Factors In Women Research Articles

Emotionally Unstable Personality Disorder and Severity of Suicide Attempt are related to Epigenetic Hypermethylation of Brain-Derived Neurotrophic Factor in Women

IntroductionBrain-derived neurotrophic factor (BDNF) has been associated with both emotionally unstable personality disorder (EUPD) and suicidal behavior. No study has yet investigated BDNF-associated epigenetic alterations in severely impaired EUPD and suicidal patients.ObjectivesThe main goal of the present study was to investigate whether epigenetic dysregulation in BDNF, CRP, IL-1, IL-2 and IL-6 were associated with EUPD and severity of suicidal behavior.MethodsThe discovery cohort consisted of 97 women with emotionally unstable personality disorder (EUPD) with at least two serious suicide attempts (SA) and 32 healthy women. The genome-wide methylation pattern was measured by the Illumina EPIC BeadChip and analyzed by robust linear regression models to investigate mean BDNF methylation levels in a targeted analysis conditioned upon severity of suicide attempt. The validation cohort consisted of 60 female suicide attempters, stratified into low- (n=45)and high-risk groups (n=15) based on degree of intent-to-die and lethality of suicide attempt method, and occurrence of death-by-suicide at follow-up.ResultsMean BDNF methylation levels exhibited hypermethylation in relation to EUPD(p=0.0343, percentage mean group difference ~3.8%). Similarly, this locus was confirmed as hypermethylated in an independent cohort of women with severe suicidal behavior (p=0.0469). Results were independent of age and BMI.ConclusionsThis study elicits emerging evidence of epigenetic dysregulation of BDNF in relation to phenotypes known to increase risk of suicide (lethality of suicide-attempt method and presence of EUPD diagnosis with history of recent SA). Further studies investigating epigenetic and genetic effects of BDNF on severe suicidal behavior and EUPD are needed to elucidate the role of epigenetic regulatory mechanisms and neurotrophic factors in relation to suicide risk.Disclosure of InterestNone Declared

Abstract P558: Association of Reproductive Characteristics With Cardiometabolic Risk Factors in Women in India an Analysis of Nationally Representative Data

Introduction: In addition to established risk factors for cardiovascular disease, women have unique biological characteristics related to reproduction that may further contribute to their CV risk. Among South Asian Indians, this aspect has been understudied. This study addresses this gap by evaluating the relationship between reproductive characteristics and cardiometabolic risk factors (CMRF) among women in India. Methods: We analyzed data from a community-based nationally representative sample of women aged 15-49 in the National Family Health Survey-5 (N= 724,115). Primary exposures (self-reported) included age at union and first delivery, use of contraception and history of pregnancy loss. Study outcomes (self-reported, objectively measured) were prevalent hypertension (HTN), diabetes mellitus (DM) and obesity. We estimated the association between each exposure and outcome using survey-weighted multivariable Poisson regression models adjusted for age, religion, caste, location, education and employment. Results: Prevalence (95% CI) of HTN (measured blood pressure of >=140/90 mm Hg), DM (self-reported or on medications to lower blood glucose levels) and obesity (body mass index > 25kg/m 2 ) was 25.8 (25.5, 26.2)%, 1.9 (1.8, 1.9)% and 24 (23.8, 24.2)%, respectively. Younger age at union and first delivery and, use of contraception [PR (95% CI): 1.13 (1.11, 1.16)] were associated with higher obesity. Pregnancy loss (due to miscarriage or abortion) was associated with higher prevalent DM [PR (95% CI): 1.21 (1.03, 1.41)] and obesity [PR (95% CI): 1.26 (1.22, 1.31)] ( Table ). Conclusion: Reproductive characteristics (age at union and first delivery, and pregnancy loss) are linked to higher prevalence of CMRF. These results provide impetus for screening for reproductive history and its inclusion in risk prediction algorithms for cardiovascular risk among Indian women. Table: Cross-sectional associations between reproductive characteristics with cardiometabolic risk factors, in the NFHS-5 (N= 724,115)

The Hypertriglyceridemic Waist Phenotype Is Associated with Several Cardiovascular Risk Factors in Women with Rheumatoid Arthritis.

