Asian Women Research Articles

Asian facial recontouring surgery

Most East Asian women prefer a smaller and smoother facial contour. To meet this aesthetic preference, the concept and surgical techniques of modern facial bone contouring surgery have evolved. Initially, facial bone contouring surgery was limited to procedures like mandibular angle and malar reductions. However, contemporary Asian facial bone contouring surgery now places a stronger emphasis on addressing the entire facial profile from a three-dimensional perspective, a concept referred to as Profiloplasty. In this article, we review the evolution of surgical techniques in Asian facial bone contouring surgery and present its current surgical concepts, particularly focusing on the three-dimensional aspects.

Factors Associated with Longitudinal Changes in Mammographic Density in a Multiethnic Breast Screening Cohort of Postmenopausal Women.

Breast density is an important risk factor for breast cancer and is known to be associated with characteristics such as age, race, and hormone levels; however, it is unclear what factors contribute to changes in breast density in postmenopausal women over time. Understanding factors associated with density changes may enable a better understanding of breast cancer risk and facilitate potential strategies for prevention. This study investigated potential associations between personal factors and changes in mammographic density in a cohort of 3,392 postmenopausal women with no personal history of breast cancer between 2011 and 2017. Self-reported information on demographics, breast and reproductive history, and lifestyle factors, including body mass index (BMI), alcohol intake, smoking, and physical activity, was collected by an electronic intake form, and breast imaging reporting and database system (BI-RADS) mammographic density scores were obtained from electronic medical records. Factors associated with a longitudinal increase or decrease in mammographic density were identified using Fisher's exact test and multivariate conditional logistic regression. 7.9% of women exhibited a longitudinal decrease in mammographic density, 6.7% exhibited an increase, and 85.4% exhibited no change. Longitudinal changes in mammographic density were correlated with age, race/ethnicity, and age at menopause in the univariate analysis. In the multivariate analysis, Asian women were more likely to exhibit a longitudinal increase in mammographic density and less likely to exhibit a decrease compared to White women. On the other hand, obese women were less likely to exhibit an increase and more likely to exhibit a decrease compared to normal weight women. Women who underwent menopause at age 55 years or older were less likely to exhibit a decrease in mammographic density compared to women who underwent menopause at a younger age. Besides obesity, lifestyle factors (alcohol intake, smoking, and physical activity) were not associated with longitudinal changes in mammographic density. The associations we observed between Asian race/obesity and longitudinal changes in BI-RADS density in postmenopausal women are paradoxical in that breast cancer risk is lower in Asian women and higher in obese women. However, the association between later age at menopause and a decreased likelihood of decreasing in BI-RADS density over time is consistent with later age at menopause being a risk factor for breast cancer and suggests a potential relationship between greater cumulative lifetime estrogen exposure and relative stability in breast density after menopause. Our findings support the complexity of the relationships between breast density, BMI, hormone exposure, and breast cancer risk.

Development and evaluation of a polygenic risk score for lung cancer in never-smoking women: A large-scale prospective Chinese cohort study.

The proportion of lung cancer in never smokers is rising, especially among Asian women, but there is no effective early detection tool. Here, we developed a polygenic risk score (PRS), which may help to identify the population with higher risk of lung cancer in never-smoking women. We first performed a large GWAS meta-analysis (8595 cases and 8275 controls) to systematically identify the susceptibility loci for lung cancer in never-smoking Asian women and then generated a PRS using GWAS datasets. Furthermore, we evaluated the utility and effectiveness of PRS in an independent Chinese prospective cohort comprising 55 266 individuals. The GWAS meta-analysis identified eight known loci and a novel locus (5q11.2) at the genome-wide statistical significance level of P < 5 × 10-8 . Based on the summary statistics of GWAS, we derived a polygenic risk score including 21 variants (PRS-21) for lung cancer in never-smoking women. Furthermore, PRS-21 had a hazard ratio (HR) per SD of 1.29 (95% CI = 1.18-1.41) in the prospective cohort. Compared with participants who had a low genetic risk, those with an intermediate (HR = 1.32, 95% CI: 1.00-1.72) and high (HR = 2.09, 95% CI: 1.56-2.80) genetic risk had a significantly higher risk of incident lung cancer. The addition of PRS-21 to the conventional risk model yielded a modest significant improvement in AUC (0.697 to 0.711) and net reclassification improvement (24.2%). The GWAS-derived PRS-21 significantly improves the risk stratification and prediction accuracy for incident lung cancer in never-smoking Asian women, demonstrating the potential for identification of high-risk individuals and early screening.

