Reproductive Age Research Articles

Unhealthy food consumption among women at reproductive age in Cambodia: Analysis of Cambodia Demographic and Health Survey 2021–2022

Noncommunicable diseases (NCDs) are significant global health issues; we examined the prevalence of unhealthy food consumption and used logistic regression to analyze its association with socio-demographic characteristics using data from the 2021-2022 Cambodia Demographic and Health Survey (CDHS), which included 19,496 women aged 15–49. Overall, 33.0% (95%CI: 31.9–34.2) of women consumed unhealthy foods within 24 hours, 21.1% (95%CI: 20.1–22.1) consumed sweet foods, 18.2% (95%CI: 17.4–19.1) consumed salty foods, 58.3% (95%CI: 57.1–59.5) consumed sweet beverages, and 16.3% (95%CI: 15.3–17.3) consumed alcohol in the last month. Only 1.5% (95%CI: 1.3–1.7) of women smoked cigarettes. Factors associated with increased odds of consuming unhealthy food included aged 15–19 years (AOR = 1.7; 95% CI: 1.5–2.1), 20–29 years (AOR = 1.3; 95% CI: 1.1–1.5), and 30–39 years (AOR = 1.3; 95% CI: 1.2–1.5), higher education (AOR = 1.6; 95% CI: 1.3–2.0), and wealthier households (AOR = 1.1; 95% CI: 0.9–1.2), residing in capital city (AOR = 2.4; 95% CI: 1.9–3.1). The study found a high prevalence of unhealthy food consumption among Cambodian women. Younger age, higher education, wealthier households, and residing in the capital city were associated with consuming unhealthy food. Public health interventions should prioritize mitigating the risk of NCDs among Cambodian women by promoting healthier lifestyles.

What’s behind the Attitudes of the Ethnic Bulgarians in Reproductive Age towards Interethnic Marriages with Members of Bulgaria’s Turkish Community?

This piece of research investigates the determinants of ethnic Bulgarians’ attitudes towards interethnic marriages with members of Bulgaria’s Turkish community. A statistical analysis was conducted to examine the role of socio-demographic factors in shaping these attitudes. It discusses many factors but focuses on the statistically significant educational attainment, settlement type, family status, and net income. Higher levels of education do not necessarily lead to more tolerant attitudes towards interethnic marriages. Settlement type and family status emerge as influential determinants. Income is important in shaping attitudes, with the better-off households exhibiting higher approval rates to interethnic mixed marriages. These and other findings contribute to understanding interethnic attitudes and provide valuable insights for policymakers and stakeholders working towards fostering social cohesion and inclusion.

Neuroendocrine tumours and pregnancy: Real-world data from an European Neuroendocrine Tumour Centre of Excellence.