To evaluate the association of HTWP with CVRF in RA. Cross-sectional study. Women (125) with RA were included (ACR, 1987). Anthropometry, bioimpedance, body mass index (BMI), disease activity score 28 (DAS28), and health assessment questionnaire disability index (HAQ-Di) were determined. The lipid profile determination includes the atherogenic index (AI) (TC/HDL) and Framingham Risk Score. HTWP is defined as a waist circumference ≥88 cm and triglycerides ≥ 150 mg/dL. Chi-squared and Student's t-tests were applied for comparisons. HTWP was found in 38 (30.4%) patients. The subgroup with HTWP had a greater frequency of arterial hypertension (AHT) (57.9 vs. 37.9, p = 0.04), Type 2 DM (23.7 vs. 8.0, p= 0.02), BMI (29.7 ± 3.2, vs. 26.8 ± 4.3, p < 0.001), fat mass (39.3 ± 4.8 vs. 34.7 ± 6.8, p < 0.001), and AI (4.7 ± 1.2 vs. 3.7 ± 1.0, p < 0.001). No differences between DAS28 and HAQ-Di were found. HTWP was associated with the presence of MetS and CVR (p < 0.001 and p = 0.012, respectively). The HTWP in RA is associated with CVRF, and its potential predictive role should be evaluated in longitudinal studies.

Reproductive Health Literacy and its Related Factors in Women of Reproductive Age Referring to Comprehensive Healthcare Centers in Chabahar in 2021

Background: Reproductive health literacy plays a vital role in the health of women as one of the vulnerable groups in the community. Therefore, the present study aimed to investigate reproductive health literacy and its related factors in women of reproductive age referring to comprehensive healthcare centers in Chabahar in 2021. Methods: This cross-sectional study was conducted on women of reproductive age referring to comprehensive urban and rural healthcare centers in Chabahar. The participants were 220 women who were selected using convenience sampling. The data were collected using the Reproductive Health Literacy Scale and analyzed via SPSS software (version 22). Results: The mean score of reproductive health literacy was significantly lower in the women aged 15-24 years, those with lower education, women in rural areas, and housewives. The mean score of reproductive health literacy was significantly different among the women in terms of socioeconomic status (P=0.12). The results of multiple linear regression analysis indicated that the age group and education could significantly predict the women’s overall reproductive health literacy. Conclusion: Following the findings of this study, effective interventions need to be incorporated into national women’s health programs to improve reproductive health literacy in women with lower age and primary education, women living in villages, and housewives

Sexual Dysfunction and Associated Factors in Women with Psoriasis.

Psoriasis, a chronic inflammatory skin disease, may negatively affect sexual function; however, data on the sexual health of female patients with psoriasis in Vietnam are lacking. To assess the risk of sexual dysfunction (SD) and its associated factors in female patients with psoriasis who visited the Ho Chi Minh City Hospital of Dermato-Venereology from April 2020 to October 2020. Cross-sectional study. A total of 302 female patients with psoriasis aged 18 to 49 years were recruited. The Female Sexual Function Index (FSFI) was used to assess the risk of SD (cut-off value at 26). The risk of SD accounted for 79.1% of the study population and was not associated with age, comorbidities, weight, or trigger factors. Urban dwellers had greater odds of SD risk than non-urban dwellers (OR = 2.63). Similar trends were observed in terms of higher education than grade 12, less than once a week of physical activities, and psychological stress as a trigger factor (OR = 1.89, 2.65, and 3.41, respectively). Female psoriasis patients with SD risk had a lower age of onset and higher weight, BMI, waist circumference, and PASI than patients who did not (P < 0.05). Psychological stress and high PASI were independent risk factors of SD risk in female patients with psoriasis (P < 0.05). Factors with negative impacts on psoriasis may also increase the risk of SD in female patients; among these factors, psychological stress and high PASI were the strongest predictors of SD in female patients with psoriasis.

Model Selection and Identification of Osteoporosis Risk Factors in Women to Improve Their Healthcare.