Inequities in colorectal and breast cancer screening: At the intersection of race/ethnicity, sexuality, and gender

ObjectiveTo investigate the joint impact of sexual orientation, gender identity, and race/ethnicity on colorectal and breast cancer screening disparities in the United States. MethodsUtilizing sampling weighted data from the 2016 and 2018 Behavioral Risk Factor Surveillance System, we assessed differences in two metrics via chi-square statistics: 1) lifetime uptake, and 2) up-to-date colorectal and breast cancer screening by sexual orientation and gender identity, within and across racial/ethnic classifications. ResultsWithin specific races/ethnicities, lifetime CRC screening was higher among gay/lesbian (within NH-White, Hispanic, and Asian/Pacific Islander) and bisexual individuals (Hispanic) compared to straight individuals, and lowest overall among transgender women and transgender nonconforming populations (p < 0.05). Asian transgender women had the lowest lifetime CRC screening (13.0%; w.n. = 1,428). Lifetime breast cancer screening was lowest among the Hispanic bisexual population (86.6%; w.n. = 26,940) and Hispanic transgender nonconforming population (71.8%; w.n. = 739); within all races, SGM individuals (except NH-White, Hispanic, and Black bisexual populations, and NH-White transgender men) had greater breast cancer screening adherence compared to straight individuals. ConclusionsDue to small, unweighted sample sizes, results should be interpreted with caution. Heterogeneity in screening participation by SGM status within and across racial/ethnic groups were observed, revealing the need to disaggregate data to account for intersecting identities and for studies with larger sample sizes to increase estimate reliability.

Black and Asian women faculty: a reader’s theater highlighting their experiences across three Hispanic-Serving Institutions

The counterstories of Black and Asian women faculty across three Hispanic-Serving Institutions (HSIs) as interpreted through Critical Race Feminism are shared in a Reader’s Theater format presented as three acts featuring conversations between the participants. In Act I, Black women faculty revealed experiences with Anti-Blackness and colorism surrounding their HSIs. Act II revealed a need for mentoring. In Act III, Black and Asian women faculty shared feeling the onus was placed upon them to build cultural competence on their HSI campuses. This Reader’s Theater denotes a need for HSIs to foster an inclusive environment for Black and Asian women faculty.

Exploratory cohort study into underlying mechanism of differences in estrogen metabolism between Asian and Caucasian women during assisted reproductive technology treatment

Explore whether racial differences in prevalence of CYP1A2∗1F polymorphism underlies estrogen metabolism differences among Asians and Caucasians. Prospective cohort study. University-based fertility practice. Asian or Caucasian patients who underwent ovarian stimulation (OS) or programmed cycle frozen embryo transfer (FET) between October 2019 and April2021. None. Trigger-day serum E2 per oocyte retrieved in OS cycles, and E2 on day of lining check in FET cycles. Seventy-one participants were enrolled, 55 in OS group (29 Caucasian and 26 Asian) and 16 in FET group (10 Caucasian and 6 Asian). Peak E2 per oocyte retrieved in the OS group (n = 48) differed by race, with significantly lower levels in Caucasians compared with Asians (177.5 ± 64.2 vs. 261.1 ± 139.5 pg/mL). Prevalence of CYP1A2∗1F polymorphism did not significantly differ by race. Compared using Kruskal-Wallis test, peak E2 per oocyte retrieved did not differ by CYP1A2∗1F genotype. In multivariate linear regression model, adjusting for body mass index, caffeine intake, and self-reported race, there remained no significant correlation. In FET group, serum E2 on day of lining check was also not significantly different by CYP1A2∗1F genotype. Although a consistent difference in serum E2 between Asians and Caucasians undergoing OS was noted, the CYP1A2∗1F polymorphism is unlikely the primary driver of this difference.

