by generalized additive models to explore the correlation between Ln HOMA-IR and Ln OSI. Then, the relationship between Ln HOMA-IR and Ln OSI was tested with multivariable linear regression model after adjustments for the potential confounders. We observed negative association between Ln HOMA-IR and Ln OSI after adjustment for potential confounders by using smoothing spline fitting curves in generalized additive model. In the multivariable linear regression model, after full adjustments, each one unit increase in Ln HOMA-IR was related to reduced Ln OSI values (β = -0.12, 95% CI, -0.15, -0.09). As sensitivity analysis, those who had HOMA-IR of quartile 3 (HOMA-IR 2.33-3.43) and quartile 4 (HOMA-IR ≥3.43) had decreases in Ln OSI values (β = -0.07, 95% CI -0.11, -0.03 and β = -0.18, 95% CI -0.22, -0.13, respectively) when compared with patients in the quartile 1 (HOMA-IR <1.63). Furthermore, stratified and interaction analysis showed a strong inverse association of Ln HOMA-IR with Ln OSI in subgroups of PCOS patients and overweight/obese populations (P-value for interaction <0.0001). HOMA-IR value was negatively associated with the ovarian sensitivity assessed by OSI. Among the PCOS and overweight/obese populations, this inverse relationship may be strong. These findings will increase the understanding of the contribution of IR to the development of decreased ovarian sensitivity within the assisted reproductive technology (ART) setting. It may have implications for optimizing gonadotropin dose manipulation in patients with IR undergoing IVF/ICSI.

Conservatism and divergence in the semiotics cholelithiasis

The aim of the study was to analyze the patterns associated with the risk of developing gallstone disease. Material and methods. The selection of signs of metabolic syndrome among patients of the hospital contingent with cholelithiasis, depending on gender and age, was carried out. There are 271 patients in the general population, of which 227 are women and 49 are men. Statistical processing of research results using the Statistica 8.0 applied software package. Results. Differences in etiology and pathogenesis lead to divergence of the phenotype of patients with cholelithiasis. At the same time, the conservatism of significant risk factors for the development of the disease remains. These include ethnic and sexual dimorphism: Caucasians are twice as likely to suffer from gallstone disease than the Khakass (7.3 and 3.4%, respectively). The incidence of gallstones in women is 8.6% (Caucasians - 10.9%; Khakaski - 6.2%). The indicators for women are 4.6 times higher than for men - 1.9% (Caucasians - 2.5%; Khakass - 1.3%). Older age: after 60 years, the number of patients increases exponentially, gender differences decrease. In the rating of comorbidities, the following are most often recorded: abdominal obesity (92.3% of patients), excess body weight (87.8%); violation of carbohydrate metabolism (86.4%), hypertension (81.7%), atherogenic dyslipidemia (50.6%) and NAFLD (23.6%). Conclusion. Together with conservative factors of susceptibility to gallstones that cannot be modified (age increase, female sex, heredity), a pathological phenotype known as metabolic syndrome is often formed. An increase in the frequency of gallstones is associated with variable combinations of metabolic syndrome components. Early detection of these signs can be used to predict and prevent the disease, since they are all modified to one degree or another. In addition, along with the conventional criteria for metabolic syndrome, the expression of gallstone disease has been established, which makes it possible to consider it a full-fledged sign.

Applying Unsupervised Machine Learning Models to Identify Serve Performance Related Indicators in Women’s Volleyball

ABSTRACT In volleyball, the effect of different factors on serve performance has usually been analyzed with traditional statistical techniques such as logistic regression or discriminant analysis. Purpose: In this study, two of the main models used in unsupervised machine learning (cluster and principal component analysis) were applied to achieve these objectives: (a) to create groups of players considering their serve coefficient, age, height, and team ranking, and (b) to identify which variables related to the serve (type and performance), the players (role, age, and height), and the teams (ranking, match location, and quality of opposition) most explained the total variance of the data during an entire women’s volleyball season. Method: A total of 20,936 serves were analyzed during the 132 matches played in the 2017–2018 season in the Liga Iberdrola (women Spanish first division). The variables were related to the serving action (type of serve and performance), the players’ traits (player role, age, and height), and the teams’ characteristics (final ranking, match location, quality of opposition, and tournament). Results: Cluster analysis showed five groups of players differing in age, serve coefficient, team ranking, and height. Principal component analysis showed how the first five components explained 72.12% of the total variance. From these components, serve coefficient, team ranking, match location, quality of opposition, and player role each contributed more than 10%. Conclusions: These findings can help coaches to improve talent selection and players’ development according to competition demands.