Osteoporosis is characterized by low bone mineral density leading to enhanced bone fragility and a consequent increase in fracture risk. The focus of this case-control study was to identify significant socioeconomic risk factors of osteoporosis in Pakistani women and examine how the risk increases for different levels of risk factors. A case-control study was conducted from November 2018 to August 2019 in two main hospitals in Faisalabad, Pakistan. Multiple logistic regression was used to explore the significant risk factors of osteoporosis and how the risk increases in cases (cases = 120) as compared to the control group (controls = 120) in the presence of these risk factors. The mean age ± standard deviation for cases and controls was 59.62 ± 10.75 and 54.27 ± 10.09, respectively. The minimum and maximum ages were 36 and 80 years, respectively. In addition to age, bone fracture, family history, regular physical activity, family size, use of meat, type of birth, breastfeeding, premature menopause, loss of appetite, and use of anticoagulants were significant risk factors with p-values less than 0.05. The risk prediction model with significant risk factors was a good fit with a p-value of 0.28, corresponding to the Hosmer-Lemeshow test value (χ2 = 9.78). This parsimonious model with Cox-Snell R2 = 0.50 (with a maximum value = 0.75) and Nagelkerke R2 = 0.66 showed an AUC of 0.924 as compared to the full model with all risk factors under study that exhibited an AUC of 0.949.

Gender Inequality at Work as a Factor of Women&amp;apos;s Career Success

The research is devoted to the problem of studying mechanisms of influence of gender inequality on career success of working women. The aim of the study is to find the connection between manifestations of gender inequality and resources available for development in the workplace and the career success of a woman. A socio-psychological model of success factors for working women was developed, including both the organizational environment and career resources for predicting success. The study was conducted in two phases in 2020–2021 using an online survey on a sample of women working in organizations in different fields. In the first phase (206 women aged 19 to 62), the relationships of the individual constructs of the model were tested; in the second phase (781 women aged 18 to 82), the socio-psychological model was tested by structural modelling (SEM). The results of the study confirm a positive relationship of women&amp;apos;s career success with the availability of organizational resources (R=0.56, p

Type 2 Diabetes in Women: Differences and Difficulties.

Lifestyle modification, along with medication, has improved the quality of life of patients with type 2 diabetes (T2D), but the treatment of diabetes in women still lacks a gender-centric approach. Expert opinions to improve diabetes management in women were collated from the open discussion forum organized by the sixth Jothydev's Professional Education Forum Diabetes Convention, which included global diabetes care experts and the general public. The review is also based on the studies published in electronic databases such as PubMed and Google Scholar that discussed the problems and challenges faced by the Indian diabetes care sector in treating women with diabetes. The complex interplay of biological, socioeconomic, psychosocial, and physiological factors in women with type 2 diabetes has not been well addressed to date. Biological factors such as neurohumoral pathways, sex hormones, genetic predisposition as well as gender-based environmental and behavioural differences must be considered for modern personalized diabetes treatment. Most importantly, pregnant women with diabetes deserve special attention. This vulnerable phase has a marked impact on the future health of both the mother and the offspring. The review provides an overview of the challenges and issues that exist in the clinical management of diabetes and its complications among women in India. Women-centric clinical approaches should be encouraged for the effective management of diabetes in Indian women.

Epidemiological Studies of Polyparasitism and Gender Associated Factors in Women in Igede Land

Introduction: Polyparasitism remains one of the most pressing public health problems with one third of the world population generally estimated to be infected. Also, Women are particularly of concern due to their gender roles which is sensitive since iil health and/or the illness of family members generally represent greater burdens for poor women in comparison to poor men.&#x0D; Aim: To epidemiologically study polyparasitism in Women of Reproductive age in Igede land of Benue State, Nigeria.&#x0D; Study Design: A cross-sectional study design was adopted for this study. Fresh stool, urine and blood samples were collected from women in Igede Land of Benue State and processed for internal parasites, urine parasites and malaria parasite respectively from September 2019 to August, 2021 using systematic random sampling technique. The study was restricted to women of reproductive age in Igedeland only. Well-structured questionnaires were further utilized to elicit information on associated factors related to polyparasitism. Positive samples were afterwards processed molecularly using PCR technology and the results documented. Data obtained was analysed using SPSS and comparative analysis was done using chi-square statistical tool.&#x0D; Results: The overall rate of polyparasitism is this study was 3.50% while a prevalence of 33.50% was recorded for single parasitic infection. The dominant parasite was Plasmodium spp. (52.16%) while the least was Strongyloides stercoralis (1.44%). Parasite combination involving Schistosoma haematobium and Malaria parasite recorded highest prevalence (36.11%) while least prevalence was recorded for coinfection with Hookworm, Entamoeba histolytica and Asccaris lumbricoides. (8.33%). Also, associated factors of excretion and water source were significant (P&lt;0.05) while meat consumption and sanitation were not significant P&gt;0.05).&#x0D; Conclusion: Polyparasitism among women in Igedeland of Benue State is relatively low with malaria parasite being the most dominant parasite.&#x0D; Recommendations: Awareness on polyparasitism should be increased among women and antihelminthic and antimalarial drugs should be distributed free of charge to women so as to help reduce the burden of parasite infection in the study area.

Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders.

There has been limited studies examining treatment-induced heavy menstrual bleeding (HMB) in women with severe mental illnesses. The aim of this study was to examine HMB prevalence and HMB-associated factors in young women (18–34 years old) diagnosed with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia (SCZ) who have full insight and normal intelligence. Eighteen-month menstruation histories were recorded with pictorial blood loss assessment chart assessments of HMB. Multivariate analyses were conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Drug effects on cognition were assessed with the MATRICS Consensus Cognitive Battery (MCCB). HMB prevalence were: BP, 25.85%; MDD, 18.78%; and SCH, 13.7%. High glycosylated hemoglobin (HbA1c) level was a strong risk factor for HMB [BP OR, 19.39 (16.60–23.01); MDD OR, 2.69 (4.59–13.78); and SCZ OR, 9.59 (6.14–12.43)]. Additional risk factors included fasting blood sugar, 2-h postprandial blood glucose, and use of the medication valproate [BP: OR, 16.00 (95%CI 12.74–20.22); MDD: OR, 13.88 (95%CI 11.24–17.03); and SCZ OR, 11.35 (95%CI 8.84–19.20)]. Antipsychotic, antidepressant, and electroconvulsive therapy use were minor risk factors. Pharmacotherapy-induced visual learning impairment was associated with HMB [BP: OR, 9.01 (95%CI 3.15–13.44); MDD: OR, 5.99 (95%CI 3.11–9.00); and SCZ: OR, 7.09 (95%CI 2.99–9.20)]. Lithium emerged as a protective factor against HMB [BP: OR, 0.22 (95%CI 0.14–0.40); MDD: OR, 0.30 (95%CI 0.20–0.62); and SCZ: OR, 0.65 (95%CI 0.33–0.90)]. In SCZ patients, hyperlipidemia and high total cholesterol were HMB-associated factors (ORs, 1.87–2.22). Psychiatrist awareness of HMB risk is concerningly low (12/257, 2.28%). In conclusion, prescription of VPA should be cautioned for women with mental illness, especially BP, and lithium may be protective against HMB.

Parathyroid Hormone-25(OH)D and Calcium-Phosphorus Ratio as Osteopenia Risk Factors in Women with Central Obesity

BACKGROUND: Central obesity has a close association with inflammation and the state of bone mass. Osteopenia is an abnormal condition of bone density. Bone mass density is influenced by several factors, such as 25(OH)D, parathyroid hormone (PTH), calcium (Ca) and phosphorus (P). The aim of this study was to evaluate the role of PTH-25(OH)D and Ca-P ratio as risk factors for osteopenia in women with central obesity.METHODS: A cross-sectional study was conducted in September 2020 to March 2021. The total subjects were 130 women aged 25-50 years old with central obesity. The diagnosis of osteopenia was done using dual X-ray absorptiometry (DXA) to measure bone mineral density. Enzyme linked fluorescent assay (ELFA) method was done to measure PTH and 25(OH)D levels, ion selective electrode method to measure Ca, and photometer method to measure P level. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value and calculated prevalence ratio (PR) for osteopenia risks, followed by logistic regression analysis.RESULTS: The PR of PTH level was 10.18 (95% CI: 1.15–5.85; p=0.01); the PTH-25(OH)D ratio was 5.12 (95% CI: 1.13–23.19; p=0.04); Ca level was 6.0 (95% CI: 1.33–27.14; p=0.02) and Ca-P ratio was 4.89 (95%CI: 1.33–17.97; p=0.02). The PR for PTH together with Ca level was 18.71 (95% CI: 2.17–160.40; p=0.008).CONCLUSION: The PTH-25(OH)D ratio and the Ca-P ratio are risk factors for the incidence of osteopenia in women with central obesity. A high PTH-25(OH)D ratio and a high Ca-P ratio would have a higher risk of developing osteopenia in this population.KEYWORDS: CRP, PTH-25(OH)D, Ca-P, osteopenia, central obesity, women

Mental Health Challenges and the Associated Factors in Women Living with HIV Who Have Children Living with HIV in Indonesia: A Qualitative Study.