The development and validation of the hair shedding visual scale for Asian women (HSVS-A).

The development and validation of the hair shedding visual scale for Asian women (HSVS-A).

Long-term prognostic value of the GenesWell BCT score in Asian women with hormone receptor-positive/HER2-negative early breast cancer

BackgroundAccurate prediction of the risk of recurrence is crucial for optimal treatment decisions in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative early breast cancer. The GenesWell BCT is a molecular assay to predict the 10-year risk of distant metastasis. In this study, we evaluated the long-term prognostic value of the GenesWell BCT assay.MethodsThe BCT score was assessed in patients with HR-positive/HER2-negative early breast cancer who did not receive chemotherapy. We compared the 15-year distant metastasis-free survival (DMFS) between risk groups classified based on the BCT score. The risk of early (0–5 years) and late (5–15 years) recurrence was evaluated based on the BCT score classification.ResultsAccording to the BCT score, 366 patients from Japan and Korea were categorized as BCT low risk (83.6%) and high risk (16.4%) for distant metastasis. Median follow-up time was 17.4 years. The 15-year DMFS rate was significantly lower in the BCT high-risk group (63.3%) than in the BCT low-risk group (93.6%) (P < 0.001). The BCT risk group was an independent prognostic factor for 15-year DMFS (hazard ratio, 4.59; 95% confidence interval 2.13–9.88; P < 0.001). Furthermore, the BCT score was a significant predictor of late recurrence (5–15 years) in patients aged ≤ 50 years and those aged > 50 years, and added prognostic information to traditional clinical prognostic factors.ConclusionThe BCT score can identify patients at low risk for recurrence who may not require adjuvant chemotherapy or extended endocrine therapy, regardless of age.

Implications of 9/11 Attacks in Waldman’s The Submission

This paper scrutinizes the impacts of 9/11 attacks as portrayed in Amy Waldman’s The Submission that is written in 2011 after a decade of the incident. The research shows that the incident of 9/11 opens up both new challenges and opportunities for the people of the world in general and the Americans in particular. The article explains the reasons for the adversities that minorities and women experience in the aftermath of the attacks as depicted in the novel. As the terrorists are men, the incident of 9/11 is generally seen as a masculine event that overshadows the sufferings experienced by the women characters. The objective of the paper is to explore the repercussions of the attacks in the lives of the women as portrayed in the text. The article pictures the trials and tribulations of women from ethnic minorities of the non-western countries. The paper employs the feminist perspective to analyze the traumatic sufferings of the Asian women. I use the concept of E. Kaplan to analyze the fictional data to investigate into the status of ethnic minorities especially women in the post-9/11 situation in the United States of America. The finding of the research implies that women face more identity crisis than their counterparts in the aftermath of the incident regarding life, liberty and pursuit of happiness which are needed to lead lives with dignity.

Epitome of Endurance :O-lan in Pearl Buck's The Good Earth

Pearl S. Buck’s fiction is unique in its representation of Asia and above all her portrayals of Asian women. Buck’s second novel The Good Earth is her magnum opus. It is an enthralling family saga which also provides a genuine picture of agricultural life in China. It deals with the chief protagonist Wang Lung’s toils against hardships in nature and the support he gets from his wife O-lan in dealing with these troubles and his rise to the position of a property owner. The novel delineates his moral degradation after he gains a good economic status and the subsequent heartbreak that Wang Lung causes to O-lan, the woman who offered him unstinted support during his trying times. This paper is an attempt to delineate the courage and endurance of O-lan, an ordinary Chinese woman in facing the trials and tribulations of life. O-lan attracts us more with her genuineness than with her beauty. She displays courage, endurance and exhibits tough physical prowess.