Neuroendocrine neoplasms (NENs) arise from the diffuse endocrine system and have been considered to be rare. However, the incidence and prevalence of these tumours have increased in recent years, and they are being seen in younger patients including women in the reproductive age group. Due to the paucity of data, diagnostic and therapeutic strategies in managing such tumours during pregnancy can be challenging to both treating physicians and patients. This article describes the experience and outcomes of managing pregnant women with NEN at a European Neuroendocrine Tumour Society (ENETS) Centre of Excellence. In this retrospective analysis, we evaluated a total of 22 pregnancies in 18 pregnant women with concurrent diagnoses of NENs who were managed at Royal Free Hospital ENETS Centre of Excellence throughout their pregnancy. These were identified from our tumour registry of 3500 NEN patients between 2015 and 2023. Cross-sectional imaging (computed tomography (CT)/magnetic resonance imaging (MRI)), pre- and post-pregnancy, for each patient was reviewed by an experienced radiologist. Tumour growth rate (TGR) was calculated using the formula: TGR = 100 × [exp (TG) - 1]; TG. [3 × log (D2/D1)]/time (months), where D1 is the tumour size at date 1; D2 is the tumour size at date 2; and time (months) = (Date 2 - Date 1 + 1)/30.44. Tumour growth rate pre-conception (TGRpc) and tumour growth rate post-partum (TGRpp) were calculated for each patient. In a sub-group of patients, positivity for oestrogen and progesterone receptors were analysed on the tumour tissue to evaluate whether the presence of these receptors affected tumour progression during the pregnancy. We also reviewed the pregnancy outcome in patients treated with somatostatin analogues during pregnancy. We analysed the data of a total 22 pregnancy encounters in 18 women: 15 pregnancies (68%) preceded the diagnosis of the NEN, whereas the diagnosis of NEN was made during pregnancy or in the post-partum period in 5 (23%) and 2 (9%) pregnancies respectively. Eight patients (44%) had a diagnosis of a pancreatic NEN, whereas 5 (28%) were diagnosed with mid-gut NENs, and a further 5 at other sites. The majority of the patients (n = 12, 67%) had evidence of metastatic disease at the time of diagnosis. Most pregnancies had a successful outcome (n = 19, 86%), whereas 3 patients (14%) had miscarriages in the 1st trimester. Five patients in total of 6 pregnancies were treated with somatostatin analogues as monotherapy during the pregnancy, and all of them had stable disease after pregnancy. All of them delivered healthy babies without any side effects or complications due to therapy. The average TGRpc was -0.8% (n = 5) and the average TGRpp was +0.96% (n = 6); 2 patients who did not have suitable targets for calculation of TGRpc developed new lesions suggesting disease progression. Moreover, 2 of the 4 patients who have had both pre-conception and post-pregnancy scans showed an increase in TGRpp compared to TGRpc. The management of NENs during pregnancy should be multidisciplinary with an individualised approach to each patient. Somatostatin analogues appear to be safe during pregnancy, though further robust studies are needed. Pregnancy per se may accelerate tumour progression, and patients should be counselled regarding this possibility.

The assembly and activation of the PANoptosome promote porcine granulosa cell programmed cell death during follicular atresia

BackgroundFollicular atresia significantly impairs female fertility and hastens reproductive senescence. Apoptosis of granulosa cells is the primary cause of follicular atresia. Pyroptosis and necroptosis, as additional forms of programmed cell death, have been reported in mammalian cells. However, the understanding of pyroptosis and necroptosis pathways in granulosa cells during follicular atresia remains unclear. This study explored the effects of programmed cell death in granulosa cells on follicular atresia and the underlying mechanisms.ResultsThe results revealed that granulosa cells undergo programmed cell death including apoptosis, pyroptosis, and necroptosis during follicular atresia. For the first time, we identified the formation of a PANoptosome complex in porcine granulosa cells. This complex was initially identified as being composed of ZBP1, RIPK3, and RIPK1, and is recruited through the RHIM domain. Additionally, we demonstrated that caspase-6 is activated and cleaved, interacting with RIPK3 as a component of the PANoptosome. Heat stress may exacerbate the activation of the PANoptosome, leading to programmed cell death in granulosa cells.ConclusionsOur data identified the formation of a PANoptosome complex that promoted programmed cell death in granulosa cells during the process of follicular atresia. These findings provide new insights into the molecular mechanisms underlying follicular atresia.

The effect of rapamycin treatment on mouse ovarian follicle development in dehydroepiandrosterone-induced polycystic ovary syndrome mouse model.

