Women's Health Research Articles

Quantum classical hybrid convolutional neural networks for breast cancer diagnosis.

The World Health Organization states that early diagnosis is essential to increasing the cure rate for breast cancer, which poses a danger to women's health worldwide. However, the efficacy and cost limitations of conventional diagnostic techniques increase the possibility of misdiagnosis. In this work, we present a quantum hybrid classical convolutional neural network (QCCNN) based breast cancer diagnosis approach with the goal of utilizing quantum computing's high-dimensional data processing power and parallelism to increase diagnosis efficiency and accuracy. When working with large-scale and complicated datasets, classical convolutional neural network (CNN) and other machine learning techniques generally demand a large amount of computational resources and time. Their restricted capacity for generalization makes it challenging to maintain consistent performance across multiple data sets. To address these issues, this paper adds a quantum convolutional layer to the classical convolutional neural network to take advantage of quantum computing to improve learning efficiency and processing speed. Simulation experiments on three breast cancer datasets, GBSG, SEER and WDBC, validate the robustness and generalization of QCCNN and significantly outperform CNN and logistic regression models in classification accuracy. This study not only provides a novel method for breast cancer diagnosis but also achieves a breakthrough in breast cancer diagnosis and promotes the development of medical diagnostic technology.

The impact of climate change anxiety on premenstrual syndrome: A cross-sectional study.

Climate change is thought to have possible effects on changes in the menstruation process, which covers an important period of time in women's lives. Our study aimed to determine the impact of climate change anxiety on premenstrual syndrome (PMS) in women of reproductive age. This is a cross-sectional study. The research was conducted online using various digital platforms between December 2023 and February 2024. This study was conducted on 456 women of reproductive age. The Personal Information Form, PMS Scale and Eco-Anxiety Scale were used for the data collection. The level of statistical significance was set at p < 0.05. The prevalence of PMS was 44.7%. The average score for the Eco-Anxiety Scale was 27.28 ± 6.44. A significant majority of participants (81.4%) stated that climate change would affect women's health, and 81.1% thought that they were affected by climate change. The Eco-Anxiety Scale scores were higher in women with PMS (p < 0.05). The results of the binary logistic regression analysis showed that being affected by climate change (odds ratio [OR] = 2.109, 95% confidence interval [CI] = 1.045-4.259, p = 0.035), age at menarche (OR = 1.249, 95% Cl = 1.073-1.453, p = 0.004) and Eco-Anxiety Scale scores were significant predictors of PMS (OR = 0.828, 95% Cl = 0.791-0.867, p < 0.001). The results of our study showed that women with PMS had higher Eco-Anxiety Scale scores. Given the global effects of climate change, it is important to investigate its effects as a risk factor for the emergence of PMS. Furthermore, women's healthcare providers play an important and beneficial role in adapting to a changing climate; these efforts will have long-term impacts.

Eating disorders of the perimenopause.

Except for psychosis, women's mental health problems across the reproductive lifespan are common. There are periods in a woman's life, associated with significant sex hormone fluctuations, that render her particularly susceptible to mood disturbance and mental health illnesses, including eating disorders. Whilst eating disorders are usually conceptualized as diseases afflicting adolescence and young adults, there is increasing evidence to suggest the landscape for eating disorders has considerably changed and includes a peak in midlife, correlating with the perimenopause. Inpatient admissions and outpatient clinic attendances have increased amongst older women. It is likely this increasing trend is the result of numerous biopsychosocial factors. A diagnosis of an eating disorder in midlife may be more common in those women simultaneously navigating the perimenopause than in midlife women who remain pre-menopausal owing to the significant ovarian hormonal fluctuations encountered in the perimenopause. Eating disorders are serious illnesses associated with significant morbidity and mortality, which are exacerbated when present at older ages. Research is beginning to recognize the importance of including this typically under-represented cohort of middle-aged women in empirical studies, which is critical to a complete etiological understanding. Recognizing and treating these varied presentations and establishing effective treatments for chronic, recurrent and new-onset eating disorders in midlife women is crucial.

Heartwired for change: advancing women's cardiovascular health.

Heartwired for change: advancing women's cardiovascular health.

Estrogen Plus Progestin and Colorectal Cancer: Long-Term Findings From the Women's Health Initiative Randomized Clinical Trial.