The Effect of Aerobic Fitness on Psychological, Attentional and Physiological Responses during a Tabata High-Intensity Interval Training Session in Healthy Young Women.

The current study examines the effects of a Tabata high-intensity interval training (HIIT) session on affective, cognitive and physiological indicators in women of different fitness levels. A total of 28 adult women (aged 24.2 ± 1.5 years) completed a 20 m shuttle run test and were then assigned to higher fitness and lower fitness groups (HF and LF, n = 14 each) according to their predicted aerobic power. On a separate occasion, participants completed a 30 min Tabata workout (six 4 min rounds separated by 1 min passive rest). Each round included eight exercises (20 s exercise and 10 s rest). Affective, physiological and cognitive responses were assessed prior to, during and after the protocol. Heart rate and blood lactate concentration increased similarly in both groups over time throughout the workout (p &lt; 0.001). Total Mood Disturbance was higher for LF (111.4 ± 15.7) vs. HF (102.9 ± 11.7) (p = 0.48), vigor showed a level by time interaction of p = 0.006 and Activation-Deactivation Adjective Check List factors deteriorated over time (p &lt; 0.001). The Concentration Grid Test was better overall for HF (10.5 ± 3.6) vs. LF (8.6 ± 3.6) (p = 0.05). The Feeling Scale and Rating of Perceived Exertion worsened similarly in both groups over time (p = 0.002 and p &lt; 0.001, respectively). Positive and negative affect and arousal did not differ between groups or change over time (p &gt; 0.05). These results show that, despite the different levels of aerobic fitness, physiological, metabolic, perceptual and affective responses were similar in the two groups of women during a 30 min Tabata session. This may imply that affective responses during this type of HIIT are independent of aerobic fitness.

Red Cell Distribution Width and Platelet Indices in Women with Pre-eclampsia: A Cross-sectional Study

Introduction: To determine the prognosis and fetomaternal outcome in eclampsia and pre-eclampsia, a simple and costeffective approach is to assess the Red cell Distribution Width (RDW) and platelet count. RDW, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and platelet markers such as Mean Platelet Volume (MPV) have been the subject of research. Aim: To compare the variation of RDW, NLR, PLR, and platelet indices between women with pre-eclampsia and gestational age-matched healthy controls. Materials and Methods: A cross-sectional study was conducted among 208 pregnant women (104 with pre-eclampsia and 104 controls) at the Department of Obstetrics and Gynaecology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, from January 2020 to June 2021. RDW, NLR, PLR, and platelet indices were analysed after obtaining detailed history, conducting clinical examinations, and relevant investigations. An Independent t-test was used as a test of significance to identify the mean difference between the two quantitative variables. Results: The RDW among cases was 17.05±4.01, whereas among controls, it was 15.09±1.86. The mean age of subjects among case group was 25.72±4.741 years, while in the control group it was 23.25±3.803 years. There was a significant difference in mean Red cell Distribution Width- Coefficient of Variation (RDW-CV) between the two groups. The MPV among cases was 9.86±1.14, while among controls, it was 8.92±1.40 (p-value=0.001). The PDW among cases was 11.30±2.20, and among controls, it was 12.72±3.50. The mean NLR among cases was 5.92±4.94, whereas among controls, it was 4.59±2.22. There was a significant difference in mean platelet count, MPV, PDW, and NLR between the two groups. Conclusion: According to the findings of the current study, RDW, NLR, and MPV were all shown to be higher in women with pre-eclampsia. Additionally, pre-eclamptic women consistently exhibited decreased PDW and platelet counts.

Does small-scale irrigation provide a pathway to women's empowerment? Lessons from Northern Ghana

Given persistent gender inequalities that influence how the benefits of technologies are distributed, the expansion of small-scale irrigation technologies requires the consideration of important gender dynamics and impacts. Women's lack of agency and access to resources relative to men, and other social constraints, often limit their ability to adopt and benefit from agricultural technologies. At the same time, expanding access to agricultural technology to women may provide a pathway for empowerment. This paper explores the potential for small-scale irrigation technologies to increase women's empowerment by evaluating the impacts of an intervention that distributed motor pumps to small groups of farmers in Northern Ghana. The paper draws on two rounds of survey data that included the Women's Empowerment in Agriculture Index, before and after the motor pump intervention was implemented. To control for possible selection bias at the baseline, the difference-in-difference method is used to estimate the impact of the program on indicators of women's empowerment. Spillover effects are estimated by comparing outcomes of farmers in treatment villages that did not receive the pumps with farmers in control villages, where no motor pumps were distributed. The results show no significant impact of the program on measures of women's empowerment. However, there are potential negative impacts, including among households that did not benefit from the intervention. The results highlight the need to pair interventions that distribute agricultural technologies with complementary investments in infrastructure that increase access to water for irrigation, as well as other activities and approaches that ensure women can reap the benefits.