Polycystic ovary syndrome (PCOS) is a complex reproductive and endocrine disorder affecting 5-10% of women of reproductive age, but the pathophysiology of PCOS still remains unknown. Here, the aim of our study was to analyze the effects of rapamycin treatment that may regulate impaired hormonal levels and folliculogenesis in dehydroepiandrosterone (DHEA)-treated PCOS mouse. We hypothesized that rapamycin may ameliorate the negative effects of PCOS in DHEA-induced PCOS mouse model. The target of rapamycin (TOR) gene product is a serine/threonine kinase that has been implicated in the control of cell growth, proliferation and autophagy, and rapamycin is a potent inhibitor of mTORC1 pathway. In this study, for the first time, mTORC1 and activation products are presented at protein and mRNA levels after rapamycin treatment in DHEA-induced PCOS mouse ovary. We showed that rapamycin treatment may regulate follicular development, hormonal levels and provide ovulation in DHEA-induced PCOS mouse. Additionally, we assessed decreased primordial follicle reserve, increased number of primary and secondary follicles, corpus luteum structure forms again after 10 days of rapamycin treatment. This study presented here suggests rapamycin treatment regulates hormonal phenotype and folliculogenesis in the ovary and also mTOR signalling pathway in granulosa cells of DHEA-induced PCOS mouse ovary which may have potential to attenuate understanding the mechanism of dominant follicle selection and anovulatory infertility.

Logistic Regression Model on Nutritional Status Based on Body Mass Index (BMI) in Women of Reproductive Age (WRA) in Indonesia

The aggregate analysis of Riskesdas data in Indonesia revealed that nearly all provinces face a serious double burden of malnutrition. Both undernutrition and overnutrition negatively affect the quality of human resources, especially when they occur in adolescent girls, Women of Reproductive Age (WRA), and pregnant and breastfeeding women, as this can lead to intergenerational nutritional problems. Body Mass Index (BMI) is a nutritional status measurement technique recommended by WHO. Nutritional problems occur when BMI is abnormal or not ideal, categorized as underweight (<18.5 kg/m²), pre-obesity (25-29.9 kg/m²), obesity class I (30-34.9 kg/m²), obesity class II (35-39.9 kg/m²), and obesity class III (>40 kg/m²). Data from laboratory results completed up to 2017, based on selected samples from the 2013 Basic Health Research (Riskesdas), were used to assess the nutritional status of the Indonesian population. This study used 9,418 respondent data samples from 33 provinces in Indonesia. Logistic regression analysis was applied because the response variable in this study is binary, representing ideal BMI (1) and non-ideal BMI (0). The independent variables used in this study include Hemoglobin level, Ferritin level, CRP level, age group, physical activity, living location, marital status, education, and risky food consumption patterns. All independent variables are categorical. The study found that the factors influencing nutritional status based on BMI in WRA are Hemoglobin level, Ferritin level, CRP level, age, and location. The resulting logit model is logit (π)=0.27695-0.1491 (Non-anemic Hemoglobin level)-0.1721 (Normal Ferritin level)+0.741 (Non-infectious CRP level)-0.2933 (Adult age group)-0.0976 (rural location). logit (π)=0.27695-0.1491 (Non-anemic Hemoglobin level)-0.1721 (Normal Ferritin level)+0.741 (Non-infectious CRP level)-0.2933 (Adult age group)-0.0976 (rural location). The largest odds ratio The largest odds ratio was produced by the CRP level variable, indicating that CRP level is the most influential factor affecting nutritional status based on BMI in WRA, where non infectious CRP compared to infectious CRP increases the likelihood of WRA having an ideal BMI.

How does surgery influence female sexuality in patients with endometriosis compared to those with other benign gynecological conditions?

BackgroundEndometriosis is a chronic, estrogen-dependent, benign condition, affecting 10–15% of women of reproductive age. It is associated with a prevalence of sexual dysfunction that is nearly twice as high as that seen in women with other benign gynecological conditions. Our study aimed to assess the effect of surgical intervention on sexual function, as measured by the FSFI (Female Sexual Function Index) score, in women with endometriosis compared to those with other benign gynecological conditions, both before and after surgery.MethodsA comparative analysis was conducted at the Medical University of Vienna from 2015 to 2020. The study included patients suspected of having endometriosis, fibroids, adnexal cysts, and/or infertility. Based on findings during surgery, patients were categorized into two groups: those with endometriosis (n = 64) and control patients (n = 38). All participants completed the FSFI questionnaire before surgery and again 8 to 18 weeks after the operation.ResultsNo significant differences were observed in the preoperative FSFI scores between the endometriosis patients and the control group. Similarly, no significant differences were found between the two groups in postoperative scores. However, in women diagnosed with endometriosis, surgical removal of endometriotic lesions significantly increased their full-scale FSFI score, and resulted in a significant improvement in the areas “desire” and “satisfaction”. Improvements were noted in all other areas as well, though they were not statistically significant.ConclusionsOur research indicates that the surgical removal of endometriotic lesions can lead to an improvement in sexual function, as measured by the FSFI, within 8 to 18 weeks post-surgery. This improvement was not observed in the control group, which underwent surgery for other benign gynecological issues.