Women living with HIV (WLHIV) are vulnerable to various mental health challenges. However, there is a paucity of studies globally and in the Indonesian context that have specifically explored mental health challenges among mothers living with HIV who also have children living with HIV (CLHIV). This qualitative study explored mental health challenges and the associated factors in mothers living with HIV who have CLHIV in Yogyakarta, Indonesia. In-depth interviews were employed to collect data from the participants (N = 23) who were recruited using the snowball sampling technique. A qualitative data analysis framework was used to guide the analysis of the findings. The findings showed that the mothers experienced a range of mental health issues due to their own, and their child’s diagnoses of stress, depression, anxiety, fear, sadness, and guilt. Lack of knowledge about HIV, fear of death, shame, not knowing whom to talk with and what to do after their own HIV diagnosis, and the HIV diagnosis of their children were factors that challenged their mental health. Difficulties in dealing with daily life or social activities of their CLHIV, dilemmas in addressing questions and complaints of their CLHIV about HIV treatment, and concerns about the health condition of their CLHIV and how their children cope with any potential negative social impacts also impacted the mothers’ mental health. Social factors such as unsympathetic expressions from friends towards them and their CLHIV and negatively worded religious-related advice from parents and relatives also contributed to their poor mental health. Our findings indicate the need for intervention programs that support mothers living with HIV and their CLHIV. Future large-scale studies involving mothers living with HIV who have CLHIV in Indonesia and other settings globally are needed to obtain a comprehensive understanding of mental health challenges and the associated factors they face.

Knowledge on Obstetric Fistula and Related factors in Women of Reproductive age in the Southeastern Zone of Tigray, Ethiopia, 2020, Crosses sectional Study

Background: Around one million girls and women worldwide are currently living with fistula. Fewer than 20,000 women are treated with obstetric fistula each year. Lack of Knowledgeon obstetric fistula is a common obstacle to seeking fistula treatment. Objectives: To determine knowledge on obstetric fistula and its associated factors among reproductive age women in south eastern zone of Tigray, 2020. Methods:A cross-sectional community-based Study was conducted in the southeastern zone of Tigray. A multilevel sampling technique was implemented to select the total number of participants. Two districts were randomly selected and from these districts 14 kebels were randomly selected and the calculated sample size (605) was allocated proportionally to each selected kebele. Data were collected in face-to-face interview using a structured questionnaire from February 26th to March 24th, 2020 after ensuring that all ethical requirements were met. The collected data were entered into Epidata version 4.2 and then exported to SPSS version 20 for analysis. Bivariate and multivariate analyzes were used to examine the relationship. Odds ratios with 95% confidence intervals and P values &lt; 0.05 were used to determine statistical association. Result:Overall, about 42.15% of the respondents had a good knowledge of obstetric fistulas. The frequently mentioned risk factors, symptoms and preventive mechanisms of obstetric fistulas were female genital mutilation (78.7%), urinary incontinence (77.5%) and avoidance of early marriage and pregnancy (79.8%).The major determinant factors identified to knowledge on obstetric fistula were, level of education(above secondary) [AOR (95%CI=2.7(1.189-6.24)], having history of modern family planning use [AOR (95%CI=2.22(1.14-4.34)], institutional delivery (for the index child)[AOR (95%CI=2.3(1.1-4.99)] and prior information about obstetric fistula[AOR (95%CI=6.1(2.65-14.1)]. Conclusion:In this study majority of reproductive age women in the study area had poor Knowledge regarding obstetric fistula. Several interventions like health education and information should be implemented to enhance the Knowledge of the community towards obstetric fistula.

A Study of Influencing Factors of Women’s Preference towards Retail Formats in Grocery Segments

In India, one of the major ways of generation of revenue, generation of employment, increased turnover and many other growth factors is retail trade. The Indian retail industry has appeared as one of the fast-paced industries due to the entry of various players. Retail industries books over 10 % of the country’s Gross Domestic Product (GDP) and around 8 % of the employment. Thus, the main objective of this paper is to study the influencing factors like Time Saving, Convenience and Credit Facility of Women’s preference towards retail outlets in Grocery Segments. The research is mainly focused on primary data which were collected from respondents through well structured questionnaire. The outcomes of this study are helpful to the various women and their preference towards retail formats in both organized and unorganized outlets, researchers and academicians who are working this field.