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.We report long-term colorectal cancer findings from the Women's Health Initiative trial where 16,608 postmenopausal women with a uterus were randomly assigned to daily conjugated equine estrogen (CEE) 0.625 mg, plus medroxyprogesterone acetate (MPA) 2.5 mg, or placebo. When intervention ended after 5.6 years, although there were 44% fewer colorectal cancers in the intervention group (43 v 72, P = .003), the cancers were more commonly lymph node-positive (59.0% v 29.4%, P = .003). Now after cumulative 24-year follow-up, with 431 colorectal cancers, CEE plus MPA no longer influenced colorectal cancer incidence (215 [0.15, annualized rate %] v 216 [0.15], hazard ratio [HR], 0.95 [95% CI, 0.79 to 1.15]). Although not statistically significant, there were more colorectal cancer deaths with CEE plus MPA (87 [0.049] v 69 [0.041] deaths, HR, 1.20 [95% CI, 0.87 to 1.65], P = .26). Vaginal bleeding (54.1% v 5.2% at 6 months) and breast changes were more frequent in the intervention group. After adjusting for postrandomization vaginal bleeding and breast changes, bowel examinations were significantly delayed in intervention group participants (P = .005), potentially contributing to diagnostic delay. Taken together, the findings suggest no clinically meaningful benefit for about 5 years of CEE plus MPA use on colorectal cancer outcome.

Menopausal Hormone Therapy and Ovarian and Endometrial Cancers: Long-Term Follow-Up of the Women's Health Initiative Randomized Trials.

Menopausal hormone therapy's influence on ovarian and endometrial cancers remains unsettled. Therefore, we assessed the long-term influence of conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) and CEE-alone on ovarian and endometrial cancer incidence and mortality in the Women's Health Initiative randomized, placebo-controlled clinical trials. Postmenopausal women, age 50-79 years, were entered on two randomized clinical trials evaluating different menopausal hormone therapy regimens. In 16,608 women with a uterus, 8,506 were randomly assigned to once daily 0.625 mg of CEE plus 2.5 mg once daily of MPA and 8,102 placebo. In 10,739 women with previous hysterectomy, 5,310 were randomly assigned to once daily 0.625 mg of CEE-alone and 5,429 placebo. Intervention was stopped for cause before planned 8.5-year intervention after 5.6 years (CEE plus MPA) and after 7.2 years (CEE-alone). Outcomes include incidence and mortality from ovarian and endometrial cancers and deaths after these cancers. After 20-year follow-up, CEE-alone, versus placebo, significantly increased ovarian cancer incidence (35 cases [0.041%] v 17 [0.020%]; hazard ratio [HR], 2.04 [95% CI, 1.14 to 3.65]; P = .014) and ovarian cancer mortality (P = .006). By contrast, CEE plus MPA, versus placebo, did not increase ovarian cancer incidence (75 cases [0.051%] v 63 [0.045%]; HR, 1.14 [95% CI, 0.82 to 1.59]; P = .44) or ovarian cancer mortality but did significantly lower endometrial cancer incidence (106 cases [0.073%] v 140 [0.10%]; HR, 0.72 [95% CI, 0.56 to 0.92]; P = .01). In randomized clinical trials, CEE-alone increased ovarian cancer incidence and ovarian cancer mortality, while CEE plus MPA did not. By contrast, CEE plus MPA significantly reduced endometrial cancer incidence.

Analyzing Gender Issues And Leadership Effectiveness In Medical Education

Medical education is an important aspect in developing a country's health system. However, there are still issues that need to be addressed, especially those related to gender and leadership within medical education. The aim of this research is to analyze gender issues and leadership effectiveness in medical education. This study used qualitative research methods. The data collection technique in this research is literature study. The data that has been collected is then analyzed in three stages, namely data reduction, data presentation and drawing conclusions. The research results show that gender issues in medical education reflect the imbalance that occurred when women first entered the medical field at the end of the 19th century. At that time, women focused more on the field of pediatrics because it was more accepted by societal norms at that time. As a result, history records that many early female physicians in the United States preferred to practice pediatric care and women's health. Meanwhile, in the context of leadership in medical education, the various leadership styles that are generally known are democratic, pacesetting, authoritative, affiliate, training and command styles.

Hormone replacement therapy for menopausal mood swings and sleep quality: The current evidence.