Utilization of Syndromic Vaginitis Diagnostic Testing Reduces 6-Month Follow-Up Outpatient Service Healthcare Costs—A Real-World Data Analysis

Background/Objectives: Vaginitis is a common infection among women of reproductive age. Although various diagnostic methodologies exist, diagnosis without the utilization of available diagnostic tests remains prevalent. This study aimed to assess downstream healthcare utilization and the cost of patients with and without diagnostic testing. Methods: This retrospective, observational study utilized the IQVIA PharMetrics® Plus database from July 2020 to October 2023. Patients with an index claim (ICD-10 code indicating vaginitis) were categorized into two cohorts: those who received a syndromic polymerase chain reaction (PCR) test and those who had no documented test on the index date or within two days. Total and service-specific healthcare resource utilization and costs were assessed for 6 months following the index event. This study was designed to inform how Syndromic Vaginitis PCR testing is used to make treatment decisions and to track outpatient and inpatient healthcare utilization for 6 months post index date represented by cost. Results: Patients who received a Syndromic Vaginitis PCR test had significantly fewer outpatient medical services in the 6 months following initial diagnosis compared to those who received no diagnostic test. This was largely attributed to a substantial decrease in other medical service visits, resulting in mean cost savings of USD 2067 (Syndromic PCR = USD 6675, SD = USD 17,187; No Test = USD 8742, SD = USD 29,894) (p-value 0.0009). Conclusions: Many vaginitis patients do not receive testing, but Syndromic Vaginitis PCR testing may be an effective diagnostic tool for reducing costs associated with vaginitis infections.

Quality of family planning counseling and associated factors among reproductive age women who are current contraceptive users at Dessie town health facilities east Amhara, 2023

BackgroundThe role of counseling in Family Planning is to care a woman in navigating the process of choosing a contraceptive method that will allow her to fulfill her family planning goals and exercise her reproductive health rights. The effectiveness and appropriateness of family planning counselling play a crucial role in a client’s decision-making process regarding contraception. The decision for a client to use contraception with effectively and properly it should be ultimately achieved the quality of family planning counclling.The aim of this research is to assess quality of family planning counseling and associated factors among reproductive age women at Dessie town health facilities, east Amhara, Ethiopia, and 2023.MethodsA facility based cross-sectional study was conducted from December 1, 2022- January 30, 2023. Study subjects were selected by using systematic random sampling method. Data was be collected by exit interview of the women and analyzed by SPSS version 26. Bivariable and Multi variable logistic regression were executed to identify associated factors with quality of family planning counseling and the P- Value <0.05 on Multi variable analysis was considered as significantly associated with the dependent variable.ResultThe proportion of women receiving good quality family planning counselling in this study was 36.5%. Contraceptive source [AOR=2.03, 95%CI (1.09, 3.75)], Contraceptive currently used [AOR=0.43, 95%CI (0.26, 0.73)], separate room for family planning counseling [AOR=3.38, 95%CI (1.09, 3.75)] and availability of all methods [AOR=3.10, 95%CI (1.85, 5.21)]were significantly associated with quality of family planning counselling.ConclusionThe proportion of women obtaining good quality FP counseling in this study low. Type of contraceptives currently used, source of contraceptives, separate room for providing family planning counseling and availability of all methods of family planning in the facility are significantly associated with quality of family planning counseling. Therefore, all health profession could be given proper counseling to increase the quality of family planning.