The correlation between Intra-abdominal Adhesions and body mass index in Women Undergoing elective repeated Cesarean Section

Background: Intra-abdominal adhesion formation is serious post-surgery problem that occurs frequently after caesarean section. Obesity is associated with many hemostasis disturbances, particularly impaired fibrinolysis, which may increase the incidence of intra-abdominal adhesions. Aim of Work: Goal of the work was to correlate between intra-abdominal adhesions and body mass index in women scheduled for a repeated cesarean section. Patients & Methods: This was observational cross-sectional research that was carried out at Obstetrics & Gynecology department, faculty of medicine, Al-Azhar university hospitals during the period between October 2021 and April 2022, and total of 232 pregnant women undergoing repeated cesarean section, were enrolled in our study. They were separated into 2 categories according to the BMI: Category I: BMI < thirty kg/m2 (N = 30) and Category II: BMI ≥ thirty kg/m2 (N = 202); Group IIa (N = 96): BMI thirty – 34.9 kg/m2; Group IIb (N = 81): BMI thirty five – 39.9 kg/m2, and Group IIc (N = 25): BMI ≥ 40 kg/m2. Results: no statistically significant variation was discovered among categories regarding preoperative Hgb. However, group II was associated with more significant blood loss compared to group I. Furthermore, the incidence of intraoperative visceral injuries was greater in category II compared to category I. Conclusion: in women undergoing cesarean section, there was a significant association between body mass index and formation of intra-abdominal adhesion with no effect on scar thickness, more frequent depressed scar and dense adhesions, larger adhesion size, longer operation duration and no effect on intraoperative bleeding.

Basic principles and structure of risk assessment of Great obstetrical syndromes

The objective: to develop a method for predicting the individual risk for great obstetric syndromes (GOS).Materials and methods. An analysis of the somatic, reproductive, and obstetric anamnesis was conducted in 572 pregnant women with clinical manifestations of GOS, in 81 of them (prediction group) signs of placental dysfunction were detected based on clinical, functional, laboratory, and ultrasound data. Control group (CG) – 50 practically healthy pregnant women with a favorable reproductive history and an uncomplicated course of this pregnancy.Functional, biophysical, hormonal, immunological and hemocoagulation indicators were calculated to determine the informative (prognostic) significance. Quantitative signs were divided into diagnostic intervals, and qualitative signs were assigned a code. The following indicators were included in the standard protocol: age, data on somatic and gynecological history, data on the pregnancy course, results of functional and laboratory examinations. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. In the I trimester of pregnancy the concentration of placental lactogen (PL) in the prediction group was 29.4 % lower than the CG indicator, estradiol (E2) amount – by 27.4 %, estriol (E3) – by 28.6 %, progesterone (PG) – by 34.4%, human chorionic gonadotropin (hCG) – by 28.3 % lower, and cortisol (CR) – by 36.1 % higher. At the beginning of the II trimester of pregnancy in the prediction group the level of PL was already reduced by 33.8 %, E2 – by 26.2 %, E3 – by 32.3 %, PG – by 37.4 %, hCG – by 30.6 %, and CR – increased by 43.6 % compared to CG.The indicators of placenta hormonal activity in the early stages of pregnancy and at the beginning of the II trimester can be prognostic signs of further disruption of the adaptive compensatory and adaptive reactions of the fetal placental complex (FPC) in the II and III trimesters of pregnancy. Among a wide range of hemostasiological indicators in the I trimester of pregnancy in the prediction group the most informative were: activated partial thromboplastin time (-23 %) and activated recalcification time (+16.2 %), the changes of which remained at the beginning of the II trimester (-40% and - 11.7% respectively). During the evaluation of thromboelastogram data, the value of “r+k” was fixed by 33.3 % lower in the I trimester and by 36 % – at the beginning of the II trimester of pregnancy. As a result of the analysis the indicators with a high information value (more than 3.0 c.u.) were selected for quantitative assessment of the degree of individual risk for the development of maladaptive disorders in the FPC. The clinical trial of the scoring method of prediction proved its high sensitivity (91.8 %) and specificity (85.6 %). Conclusions. A multi-faceted analysis of anamnestic data, features of the pregnancy course, basic clinical, laboratory and functional indicators in women with clinical manifestations of GOS made possible to develop an effective methodology for predicting the risk for GOS development with high levels of sensitivity and specificity.