A Prebiotic Hydrogel to Prevent Cervical Cancer by Optimizing the Vaginal Ecology and Reducing Oncogenic Biological Risk Factors in Women Across Global Health Care Access

PURPOSE Persistent oncogenic, high-risk human papillomavirus (hrHPV) is a leading cause of cervical cancer and driven by vaginal dysbiosis and mucosal irritation. There is a high need for a product to optimize vaginal ecology and decrease biological risk factors of hrHPV persistence and cervical cancer. METHODS A prebiotic hydrogel (PreBioGyn) was designed for cervical cancer prevention to support the cervicovaginal ecology and anti-viral function. PreBioGyn was compared to over-the-counter (OTC) acidifying vaginal gels RepHresh and Trimosan for impact on: (1) in-vitro growth of L. crispatus—a Lactobacillus essential for the healthy vaginal biome; (2) inhibition of P. bivia—a pathobiont characteristic of vaginal dysbiosis and directly linked to hrHPV reactivation and cervical cancer spread; (3) mucosal irritation potential measured as daily mucus production by slugs (Arion lusitanicus) after 5-day intermittent product exposure; and (4) osmolality and mucoadhesion essential for compatibility with the cervicovaginal mucosal barrier (ability of gel to interdigitate with mucins in vivo). RESULTS Exposure to PreBioGyn for 24 hours completely suppressed P. bivia while sustaining L. crispatus growth which was recovered at 100 ± 1%. Trimosan was bactericidal to L. crispatus within 4 hours incubation and RepHresh within 24 hours of incubation. The mucosal irritation potential of PreBioGyn equaled negative controls, whereas the OTC acidifying-gels resulted in greater irritation potential with &gt; 2-fold mucus production versus the control ( P &lt; .05). The PreBioGyn formula was iso-osmotic to the human vagina (280 mOsmo/kg), while RepHresh was hyper- (1,400 mOsmo/kg) and Trimosan - hypoosmotic (81 mOsmo/kg). The mucoadhesion index of PreBioGyn (10 ± 2.0) was higher ( P &lt; .05) than that of RepHresh (1 ± 0.2) and Trimosan (1 ± 0.3). CONCLUSION Our results provide preclinical evidence for the biocompatibility and safety of the Pre-BioGyn gel. The prebiotic PreBioGyn vaginal gel improved microbiota parameters essential for cervical cancer prevention, compared to leading OTC acidifying-gels. PreBioGyn may offer a simple, affordable user-directed cervical cancer prevention intervention.

Endometrial Dysbiosis Is Related to Inflammatory Factors in Women with Repeated Implantation Failure: A Pilot Study.

An abnormal endometrial microbiota has been suggested to impair the process of embryo implantation, thus leading to repeated implantation failure (RIF) in women undergoing in vitro fertilization (IVF). However, the molecular mechanisms linking uterine microbiota and IVF out-comes are still an open question. The aim of this cohort study was to outline the relationship between endometrial microbiota, inflammation and IVF outcomes. To this purpose, endometrial microbiota and selected components of the “cytokine network” were analyzed in women presenting RIF and divided between eubiosis and dysbiosis groups, according to the percentage of endometrial lactobacilli (≥90% or <90%, respectively). The Dysbiosis group presented significantly higher tissue concentrations of the inflammatory markers (IL-6, IL-1β, HIF-1α and COX-2) and significantly lower levels of the anti-inflammatory/well-being factors, IL-10 and IGF-1, with respect to women with eubiosis. Moreover, the Lactobacillus percentage was negatively related to the concentrations of the inflammatory molecules and positively related to IL-10/IGF-1. Interestingly, the number of IVF attempts was directly related to the levels of the inflammatory factors COX-2, IL-1β and HIF-1α in the eubiosis group. Overall, endometrial dysbiosis was demonstrated to be associated with inflammation-related endometrial changes affecting the process of embryo implantation, underlining the importance of assessing uterine microbiota in patients undergoing IVF.