Snoring might be a warning sign for metabolic syndrome in nonobese Korean women

Metabolic syndrome (MetS) is an underlying cause of various diseases and is strongly associated with mortality. In particular, it has been steadily increasing along with changes in diet and lifestyle habits. The close relationship between sleep apnea and MetS is well established. In addition, these two diseases share a common factor of obesity and have a high prevalence among obese individuals. Nevertheless, the association can vary depending on factors, such as race and sex, and research on the relatively low obesity rates among East Asians is lacking. This study aimed to investigate the association between snoring and MetS in nonobese Koreans. A total of 2478 participants (827 men and 1651 women) were enrolled in the Korean National Health and Nutrition Examination Survey from 2019 to 2020. We used the National Cholesterol Education Program Adult Treatment Panel III criteria for MetS and a snoring questionnaire. Logistic regression analysis was used to measure the association between MetS and various confounding factors according to age and sex in participants with body mass index (BMI) < 23 kg/m2. MetS was significantly higher in participants with snoring than in those without snoring (26.9% vs. 19.6%; p = 0.007). In multivariate logistic regression analysis, age (odds ratio [OR] 1.070, 95% confidence interval [CI] 1.059–1.082, p < .001), sex (OR 1.531, 95% CI 1.139–2.058, p = 0.005), and snoring (OR 1.442, 95% CI 1.050–1.979, p = 0.024) were significantly associated with MetS in patients with a BMI < 23 kg/m2. Finally, regression analysis showed that snoring was significantly associated with MetS in women with a BMI of less than 23 kg/m2, especially with younger ages (40–49 years, OR 4.449, 95% CI 1.088 to 18.197, p = 0.038). Snoring was closely associated with MetS in women aged 40–50 years with a BMI of less than 23 kg/m2 compared to other participants. However, the association was not found in women aged 60 and over. Therefore, sufficient consideration should be given to the possibility of MetS when snoring is present in nonobese middle-aged Asian women.

THU313 Lactation As A Possible Protective Factor For Postpartum Diabetes In Women With Gestational Diabetes Mellitus: A Retrospective Analysis

Abstract Disclosure: V.R. Dávila-Parrilla: None. C. Stanton: None. C. Hackerson: None. H. Song: None. J.R. Hens: None. J.J. Wysolmerski: None. A. Merriam: None. R. Belfort De Aguiar: Research Investigator; Self; Fractyl Laboratories. Gestational diabetes mellitus (GDM) is associated with a variety of health issues for the developing babies, and it has long-term implications to the mother’s health such as increased risk of Type 2 Diabetes Mellitus (T2DM). Prior studies have shown that lactation appears to protect women with GDM against development of T2DM. A retrospective analysis was performed to better characterize the population of women with GDM seen at the Yale New Haven Hospital (YNHH) and evaluate the potential effects of lactation on postpartum diabetic/pre-diabetic status. We hypothesized that mothers who chose exclusive lactation would have an improvement in postpartum oral glucose tolerance test (OGTT) results when compared to those who chose exclusive formula feeding or a combination of both. Medical records of 71 women with GDM followed at the Maternal-Fetal Clinic (MFM) with singleton and who delivered at YNHH were identified and data were collected from chart review. All women were scheduled for a ∼6-8 weeks postpartum visit. Of these, 55 (77%) attended their visit and completed an OGTT. Their average age was 33±5 y.o, pre-pregnancy BMI was 33.8±7.1 and post-partum BMI was 31.1±10.7 kg/m². Racial distribution was: 62% Caucasian, 18% African American, 13% Asian women and a 7% chose “not listed” category. During pregnancy, patients’ GDM was treated with dietary modifications only (45.5%), insulin (45.5%) or metformin (9.1%). When looking at preferred infant feeding practices, 44% of mothers chose exclusive lactation, 27% formula fed exclusively, and 29% preferred using mixed feeding (both formula and lactation). A significant difference was found when comparing infant feeding practice by race with 50% Caucasian choosing exclusive lactation in contrast to 15% of African American (P=0.056). There were no significant differences in BMI pre-pregnancy and postpartum between groups when sorting by infant feeding practices. However, BMI at the time of post-partum OGTT was higher in women that did not lactate in comparison to the women that exclusively formula fed (28.9±13, 36.1±6.7, P=0.05). Based on post-partum OGTT, 71% normalized to healthy status while 22% were diagnosed with pre-DM and 7% T2DM. No significant differences in fasting and 2-hour glucose levels were observed when comparing infant feeding practices. DM status was not affected by race or BMI. We observed that almost one third of the women with GDM that came to the 6–8-week postpartum OGTT remained pre-diabetic/diabetic and no beneficial effect of lactation in glucose metabolism was noted. We speculate that longer duration of lactation is needed for the protective effects of lactation in preventing dysglycemia to be noted. Presentation: Thursday, June 15, 2023