Лікування стрес індукованих розладів у жінок з лейоміомою матки на фоні гормонотерапії у військовий час

The purpose of the study was to assess psychosomatic changes and determine clinical and laboratory indicators in women with uterine fibroids under the conditions of using hormonal therapy and a drug with anxiolytic effect. Materials and methods. The study analyzed the results of 60 women with uterine fibroids who had anxiety disorder symptoms. The patients were divided into two groups: Group I – patients with uterine fibroids who took combined oral contraceptives (n=30); Group II – patients with uterine fibroids who took the anxiolytic medication fabomotizole concurrently with combined oral contraceptives (n=30). Results and discussion. The research established that patients with uterine fibroids had a change in their psycho-emotional state with a tendency to a high level of anxiety and depression. Treatment with combined oral contraceptives and fabomotizole demonstrated a more stable emotional background as compared to patients who took only combined oral contraceptives. The percentage of patients with the low level anxiety increased and the percentage of patients with the high level anxiety decreased. Among women who were treated with combined oral contraceptives only, there was still a considerable proportion of patients with high levels of anxiety and depression. It was found that the use of combined oral contraceptives in combination does not result in changes regrading the size of the tumor compared to the indicators of patients who did not take the drug with an anxiolytic effect. However, this group of patients demonstrated a tendency to stabilize the growth of nodes, to decrease clinical manifestations in the form of pain and intermenstrual bleeding in the first months of taking combined oral contraceptives. It should be noted that in patients who were not administered fabomotizole, the studied indicators remained at a lower level compared to the indicators of patients who were prescribed this drug. Probably, restoration of the psycho-emotional state in women with uterine fibroids under the influence of fabomotizole increases the effectiveness of hormonal therapy. Conclusion. The patients of both studied groups were shown to have developed pronounced anemia, which was confirmed by low values of hemoglobin in the blood, and the levels of ferritin and transferrin in the blood serum decreased. An increase in the studied indicators was observed after combined oral contraceptive treatment, and specifically after treatment with a combination of combined oral contraceptives and fabomotizole. However, the levels of ferritin and transferrin remained at a lower level compared to normal values

CLINICAL-ANAMNESTIC CHARACTERISTICS OF NONSPECIFIC VAGINITIS IN WOMEN IN DIFFERENT AGE GROUPS

The purpose of the study was to study the clinical and anamnestic characteristics of women with specific vaginitis in different age groups from different angles. Materials and research methods. The research was carried out at the Research Institute of Obstetrics and Gynecology. The study included 120 women of reproductive age who were diagnosed with nonspecific vaginitis. Examination of women was carried out according to the generally accepted scheme: anamnesis, including complaints of patients, general clinical and gynecological examinations, laboratory, instrumental, bacteriological studies, the calculation was carried out by a mathematical method. The largest part of all patients was aged 18-30 years, i.e. reproductive age. Results and its discussion. The frequency of menstrual irregularities in women included in the study with nonspecific vaginitis was high. When studying pregnancy-related indicators in women with nonspecific vaginitis, it was found that the frequency of primary and secondary infertility, as well as miscarriage in these women, is quite high. The structure of extragenital diseases in women with nonspecific vaginitis was different. Although various pathologies (of the urinary system, respiratory organs, gastrointestinal tract, nervous system) occurred with different frequencies, the rates were quite high.

Free-androgen Index in Women with Polycystic Ovarian Syndrome: A Meta-Analysis

Abstract Objectives Hyperandrogenism, a key feature of polycystic ovarian syndrome (PCOS), is caused by excess androgen secretion, most commonly of ovarian origin. Although the serum total testosterone (TT) levels have long been used as a traditional measure of hyperandrogenemia in women with PCOS, it is associated with many fallacies due to the fact that a component of TT is linked to sex hormone-binding globulin (SHBG). Recent research has discovered that measuring free testosterone levels and computing the free androgen index (FAI), which is a ratio of TT and SHBG, are better predictors of androgen excess in PCOS. The aim of this meta-analysis is to determine the association of FAI in diagnosing hyperandrogenism and its ability to discriminate PCOS from controls. Materials and Methods The publicly available databases PubMed, Scopus and Web of Science were searched using MeSH terms, ‘Polycystic Ovarian Syndrome’ OR ‘PCOS’ OR ‘PCOD’ AND ‘Testosterone’ AND ‘Sex Hormone Binding Globulin’ OR ‘SHBG’ to collect the full-text articles for the retrieval of related data of case–control and cross-sectional studies. The studies quality was assessed using the Newcastle–Ottawa scale, and a sub-group analysis and publication bias between the studies was evaluated by funnel plot. Statistical Analysis The R program (v4.0.3) and R packages ‘metafor’ and ‘dmetar’ were used for statistical analyses of quantitative data and the plots were generated using ‘ggplot2’ package through a comparison of pooled SMD by Egger's linear regression and Beggs-Mazumdar tests. Results Twenty-four studies involving 7,847 participants including 3,290 controls and 4,557 PCOS were included in the meta-analysis. The pooled data analysis of the included studies showed that the PCOS women had higher FAI than controls, with SMD of 1.56 (95%CI 1.08–2.04; p &lt; 0.01). The publication bias was tested using a funnel plot and Egger's regression asymmetry test, which revealed no risk of publishing bias (p = 0.1727). Additionally, the sub-group meta-analysis of geographic region revealed that FAI levels were more significant in PCOS subjects of Asia and Europe, compared with the American region. Conclusion Overall, this meta-analysis indicates that FAI could be a reliable marker to differentiate PCOS patients from controls in Asian and European ethnicities.