Reflections on timing of motherhood - a qualitative online study with women of reproductive age

BackgroundThe age of Danish women giving birth to their first child has risen throughout the last 50 years, and the number of women and men who are having their first child when they are at advanced maternal or paternal age is increasing worldwide. Postponing parenthood is not unique to Denmark, as the same pattern is seen especially in other European and Western countries. The aim of this study was in a social media setting to explore reflections on the timing of motherhood among Danish women of reproductive age who not yet had children.MethodThis study was a qualitative study based on three online focus groups on Facebook. Twenty-six women of reproductive age discussed the timing of motherhood for three days in January 2020. Data were analyzed using Systematic Text Condensation.ResultsThree main themes were identified: ‘Life before parenthood’, ‘To plan for a child’ and ‘A life without children’. Several external and internal conditions influence whether and if so when women consider becoming mothers. Regarding the biological capacity for having children, women compare themselves with their female relatives and friends and colleagues regarding the social norms surrounding motherhood. Women with no children often experience either positive or negative pressure from family, friends, and colleagues regarding when to have children.ConclusionSeveral internal and external considerations influence when and if women become mothers. Social surroundings such as family, friends, and colleagues have an impact on women’s reproductive considerations in terms of pressure to have children in the future. Danish women tend to compare their reproductive capacity to their female relatives and compare the social norms surrounding motherhood to their female friends. Women in this study were positive towards discussing the timing of motherhood with other women of reproductive age on social media.

Increased DNMT1 acetylation leads to global DNA methylation suppression in follicular granulosa cells during reproductive aging in mammals

With increasing age, the reproductive performance of women and female animals declines. However, the molecular mechanisms underlying ovarian aging and age-related fertility decline remain unclear. Granulosa cells (GCs) are suspected to play an important role in reproductive aging, and their proliferation, apoptosis, and steroid hormone secretion are used to determine the fate of follicles and ovarian function. First, we found that the proliferative ability of GCs from the old mouse group (10-month-old) decreased compared with that from the young mouse group (6-week-old), and cell cycle arrest occurred in old mice. To investigate changes in protein modification, we compared the levels of protein acetylation in GCs from young and old mice. We found that the K1118, K1120, K1122, and K1124 sites of DNA methyltransferase 1 (DNMT1) were increasingly acetylated with age, resulting in a decrease in DNMT1 protein expression. Therefore, we performed whole-genome methylation sequencing of GCs in the two groups and found that the CG methylation levels in the old group were lower than those in the young group. Furthermore, the inhibition of DNMT1 expression in GCs resulted in cell cycle arrest. This study revealed the dynamics and importance of protein acetylation and DNA methylation in GCs during reproductive aging. The findings provide a theoretical basis for studying the mechanism of reproductive aging in mammals.

Elevated N-glycosylated cathepsin L impairs oocyte function and contributes to oocyte senescence during reproductive aging.

Age-related declines in oocyte quality and ovarian function are pivotal contributors to female subfertility in clinical settings. Yet, the mechanisms driving ovarian aging and oocyte senescence remain inadequately understood. The present study evaluated the alterations in N-glycoproteins associated with ovarian aging and noted a pronounced elevation in N221 glycopeptides of cathepsin L (Ctsl) in the ovaries of reproductive-aged mice (8-9 months and 11-12 months) compared to younger counterparts (6-8 weeks). Subsequent analysis examined the involvement of Ctsl in oocyte aging and demonstrated a significant elevation in Ctsl levels in aged oocytes. Further, it was revealed that the overexpression of Ctsl in young oocytes substantially diminished their quality, while oocytes expressing an N221-glycosylation mutant of Ctsl did not suffer similar quality degradation. This finding implies that the N221 glycosylation of Ctsl is pivotal in modulating its effect on oocyte health. The introduction of a Ctsl inhibitor into the culture medium restored oocyte quality in aged oocytes by enhancing mitochondrial function, reducing accumulated reactive oxygen species (ROS), lowering apoptosis, and recovering lysosome capacity. Furthermore, the targeted downregulation of Ctsl using siRNA microinjection in aged oocytes enhanced fertilization capability and blastocyst formation, affirming the role of Ctsl knockdown in fostering oocyte quality and embryonic developmental potential. In conclusion, these findings underscore the detrimental effects of high expression of N-glycosylated Ctsl on oocyte quality and its contribution to oocyte senescence, highlighting it as a potential therapeutic target to delay ovarian aging and enhance oocyte viability.