Marked alterations in the normal female hormonal milieu in the perimenopausal period significantly affect women's health, leading to decreased well-being, psychological distress, and impaired quality of life. Common menopausal symptoms include hot flashes, sleep and mood changes, fatigue, weight gain, and urogenital disturbances. Clinicians often neglect mood swings and disrupted sleep, although those can significantly limit the productivity of women and impair their cognitive function and mental health. Evidence-based management should include a personalized, holistic approach to alleviate symptoms and careful consideration of the risks vs benefits of hormone replacement therapy (HRT), with due consideration of personal preferences. A research paper in the recent issue of the World Journal of Psychiatry by Liu et al investigated the role of HRT in altering mood changes and impaired sleep quality in menopausal women, which helps us to understand the benefits of this treatment approach.

Mammographic density and breast cancer risk among Black American women.

High mammographic density is a well-established risk factor for breast cancer; however, data from Black women are limited. It is largely unknown how mammographic density is associated with breast cancer subtypes among Black women. We examined the association between percent mammographic density (PMD) and breast cancer risk among participants in the Black Women's Health Study. Digital screening mammograms were available for 363 cases and 5541 non-cases. Cumulus software was used to assess PMD. We used inverse probability of sampling weights and Cox proportional hazards models, adjusted for age and body mass index, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) overall and by age at mammography and estrogen receptor (ER) status of the breast tumors. Multivariable models included additional breast cancer risk factors. Tests of statistical significance were 2-sided. In simple models, women in the highest quartile of PMD had 53% increased odds of breast cancer compared to those in the lowest quartile (HR 1.53; 95% CI: 1.11, 2.11). HRs were 1.37 (95% CI: 0.83, 2.24) among women <55 years of age and 1.68 (95% CI: 1.10, 2.56) among women aged ≥55 years. HRs were 1.49 (95% CI: 1.02, 2.16) for ER+ cancer and 1.45 (95% CI: 0.73, 2.87) for ER- cancer. Associations were largely unchanged in multivariable models. In this study of U.S. Black women, higher PMD was associated with ER+ and ER- breast cancer risk. Findings from this study reinforce the importance of breast density as a risk factor for breast cancer in Black women.

Research progress on correlative prediction factors and prediction models of endometriosis associated ovarian carcinoma.

Endometriosis is a common benign disease in women of childbearing age, with a malignant change rate of about 1%. Endometriosis associated ovarian cancer (EAOC), which usually occurs in the ovaries, is a serious threat to women's health. Early identification of high-risk groups of EMs malignant transformation is of great significance for the prevention and treatment of EAOC. However, there is still a lack of specific and sensitive prediction factors. In recent years, scholars at home and abroad have used traditional statistical methods and machine learning to explore EAOC related prediction factors and prediction models. This paper mainly reviews and evaluates the diagnosis and prediction model of EAOC. Studies were identified by searching the CNKI, PubMed and Web of Science Core Collection, (WOSCC) till 2023, Data which met the inclusion criteria of clinical studies were evaluated about the quality. This paper analyzes and summarizes the prediction factors and prediction models in the literature. After screening, 7 relevant studies were finally obtained. Prediction factors included: age, menstruation, menopausal status, course of disease, infertility associated with endometriosis, history of single estrogen use during menopause, serological indexes: human epididymis protein 4, carbohydrate antigen 125(CA125), ovarian malignancy risk algorithm, indications for ultrasound examination: cyst shape, structure and blood flow signal, etc. Prediction models: Alignment diagram, Multivariate logistic regression model, Gail model, Gradient Boosting Decision Tree and Lasso-logistics regression. Related models were in good agreement with the actual situation, and have good sensitivity and specificity. The relevant prediction factors and prediction models were summarized to provide reference and new thinking for the research of prediction models in the field of EAOC, in order to develop standardized long-term management strategies for high-risk groups of EAOC and realize the advance of the diagnosis threshold of patients with EAOC.