When does the Japan Empowering Women Index outperform its parent and the ESG Select Leaders Indexes?

This paper examines and compares the performance of the Japan Empowering Women Index (WIN), Japan ESG Select Leaders Index (SLI), and their parent, the Japanese Investable Market Index (IMI) using data from April 2013 to October 2020. Without regime switching, our benchmark analysis suggests that none of the indexes outperforms the market on average. We also investigate the possible regime-dependent performance of each index to identify the periods when WIN outperforms the market, the IMI, and the SLI, if ever. Our results indicate regime-dependent performance of the WIN and IMI and regime-independent performance of the SLI. For example, when the market performance of the previous month is relatively poor, the WIN tends to outperform the market, while the IMI tends to underperform. Our results also show that, when the market volatility of the previous month is relatively small, the WIN outperforms the market. However, the WIN and IMI tend to underperform the market under the high market volatility regime.

Dynamics of Anthropometric Indicators in Women of Fertile Age with Cushing's Syndrome After Surgical and Drug Treatment

We studied the dynamics of anthropometric indicators in 153 women of fertile age with Cushing's syndrome, who applied for excess weight, lack of menstruation and infertility in the RSSPMC of Endocrinology of the PHM of the Republic of Uzbekistan, from 2000 to the present. The control group consisted of 20 women with obesity of varying degrees and without menstrual irregularities.According to the classification of the American Association of Endocrinologists from 2012, all female patients with SC registered since 2000 (the dead are not included) were distributed according to etiology as follows: 1 g. - patients with ACTH-dependent CS– 115 (75.2%), 2 g. - with ACTH-independent CS - 35 (22.9%) and group 3 - patients with ACTH-ectopic CS - 3 (1.9%). 6 months after surgical and drug treatment, in groups 1 and 2 of patients there was a significant improvement compared with the average OT, OB, OT / OB data before treatment, while in patients of 3 groups there were significant changes in the average OT, OB, OT values / OB after 6 months of treatment not established.

Predictive plasma biomarker for gestational diabetes: A case-control study in China

ObjectiveThis study aims to find new plasma biomarkers in early pregnancy. DesignThe original study enrolled 1219 pregnant women. We investigated protein expression profiles of placental tissues from women with GDM (n = 89) and normal glucose tolerance (NGT) (n = 83). Maternal plasma samples between two groups in early and middle pregnancy were used for validation of candidate biomarkers. MethodsDifferentially expressed proteins (DEPs) were identified by label-free quantitative proteomics from human placenta samples between two groups. Several DEPs were validated in plasma by Luminex assays. An automatic biochemical analyzer was used to detect blood lipid indexes. The associations of GAL-3BP with biochemical indicators were demonstrated by Pearson's correlation analysis. Binary logistic regression was used to model potential predictive indicators in early pregnancy of GDM. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of the predictive model and the value of GAL-3BP. Results123 DEPs were found in placenta involved in ribosomal function, pancreatic secretion, oxidative phosphorylation, and inflammatory signaling pathway. Plasma GAL-3BP are significantly higher in women with GDM than NGT in the first (p = 0.008) and second (p = 0.026) trimester, but C9 and VWF have no difference. The predictive value of GAL-3BP in the first trimester of pregnancy (AUC 0.64) is better than that in the second trimester (AUC 0.61), and combined predictive model of TG and GAL-3BP at early pregnancy has greater predictive and diagnostic value for GDM (AUC 0.69) than individual GAL-3BP (AUC 0.64). ConclusionsPlasma TG and GAL-3BP has good predictive and diagnostic value at early pregnancy, suggesting that these two indicators may be used as biomarkers for early prediction and diagnosis of GDM. SignificanceThe advantage of this study is that circulating TG and GAL-3BP might differentiate the progress of women with GDM and normal glucose tolerance (NGT) at the early stage of pregnancy. It is the first study to consider the role of GAL-3BP as an early predictive biomarker in the development of GDM during the whole pregnancy. Another advantage is that volunteers in this study were recruited from two provinces in China to eliminate the impacts of environmental confounders. The similar changes of blood glucose/lipid indicators for women with GDM and NGT in both regions was found in the first and second trimester of pregnancy, which added to the reliability of analytical results.