Healthcare professionals’ views on the accessibility and acceptability of perinatal mental health services for South Asian and Black women: a qualitative study

BackgroundPerinatal mental illness affects one third of new and expectant mothers. Individuals from ethnic minority groups experience higher rates of mental health problems and higher suicide rates. Despite this, women from ethnic minorities—Black and South Asian women in particular—are less likely to receive support from mental health services in the perinatal period. Healthcare professionals (HCPs) who have contact with women during this period have a unique perspective, and their views may provide insights to understand and remedy this health inequality. This study aimed to identify healthcare professionals’ views on the current accessibility and acceptability of perinatal mental health services, and ways of improving services by addressing the barriers for these women.MethodsSemi-structured interviews were conducted with twenty-four healthcare professionals who work with patients in the perinatal period. Purposive sampling was used to select HCPs from a range of different professions (including mental health staff, midwifery, primary care, social care). The data were analysed using Framework Analysis.ResultsThree main themes were identified from the data: (1) lack of awareness and understanding of perinatal mental illness and service structure in both healthcare professionals and patients; (2) patients’ relationships with family, friends and healthcare professionals can both hinder and facilitate access to services; (3) healthcare professionals encourage raising awareness, flexibility, developing shared understandings and questioning assumptions to improve the accessibility and acceptability of services.ConclusionKey insights into explaining and remedying the health inequalities observed between ethnic groups were proposed by healthcare professionals. Recommendations included sharing information; taking steps to ensure each woman was considered as an individual in her relationship with her culture, ethnicity and childrearing practices; and healthcare professionals addressing their possible unconscious biases through engaging in personal reflexive practices. Reasons these are currently not being implemented deserve further research, and the potential of novel roles such as peer support workers in bridging the space between ideals and practice needs further investigation.

Evaluation of the accuracy of heart dose prediction by machine learning for selecting patients not requiring deep inspiration breath‑hold radiotherapy after breast cancer surgery.

Increased heart dose during postoperative radiotherapy (RT) for left-sided breast cancer (BC) can cause cardiac injury, which can decrease patient survival. The deep inspiration breath-hold technique (DIBH) is becoming increasingly common for reducing the mean heart dose (MHD) in patients with left-sided BC. However, treatment planning and DIBH for RT are laborious, time-consuming and costly for patients and RT staff. In addition, the proportion of patients with left BC with low MHD is considerably higher among Asian women, mainly due to their smaller breast volume compared with that in Western countries. The present study aimed to determine the optimal machine learning (ML) model for predicting the MHD after RT to pre-select patients with low MHD who will not require DIBH prior to RT planning. In total, 562 patients with BC who received postoperative RT were randomly divided into the trainval (n=449) and external (n=113) test datasets for ML using Python (version 3.8). Imbalanced data were corrected using synthetic minority oversampling with Gaussian noise. Specifically, right-left, tumor site, chest wall thickness, irradiation method, body mass index and separation were the six explanatory variables used for ML, with four supervised ML algorithms used. Using the optimal value of hyperparameter tuning with root mean squared error (RMSE) as an indicator for the internal test data, the model yielding the best F2 score evaluation was selected for final validation using the external test data. The predictive ability of MHD for true MHD after RT was the highest among all algorithms for the deep neural network, with a RMSE of 77.4, F2 score of 0.80 and area under the curve-receiver operating characteristic of 0.88, for a cut-off value of 300 cGy. The present study suggested that ML can be used to pre-select female Asian patients with low MHD who do not require DIBH for the postoperative RT of BC.

Dental Insurance Coverage, Dentist Visiting, and Oral Health Status among Asian Immigrant Women of Childbearing Age in Canada: A Comparative Study.