Understanding Behavioral Drivers of Iron and Folic Acid Supplementation and Vitamin A- and Iron-Rich Food Consumption among Women and Adolescent Girls in Niger.

This study examined drivers and barriers to iron and folic acid (IFA) supplementation and consumption of iron- and vitamin A-rich foods among women of reproductive age (WRA) and adolescent girls in Niger. This was an exploratory qualitative study using focus group discussions and semi-structured interviews. This study was conducted in the rural areas of three districts in Maradi and Zinder regions of southern Niger. The study included a purposive sample of 56 WRA (15-49 years), 34 non-pregnant adolescent girls (10-14 years), 105 family members and community leaders, 32 health workers, and 12 national and regional level stakeholders. Respondents demonstrated widespread knowledge of recommendations for IFA during pregnancy and had positive attitudes toward supplements. However, supply barriers were significant, and adherence was limited by side effects, among other constraints. Despite knowledge about and positive attitudes towards micronutrient source foods, respondents reported that limited food access was an overriding constraint to increasing consumption. WRA were seen as nutritionally vulnerable, however husbands were often not able to provide sufficient nutritious food and there was a cultural expectation that wives serve themselves food last. Adolescent girls were not seen as nutritionally vulnerable and there was little family support for their consumption of nutritious foods. Projects should work with local actors to develop multi-pronged solutions that address supply and access barriers for IFA and micronutrient-rich foods and to improve social support for nutrition.

Determining the relationship between gynecologic cancer awareness and health literacy among women of reproductive age: a descriptive study.

To determine the relationship between gynecologic cancer awareness and health literacy among women of reproductive age. This study was conducted in a descriptive design and involved 510 women. Data collection utilized the "Personal Information Form", "Gynecologic Cancer Awareness Scale (GCAS)" and "Health Literacy Scale (HLS)", gathered. Pearson correlation and linear regression analyses, independent samples t-test, one-way analysis of variance and post hoc analyses were employed for data analysis. Effect sizes were calculated using eta-squared (η2) coefficients. The mean total score of women on the GCAS was 154.42 ± 18.27, while the mean total score on the HLS was 57.07 ± 7.86. Significant differences were observed in women's GCAS total scores concerning age, perceived income status, and history of gynecological examination, whereas significant differences were noted in HLS total scores concerning age, educational status, marital status, and perceived income status. A weak positive correlation was detected betwixt women's GCAS and HLS total scores. It was determined that 20.8% of the total variation in gynecologic cancer awareness level was explained by health literacy. Women exhibit an above-average level of awareness regarding gynecologic cancers. Health literacy level contributes to an increase in gynecologic cancer awareness.