Effects of Flibanserin on Subdomain Scores of the Female Sexual Function Index in Women With Hypoactive Sexual Desire Disorder.

Flibanserin treatment increases sexual desire and satisfying sexual events while decreasing distress in certain women diagnosed with acquired, generalized hypoactive sexual desire disorder (HSDD). Additional aspects of sexual function and the time course of response have not been fully characterized. To evaluate changes in sexual function assessed by the subdomains of the Female Sexual Function Index (FSFI) in women with HSDD treated with flibanserin. FSFI data pooled from 3 pivotal flibanserin trials in premenopausal women (flibanserin=1,165; placebo=1,203) and FSFI data from one complete flibanserin trial in postmenopausal women (flibanserin=432; placebo=463) were subjected to post-hoc analyses. For each FSFI subdomain, least squares mean change from baseline was calculated at each assessment visit (treatment weeks 4, 8, 16, 24) and treatment groups were compared using analysis of covariance. Standardized effect size (Cohen's d) was also determined for each FSFI subdomain. Changes from baseline in FSFI subdomains. Compared to placebo, both premenopausal (P < .02) and postmenopausal (P < .045) patients in the flibanserin group reported significantly greater increases over baseline in the FSFI subdomain scores of desire, arousal, lubrication, orgasm, and satisfaction. In premenopausal patients, significant improvements were observed at the first assessment of response (week 4) and were maintained through week 24. In postmenopausal patients, significant improvements were observed at week 4 for desire and arousal, while significant improvements in lubrication, orgasm, and satisfaction were observed at week 8. At week 24, excluding the pain subdomain, standardized effect sizes ranged from 0.18 to 0.28 in the premenopausal cohort and 0.12 to 0.29 in the postmenopausal cohort. In both pre- and postmenopausal patients, improvements in pain were smaller and largely undifferentiated between treatment groups. While variations in time to response should be taken into consideration, on average, the beneficial impact of flibanserin on overall sexual function occurs within the first month of treatment. The data also suggest that the response to flibanserin is sustained for the duration of treatment. Sexual function assessments were performed in a large cohort of 2,368 premenopausal women and 895 postmenopausal women. However, the FSFI assesses changes over a 1-month period and time points earlier than 4 weeks could not be assessed. These analyses suggest that assessment of benefit of flibanserin in HSDD should include improvements across all domains of sexual function, not only desire. Simon JA, Clayton AH, Goldstein I, et al. Effects of Flibanserin on Subdomain Scores of the Female Sexual Function Index in Women With Hypoactive Sexual Desire Disorder. Sex Med 2022;10:100570.

Gender features of the cytokine profile in patients with chronic atrophic gastritis

Background. Сhronic atrophic gastritis certainly remains an urgent problem of gastroenterology but data on sexual differences in the content of cytokines in this pathology are quite contradictory. The purpose of the study: to assess the gender characteristics of the cytokine profile in patients with chronic atrophic gastritis. Materials and methods. The study included 120 patients with gastric atrophy, according to histological examination of biopsies. The control group consisted of 20 healthy individuals, men and women equally. In all patients, we have evaluated the levels of interleukins (IL-8, IL-10, IL-18), tumor necrosis factor alpha (TNF-α), vasculoendothelial growth factor (VEGF) by enzyme-linked immunosorbent assay using appropriate reagent from Vector-BEST kits and the Stat Fax 303 Plus analyzer. Results. In men with chronic atrophic gastritis, there is a more pronounced imbalance towards pro-inflammatory cytokines, in particular the level of IL-18 is 1.7 times higher (p&lt;0.05) than in women. In 46.2% of cases, the content of IL-8 was also elevated in men by 1.3 times (p&gt;0.05) compared to women. The level of anti-inflammatory cytokine IL-10 does not have a significant gender difference in patients with precancerous conditions of the stomach. The median of IL-18/IL-10 ratio in men is 2 times higher than in women: 65.36 (21.67; 154.25) vs. 32.15 (12.76; 191.85) (p&lt;0. 05). In males, IL-8/IL-10 ratio is also 1.5 times higher, which is 2.25 (1.29; 7.68) vs. 1.49 (0.75; 9.78) but this difference was not statically significant. Serum content of VEGF in men exceeded the same indicator in women by 1.4 times (p&lt;0.05). Direct correlation between VEGF content and the levels of TNF-α (r=0.47, p&lt;0.05), IL-8 (r=0.42, p&lt;0.05), IL-18 (r=0.58, p&lt;0.05) confirm the evidence of increased VEGF expression under the influence of many proangiogenic growth factors and proinflammatory cytokines. Conclusions. With an increase in the level of IL-18 and VEGF by more than 30%, men require dynamic monitoring for early detection of precancerous structural changes in the gastric mucosa.