This study examined the dental insurance coverage, dentist visits, self-perceived oral health status, and dental problems among Asian immigrant women of childbearing age in contrast to Canadian women of childbearing age and non-Asian immigrant women of childbearing age. Potential barriers to dental care services among Asian immigrant women were explored. This analysis utilized data from the combined Canadian Community Health Survey from 2011 to 2014. The analytical sample consisted of 5737 females whose age was between 20 and 39 years. Multivariable logistic regression models assessed immigrant status and other factors in relation to the indicators of dental health (i.e., dental visit, self-perceived oral health, acute teeth issue, and teeth removed due to decay). Amongst Asian women immigrants of childbearing age, there was a significantly lower frequency of dentist visits compared to non-immigrant counterparts (OR = 0.53; 95% CI: 0.37-0.76). The most commonly reported reason for not seeking dental care in the last three years was that the "respondent did not think it was necessary". Relative to Canadian born women of same age bracket, Asian women of childbearing age reported fewer acute teeth issues (OR = 0.67; 95% CI: 0.49-0.91) and had a greater risk of tooth extracted due to tooth decay (OR = 3.31; 95% CI: 1.64-6.68). Furthermore, for Asian women immigrants, their major barriers to dental care included low household income (≤$39,999 vs. $40,000-$79,999 OR = 0.26) and a lack of dental insurance (no vs. yes OR = 0.33). Asian immigrant women showed lower utilization of dental services than non-immigrant women. A perceived lack of necessity, lower household income, and dental insurance coverage were major barriers to professional dental usage for most Asian immigrants of childbearing age.

Effectiveness of health literacy and relaxing music on quality of sleep and risk for antenatal depression.

Pregnant women experience increased sleep disturbances during the third trimester of their pregnancy, which may result in the development of psychological issues in the perinatal period. There is a dearth of interventional studies that combine health literacy and the provision of music for the benefit of pregnant women in South Asia. To determine the effectiveness of a combination of Comprehensive Health literacy And Relaxing Music (CHARM) interventions on quality of sleep and risk for antenatal depression among women visiting antenatal outpatient departments of a tertiary hospital in South India. A four-arm parallel-group randomized controlled trial was adopted; 128 low-risk primigravid women were recruited and randomly assigned to the four groups using block randomization. The interventions included relaxing music interventions, comprehensive health-literacy interventions, combinations of both as CHARM interventions, and standard antenatal care. All the interventions were provided for four weeks. The quality of sleep among pregnant women was assessed using the Pittsburgh Sleep Quality Index Scale at baseline and after four weeks of intervention. Women at risk of developing antenatal depression were screened using the Edinburgh Postnatal Depression Scale-Antenatal Version. Pregnant women who received CHARM interventions had significant improvement in quality of sleep when compared with other interventions (F(3,124) =15.0, P < .001, effect size η p2= 0.27). Also, 38 (29.6%) of the included pregnant women were at risk of developing antenatal depression, which was reduced to 21 (16.4%) following the intervention. CHARM intervention could promote quality sleep and reduce the risk of developing antenatal depression, thereby improving perinatal mental health.

Women’s Islamic Activism Rises in Kyrgyzstan

Despite the violence of Soviet rule, Soviet policies improved the status of women in Central Asia. The collapse of the Soviet Union ushered in a restoration of revival of Islam and patriarchal customs. In Kyrgyzstan, Islamic organizations are taking an increasingly active role in public life, often delivering necessary services that the state no longer provides. But here, female-run Islamic groups have gained influence, and pious women are challenging both patriarchal and secular norms.

EP18.37: A point‐of care urine test to predict pre‐eclampsia development in Asian women with suspected pre‐eclampsia

EP18.37: A point‐of care urine test to predict pre‐eclampsia development in Asian women with suspected pre‐eclampsia

EP20.07: Prediction of pregnancy associated hypertension in Asian women using machine learning algorithms

EP20.07: Prediction of pregnancy associated hypertension in Asian women using machine learning algorithms

EP18.12: A point‐of‐care urine test to predict adverse maternal and neonatal outcomes in Asian women with suspected pre‐eclampsia

EP18.12: A point‐of‐care urine test to predict adverse maternal and neonatal outcomes in Asian women with suspected pre‐eclampsia