Relationship between Health Literacy and Marital and Sexual Satisfaction and Some Demographic Factors in Women Referring to Health Centers in Ardabil in 2019

Relationship between Health Literacy and Marital and Sexual Satisfaction and Some Demographic Factors in Women Referring to Health Centers in Ardabil in 2019

Adverse Events (AEs) After Left Ventricular Assist Device (LVAD) Implantation and Associated Psychosocial Risk Factors in Women

<h3>Purpose</h3> Reasons for women's increased probability to experience AEs after LVAD implantation compared to men remain uncertain. The present analysis examined pre-implant psychosocial risk factors focusing on women. <h3>Methods</h3> We analyzed AEs in 19,984 patients (21.3% women), who received a primary continuous-flow LVAD between 7/2006 and 12/2017 and were enrolled in the INTERMACS. AEs considered were infection, neurological dysfunction, rehospitalization, respiratory failure, bleeding, device malfunction/ pump thrombosis, renal dysfunction and cardiac arrhythmia. Cumulative incidence functions were calculated for each AE including the competing outcomes death, heart transplant and device explant due to recovery. Event-specific Cox proportional hazard models were run, controlling for device-related factors, medical parameters, age and psychosocial factors (e.g., substance abuse, limited social support, severe depression, other major psychiatric diagnosis). <h3>Results</h3> Women were more likely than men to experience six out of the eight AEs. After 1 year, differences in women's and men's probability for AEs were most apparent for infection (44.4% in women vs. 39.2% in men, <i>p</i> < .001), neurological dysfunction (19.8% vs. 16.1%, <i>p</i> < .001) and rehospitalization (72.1% vs. 68.9%, <i>p</i> = .002). After multivariable adjustments, in women an increased rate of infection was associated with obesity and younger age. Rehospitalization was associated with major psychiatric diagnosis, smoking history, and younger age. Neurological dysfunction was associated with history of alcohol abuse [all HRs between 1.01 and 1.60, all <i>p</i> < .05]. <h3>Conclusion</h3> Women were more likely than men to experience AEs. We confirm previous findings by using an adequate competing risks approach for each AE separately. Each AE was specifically and independently associated with psychosocial factors. Substance abuse and younger age appear to be of particular relevance. These findings underline the importance of promoting: 1.) gender-sensitive research to shed more light on women's enhanced risk for AEs; 2.) rigorous assessment of psychosocial risk factors before LVAD implant. This is warranted to improve clinical practice for women.

Postpartum Levothyroxine Adjustment and Its Impact Factors in Women With Hypothyroidism in Pregnancy

ObjectiveWomen with hypothyroidism need to increase exogenous thyroid hormone levels during pregnancy to reduce adverse outcomes. Few studies have reported the effect of gestational levothyroxine (LT4) variations on postpartum LT4 treatment. MethodsWomen were classified as having subclinical hypothyroidism (SCH) (n = 101), overt hypothyroidism (OH) caused by autoimmune thyroiditis (AIT-OH), OH following thyroidectomy for benign thyroid disease (BA-OH) (n = 66), and OH after surgery for papillary thyroid cancer (PTC-OH) (n = 46). Thyroid function was monitored, and LT4 therapy was adjusted accordingly. ResultsAfter delivery, all women with SCH stopped LT4 treatment, and 57.4% of them restarted LT4 treatment in the following 1 year, independently of the gestational LT4 variations. Among patients with OH, after adjusted by gestational body weight, 49.1% of them had LT4 doses less than the prepregnancy dose (baseline) in late pregnancy, leading to LT4 reduction in postpartum. The LT4 dose was reduced to approximately 50% baseline for women with AIT-OH and BA-OH and reduced by 27% for women with PTC-OH. The reduction reasons for AIT-OH and BA-OH were thyroid-stimulating hormone levels of <2.5 mU/L during pregnancy and postpartum thyrotoxicosis occurrence (39.4%), and for PTC-OH, the reason was thyroid-stimulating hormone overinhibition (<1.0 mU/L) before delivery. ConclusionFor patients with SCH, postpartum LT4 treatment could initially be suspended. For women with OH, if the LT4 dose in late pregnancy was less than baseline, a prepregnancy dose reduced by 50%, 50%, and 27% should be applied after delivery for women with AIT-OH, BA-OH, and PTC-OH, respectively.

Examining the Dynamic Nature of Anterior Cruciate Ligament Injury Risk Factors in Women's Collegiate Soccer.

Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women's soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Prospective cohort study. Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women's soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10weeks of a competitive soccer season. Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women's collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.