Research of Lipid Metabolism Disorders in Female Combatants

The objective: to find out the peculiarities of stress-induced changes in lipid metabolism indicators in women who have experienced concussion during combat operations. Study the state and morphostructure of adipose tissue. To analyze the relationship between lipid metabolism disorders and changes in reproductive health of female combatants. Materials and methods. The research was conducted at the Department of Obstetrics, Gynecology and Reproductology of the Ukrainian State Institute of Reproductology of the Shupyk National Healthcare University. 118 women participated in the study. Group I consisted of examination data of women who suffered concussion during combat operations with PTSD, group II – control, it consisted of healthy women. Average age of women who participated in hostilities and suffered contusion 27.08±4.23 years. Results. The influence of stress factors associated with military service in women servicemen on the development of lipid metabolism disorders is obvious. In the main group (118 women), blood cholesterol levels were significantly higher than in the control group. In parallel, a very low level of anti-atherogenic lipoprotein fractions was detected. Lipid metabolism in women who experienced concussion during combat with PTS was characterized by a high frequency of hyperlipidemia of types IIa and IIb, higher serum concentrations of atherogenic lipids fractions (CL, CL-LDL) and low anti-atherogenic fractions (CL-HDL), which were observed in all age subgroups and progressed with age. Conclusions. As a result of lipid metabolic disorders, the prerequisites for the development of hyperproliferative diseases of the female reproductive system, early and severe atherosclerosis are created.

Associations of bone mass and polygenic risk of osteoporosis with indicators of arterial wall condition

Background: The identification of genetic factors that are simultaneously responsible for the predisposition to the development of cardiovascular diseases (CVD) and osteoporosis (OP) is important for the prevention of both conditions.Aim: The aim of this study is to evaluate three genetic risk scales (GRS) that previously showed an association with bone mineral density (BMD) and fracture risk, as well as to study the associations of these GRS with vascular wall pathology.Materials and methods: 250 female outpatients (aged 45 to 69) were enrolled into a cross-sectional study. The intima-media thickness (IMT), the presence and number of atherosclerotic plaques (AP) were studied using duplex scanning. Pulse wave velocity (PWV), augmentation index (AI) were measured by applanation tonometry. Coronary vessels calcium deposits were registered by multispiral computed tomography (MSCT) using the Agatston calcium index (CI). The BMD of the spine, hip neck (HN) and proximal hip (PH) was measured using double energy x-ray absorptiometry. Bone resorption marker type-1 collagen C-terminal telopeptide (CTx) was assessed solid-phase enzyme immunoassay. The genetic study included DNA extraction from whole blood samples. Targeted sequencing was performed on the Nextseq550 sequencer (Illumina, USA). Statistical analysis was carried out using the SAS software package for Windows, version 9.0 (SAS Institute Inc., USA).Results: The chance of detecting low bone mass increased more than 4 times at values of IMT ≥0.9 mm (OR=4.17; 95%CI [1.2–14.4], p&lt;0.02), 2.4 times in the presence of AP in the carotid arteries (OR=2.45; 95%CI [1.12–4.88], p&gt;&lt;0.05), by 6.7 times with an Agatstone CI ≥ 100 units (OR=6.68; 95%CI [1.56–28.7], p&gt;&lt;0.001), 1.4 times (OR=1.43; 95%CI [0.56–3.68], p&gt;&lt;0.438) with a PWV ≥10 m/s, 1.2 times (OR=1.2; 95%CI [0.601–2.43], p&gt;&lt;0.60) with increased AI ≥ 27%. According to multivariate linear regression analysis (adjusted for age, duration of postmenopause, marker of bone resorption CTx), a significant association of all GRS with BMD in all parts of the skeleton was revealed. Both univariate and multivariate regression models adjusted for several covariants (age, total cholesterol, systolic blood pressure) showed a reliable association of GRS62 with the presence of plaques and GRS63 — with coronary artery CI. Conclusion: The results of the study demonstrated the association of polygenic genetic risk of GRS-based OP with BMD and vascular wall status indicators in women in the peri and postmenopausal periods.&gt;&lt; 0.02), 2.4 times in the presence of AP in the carotid arteries (OR=2.45; 95%CI [1.12–4.88], p&lt; 0.05), by 6.7 times with an Agatstone CI ≥ 100 units (OR=6.68; 95%CI [1.56–28.7], p&lt; 0.001), 1.4 times (OR=1.43; 95%CI [0.56–3.68], p&lt; 0.438) with a PWV ≥10 m/s, 1.2 times (OR=1.2; 95%CI [0.601–2.43], p&lt;0.60) with increased AI ≥ 27%. According to multivariate linear regression analysis (adjusted for age, duration of postmenopause, marker of bone resorption CTx), a significant association of all GRS with BMD in all parts of the skeleton was revealed. Both univariate and multivariate regression models adjusted for several covariants (age, total cholesterol, systolic blood pressure) showed a reliable association of GRS62 with the presence of plaques and GRS63 — with coronary artery CI.&gt;&lt; 0.60) with increased AI ≥ 27%. According to multivariate linear regression analysis (adjusted for age, duration of postmenopause, marker of bone resorption CTx), a significant association of all GRS with BMD in all parts of the skeleton was revealed. Both univariate and multivariate regression models adjusted for several covariants (age, total cholesterol, systolic blood pressure) showed a reliable association of GRS62 with the presence of plaques and GRS63 — with coronary artery CI.Conclusion: The results of the study demonstrated the association of polygenic genetic risk of GRS-based OP with BMD and vascular wall status indicators in women in the peri and postmenopausal periods.