Impact of Dietary Patterns and Serum Amino Acid Profile on Metabolic Syndrome Development in Mexican Women with Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the main endocrine disorder in women of reproductive age worldwide. This condition is often associated with various metabolic alterations that contribute to the development of metabolic syndrome (MetS). Recent research suggests that branched-chain amino acid (BCAA) dysregulation is observed in PCOS. This study aims to investigate the relationship between dietary patterns, body composition, metabolic analytes, and serum amino acid levels in Mexican women with PCOS. Utilizing a cross-sectional design, we found that both study groups, PCOS (n = 24) and PCOS + MetS (n = 21), exhibited increased relative fat mass and dietary habits characterized by high simple sugar intake and low protein consumption, correlating with levels of relative fat mass and leptin. Notably, serum concentrations of BCAAs and glutamic acid were significantly elevated in the PCOS + MetS group. Our findings suggest that a metabolic approach may enhance the prediction and management of MetS in women with PCOS, highlighting the importance of dietary interventions in this population.

Management of Ovarian Cysts through Individualized Homoeopathic Medicine: A Case Series

AbstractOvarian cysts are common gynecological problems encountered by gynecologists in their day-to-day practice. They are benign growths arising from the ovary and occur in the reproductive age group. Conventional system of medicine usually opts for surgical procedures in such cases. Homoeopathic system of medicine is a specialized system that believes in individualization. This article reports five cases of suffering from ovarian cysts, who reported at Dr. D.P. Rastogi Central Research Institute, Noida, Uttar Pradesh, India. All the five cases were treated successfully with individualized homoeopathic medicines. Each patient received individualized homoeopathic medicine selected on the basis of the totality of symptoms using synthesis repertory with the help of RADAR software. Pre and post treatment ultrasongraphy USG reports were kept as evidence. The assessment of causal attribution of homeopathic treatment effect was performed using the Modified Naranjo Criteria for Homeopathy (MONARCH). Marked improvement was observed in all five cases, with complete resolution of the cysts along with symptomatic relief, which was evident by USG reports. The MONARCH scores were +9/13, +7/13, +8/13, +9/13, and +7/13, which indicate a positive causal attribution of homeopathy in relieving the symptoms. This case series suggests a significant role of individualized homeopathic medicines in the resolution of ovarian cysts and associated symptoms. The results obtained from this case series are encouraging.

Adaptation of the G-NORM (Gender norms scale) in Uganda: An examination of how gender norms are associated with reproductive health decision-making.

Restrictive gender norms exacerbate health inequalities all over the world. More specifically, they prevent women from seeking preventive health services, constrain women's economic empowerment, and are associated with reproductive health decision making. Gender norms, a subset of social norms, are dynamic and change over time. However, we lack data on how they are changing and how these changes affect health outcomes because current measures do not adequately capture the complex concept of gender norms. We originally developed and validated a gender norms scale, the G-NORM, in India. In this study, using cross-sectional data, we adapted the G-NORM from Southeast Asia (India and Nepal) to sub-Saharan Africa (Uganda) in four steps: 1. Formulation of new scale items (via qualitative analysis) 2. Cognitive Interviewing 3. Questionnaire Administration (n = 2422 women of reproductive age) and 4. Psychometric analysis (Confirmatory Factor Analysis). Like the original scale, descriptive norms and injunctive norms comprised two unique sub scales with high Cronbach's alphas (.80 & .92). Average scores differed depending on the type of norm suggesting that some gender norms are changing faster than others. Specifically, more equitable injunctive norms were associated with lower odds of partner-dominated contraceptive decision making but descriptive norms were not. Gender norms serve as a multi-faceted determinant of health and wellbeing and require measurement tools which account for their conceptual complexity. Validating the G-NORM in Uganda expands measurement options for researchers in the sub-Saharan African region working to change norms to reduce health inequalities or to understand the gender normative context before beginning a study.