Vitamin B12 is correlated with insulin resistance and metabolism disorder markers in women with recurrent pregnancy loss

ObjectivesRecurrent pregnancy loss (RPL) seriously affects women's reproductive and mental health, and the incidence has increased in recent years. Insulin resistance (IR) acts as a significant contributing factor to RPL. Studies suggest that vitamin B12, folate intake, and homocysteine are correlated with IR, but the exact nature remains controversial and requires further investigation. In this study, we aimed to assess the levels and correlations between vitamin B12-folate-homocysteine and insulin resistance in RPL patients. Study design73 control subjects and 256 RPL patients (144 RPL patients without IR and 112 RPL patients with IR) were included in this observational retrospective cross-sectional study. The differences in vitamin B12, folate, and homocysteine levels between RPL patients with and without IR were analyzed using a Student's t-test. Pearson correlations were utilized to examine the correlation between vitamin B12-folate-homocysteine and glucose and lipid metabolism parameters. Multivariable linear regressions were used to assess the independent correlation of each factor with HOMA-IR. ResultsCompared to the control subjects, RPL patients exhibited lower vitamin B12 (p < 0.001) and folate (p < 0.001), and higher homocysteine (p = 0.001). RPL patients with IR described decreases in vitamin B12 (p = 0.003) and folate (p = 0.028), and increases in homocysteine (p = 0.033) as RPL patients without IR. Vitamin B12 in RPL patients was significantly negatively correlated with homocysteine (r = −0.348, p < 0.001), HOMA-IR (r = −0.214, p < 0.001), BMI (r = −0.160, p = 0.017), TG (r = −0.148, p = 0.039) and CHO (r = −0.149, p = 0.038) and positively correlated with folate (r = 0.217, p < 0.001). In multivariable linear regressions, after adjusting for age, strong correlations were observed between vitamin B12 (β = −0.197, p = 0.010), BMI (β = 0.466, p < 0.001), and HOMA-IR in RPL patients. ConclusionVitamin B12 is significantly correlated with IR in RPL patients. Circulating vitamin B12-folate-homocysteine metabolism could be a window of the pathological process of IR, obesity, and lipid metabolism disorders in RPL patients.

Mistreatment in healthcare: peripartum experience in a Tunisian maternity

BackgroundMistreatment in healthcare is defined by the set of behaviors, acts, and omissions committed by the healthcare providers on patients. Pregnant women can be exposed to this behavior during pregnancy, childbirth, and the postpartum period. It can have several aspects and affects the women's mental health, social and professional life, and also their newborns and families. ObjectiveThis study was made to estimate the frequency of mistreatment during the peripartum period in a Tunisian maternity unit, determine its impact on the parturient and her entourage, and draw up recommendations for the prevention of this public health problem. Study DesignWe conducted a cross-sectional survey in Department C of the Tunis Maternity and Neonatology Center from July 2022 to September 30, 2022. Our questionnaire encompassed verbal and physical abuse, patient information, consent, unprofessional conduct, poor communication, and discrimination. ResultsThis study included 400 patients. The average age was 29.3+–5.65. Single women represented 12.3% of the cases. Seventy-five percent of women reported having been victims of at least one type of violence during childbirth. Verbal abuse was the most frequent type observed. Eighty-two percent of women reported verbal abuse, while 23.25% underwent physical violence. After the delivery, 391 women (97.8%) stated that the delivery was a source of anxiety and that they were not ready to repeat the experience. Six of them were followed up in psychiatry. Mistreatment was expressed by a lack of information and/or respect for consent, unprofessional conduct, or poor communication between the caregiver and the patient. ConclusionThis study emphasizes the significance of including women in decision-making processes regarding their care. Establishing systematic approaches for providing information and obtaining consent is crucial, ensuring a dynamic approach that promotes women's freedom of choice.

Big data and AI for gender equality in health: bias is a big challenge.

Artificial intelligence and machine learning are rapidly evolving fields that have the potential to transform women's health by improving diagnostic accuracy, personalizing treatment plans, and building predictive models of disease progression leading to preventive care. Three categories of women's health issues are discussed where machine learning can facilitate accessible, affordable, personalized, and evidence-based healthcare. In this perspective, firstly the promise of big data and machine learning applications in the context of women's health is elaborated. Despite these promises, machine learning applications are not widely adapted in clinical care due to many issues including ethical concerns, patient privacy, informed consent, algorithmic biases, data quality and availability, and education and training of health care professionals. In the medical field, discrimination against women has a long history. Machine learning implicitly carries biases in the data. Thus, despite the fact that machine learning has the potential to improve some aspects of women's health, it can also reinforce sex and gender biases. Advanced machine learning tools blindly integrated without properly understanding and correcting for socio-cultural sex and gender biased practices and policies is therefore unlikely to result in sex and gender equality in health.

The Unique Impacts of COVID-19 on Low-Income and Diverse Canadian Women's Mental Health Profiles: A Latent Transition Analysis.