MEDICAL STUDENT'S MENSTRUAL CYCLE: THE UNKNOWN UNKNOWNS

Background: The menstrual cycle is a health indicator in women. The change in health makes female students feel less confident in communicating, studying, and living. Therefore, the study on the characteristics of the menstrual cycle in female medical students brings many practical meanings by figuring conclusions and solutions to improve both physiological and mental discomforts for women during menstruation. Objectives: Can Tho University of Medicine and Pharmacy (CTUMP) 3rd year medical students were studied for the characteristics, the abnormalities of the menstrual cycle, and the premenstrual syndrome. Materials and methods: The design of a cross-sectional descriptive study with analysis by direct interview method was conducted on 126 female 3rd year medical students at CTUMP. Results: Long menstrual cycle time accounted for 38.1% of subjects, while short menstrual cycle time accounted for 0.8%. The study also found that the average menstrual period was 5.00±1.34 days. The premenstrual syndrome was observed in 47.3% of students, with abdominal pain and low back pain accounted for the highest rate (63.5%), and headache accounted for the lowest rate (9.5%). Menorrhagia had a low prevalence (7.1%), whereas menstrual cramp was much more common (60.3%). Conclusions: Long menstrual cycles occurred at a high rate among medical students. Abdominal pain and low back pain were the most common symptoms before menstruation. Menstrual cramp was the most common abnormality of the menstrual cycle among CTUMP female medical students.

Women Empowerment in Pakistan: Multilevel Measurements, Spatial Differences, and Contributing Factors

Based on Pakistan Demographic and Health Survey (PDHS) 2017-18 data covering a sample of 15068 currently married females aged 15-49 years, the study intends to investigate the women empowerment situation across the regions and districts of Pakistan as well as to explore the factors affecting women empowerment in Pakistan. An index of women empowerment (ranging from score 0 to 7) was constructed by taking the sum of the seven indicators on the five dimensions: woman's participation in decision making, awareness, employment, self-esteem, and financial inclusion status. The extent of women empowerment regarding each particular indicator is gauged (in percentage) at a national level as well as at regional and district levels. Regarding each particular indicator of women's empowerment, spatial differences exist across the country at the regional and district levels. At the country level, women empowerment is poor in Pakistan. Nearly 86% of respondent women said they were currently not working (unemployed). Similarly, 92% said they did not have an account in a bank or financial institution. At the same time, 57% percent of women reported that they do not own a mobile phone, 87% indicated that they never used the internet, and 40% stated that they were not watching television. At the country level, the women empowerment index's mean score was 2.14. The mean score of the women empowerment index at the regional level stood between 0.52 (in FATA) and 3.43 (in ICT), whereas at the district level, the mean score of the index stood between 0.03 (in South Waziristan) and 4.82 (in Hunza). Out of a total of 143 districts in Pakistan, in 13 districts, the mean score of the women empowerment index remained less than 1. Findings of the ordered logit regression showed that women's higher education, age, husband's higher education, household wealth status, female headship of household, number of living children, and belongingness to the urban area are positively associated with the empowerment of women.