MiR-193b-5p and miR-374b-5p Are Aberrantly Expressed in Endometriosis and Suppress Endometrial Cell Migration In Vitro

(1) Background: Endometriosis is a highly prevalent gynecological disease affecting 10% of women of reproductive age worldwide. miRNAs may play a role in endometriosis, though their exact function remains unclear. This study aimed to identify differentially expressed miRNAs in endometriosis and study their functions in the disease. (2) Methods: Endometrial tissue was collected from women with endometriosis (n = 15) and non-endometriosis controls (n = 17). Dysregulated miRNAs were identified through small RNA-sequencing, and their biological significance was explored by target gene prediction and pathway analysis. Selected miRNAs were examined in paired ectopic endometriomas and eutopic endometrium (n = 10) using qRT-PCR. Their roles in cell migration and proliferation were further examined in vitro using functional assays. To identify potential target genes, we performed mRNA sequencing on transfected cells and the endometrioma cohort. (3) Results: We identified 14 dysregulated miRNAs in the eutopic endometrium of women with endometriosis compared to endometrial tissue from women without endometriosis. Pathway analysis indicated enrichment in cell migration and proliferation-associated pathways. Further ex vivo studies of miR-193b-5p and miR-374b-5p showed that both miRNAs were upregulated in endometrioma. Overexpression of these two miRNAs in vitro inhibited cell migration, and mRNA sequencing revealed several migration-related genes that are targeted by these miRNAs. (4) Conclusions: Our study identified two key endometrial miRNAs that may be involved in the pathogenesis of endometriosis by regulating cell migration.

Evaluation of Body Composition Assessment Methods in Reproductive-Aged Iranian Women: A Cross-Sectional Study Between Body Mass Index (BMI) and Bioelectrical Impedance Analysis (BIA)

Background: Despite the introduction of modern scales for assessing physical health, "body mass index" (BMI) remains a foundational metric in many health assessments. Objectives: This community-based cross-sectional study aims to compare BMI with bioelectrical impedance analysis (BIA) in evaluating the physical health of Iranian women of reproductive age. Methods: A descriptive cross-sectional study was conducted on 182 Iranian women aged 30 - 45 years, selected through random sampling from the population served by selected urban health centers. The Omron BF511 bioelectrical impedance analysis device was used to measure BMI, skeletal muscle mass, total body fat, and visceral fat. A structured questionnaire was also administered to collect sociodemographic data. Results: The average BMI of the participants was 27.47 kg/m², with skeletal muscle mass comprising 24.98%, visceral fat averaging 6.93%, and total body fat at 40.04%. When comparing BMI with total body fat, 52% of cases were misclassified; with visceral fat percentage, 68% were misclassified; and with skeletal muscle mass percentage, 73% were misclassified. Misclassification was most pronounced among individuals with a normal BMI who were overweight or obese according to body fat percentage. Conclusions: This study highlights the critical need to reassess the use of BMI as an accurate health indicator for women of reproductive age. The researchers argue that reliance on BMI as a sole health metric is outdated, emphasizing the need for a comprehensive reevaluation of health assessment criteria for women in this demographic.

Expression of mRNA-TLR-5 Gene in Patients with Endometriosis using Real-time PCR in Tehran, Iran.

Endometriosis is one of the common diseases of women, especially in reproductive age, and it is one of the most important causes of infertility in women. The aim of this study was to investigate the level of mRNA-TLR-5 expression in women with endometriosis. The present study was performed in Nikan Hospital, Tehran, Iran, in 2021. The samples of endometrial mucosa for the eutopic group and an ovarian endometriotic cyst for the ectopic group were obtained from the patients who underwent laparoscopic surgery at the Fetal Infertility Center and were diagnosed with endometriosis. Normal endometrial samples were also obtained from patients who had no history of infertility and underwent laparoscopic TL surgery for reasons other than endometriosis such as ovarian cysts (control group). After RNA extraction and cDNA synthesis, TLR-5 gene expression was evaluated by the Real-Time PCR method. Based on the results of the comparison of TLR-5 gene expression in all three ectopic, eutopic endometrium, and control groups by Real-Time PCR, it was found that the TLR-5 gene expression is significantly higher in ectopic samples than in the other two groups, but there is a significant difference between two utopic and control groups. The increase in TLR-5 expression in the ectopic group can probably be a reason for reducing the apoptosis of cells entered into the peritoneal cavity and creating an environment for the survival and proliferation of these cells.