There is evidence of an overall decline in women's mental health, particularly those with young children, in the wake of the COVID-19 pandemic. However, research has also found heterogeneity in women's mental health responses. This longitudinal study sampled low-income women with young children by recruiting from the government's child care financial subsidy waitlist. To examine heterogeneity in women's mental health responses to COVID-19, a latent transition analysis was employed to identify profiles of anxiety, depression, and stress among 289 low-income mothers. Using these identified profiles, we examined the transitional patterns between profiles before and during COVID-19 and the sociodemographic and familial factors related to these profiles. A three-profile solution was identified prior to COVID-19 and a four-profile solution during COVID-19, with some profiles exhibiting qualitatively different defining characteristics. Latent transition analyses found diverse patterns of mental health changes after the onset of COVID-19. Mothers with better mental health prior to COVID-19 tended to have the most stable mental health during COVID-19. In contrast, mothers who were highly stressed prior to COVID-19 were equally likely to improve or decline after the onset of the pandemic. In addition, the relationships between race, parenting practices, child temperament, and child mental health were significantly related to mothers' mental health profiles. These findings describe mothers' experiences and areas where policymakers and practitioners can tailor support to low-income women with young children.

Impact of Obesity, Menopause, and Depression in Women's Health: An Attempt to Decipher the Complex Relationship.

Menopause symptoms may be distressing, especially when they appear at a time when women are expected to play significant responsibilities in society. Numerous biological systems are influenced by the hormonal changes that start during the menopausal transition. This review attempts to decipher the complex relationship between obesity, menopause, and depression, citing some recent longitudinal and cross-sectional studies. Additionally, this study provides a summary of the different phytoestrogens, their sources, and probable mechanisms of action in addition to available therapeutic alternatives. For this review purpose, the authors have gone through a vast number of articles from various scientific databases like PubMed, Google Scholar, and Web of Science. It is becoming clear that the physiological basis for these menopausal symptoms is complicated and connected to estrogen deficiency, but not alone. Other hormones like FSH, LH, progesterone, and inhibin B are the major ones that are both directly and indirectly responsible for most of the menopausal symptoms. Numerous longitudinal and cross-sectional studies have found a direct relationship between the incidence of menopause and depression as well as obesity. Phytoestrogens like stilbene, lignans, isoflavone, and coumestan have been reported to be the alternatives to synthetic estrogen with lesser side effects, as reported in various studies. The complex relationship between depression, menopause, and obesity presents a complex obstacle to women's health and overall well-being. There might be a lot of promising prospects for revolutionary advancements in women's health during the menopausal stage in the future. Promising drug development that targets not just one but also the three conditions -obesity, menopause, and depression - as well as more thorough research are needed to improve the healthcare system for women who suffer from these conditions.

Less than one in five teenage women in Ethiopia know about emergency contraception.

Teenage women's fertility health faces significant challenges from unintended pregnancies and unsafe abortions. Using an emergency contraception within a defined time period could prevent unintended pregnancy and its damaging consequences, like unintended childbirth and unsafe abortion. Despite it being an appropriate contraception, the knowledge of teenage women about emergency contraception is lower among women in developing countries. Therefore, this study aimed to examine the magnitude of emergency contraception knowledge and its associated factors among teenage women in Ethiopia. Data for this study was obtained from the recent Demographic and Health Surveys. A total weighted sample of 3,381 teenage reproductive women were included. The significant associated factors with emergency contraception knowledge among teenage reproductive women were determined by fitting a multilevel mixed-effect binary logistic regression model. Finally, Adjusted Odds Ratio (AOR) with a 95% confidence interval and a P value of less than 0.05 was used to declare statistical significance. In Ethiopia, the magnitude of teenage women who knew about emergency contraception was 19.47% (95%CI: 18.17, 20.84). Age 17 years (AOR = 1.76, 95%CI, 1.24, 2.48) and age 19 years (AOR = 2.18, 95%CI, 1.47, 3.22), primary education level (AOR = 2.76, 95%CI, 1.60, 4.76), secondary and above educational level (AOR = 4.70, 95%CI, 2.62, 8.44), being protestant followers (AOR = 0.63, 95%CI, 0.45, 0.87), being muslim followers (AOR = 0.68, 95%CI, 0.49, 0.93), media exposure (AOR = 3.36, 95%CI, 2.59, 4.34), rural residence (AOR = 0.45; 95%CI: 0.22, 0.86), and high community level education (AOR = 140, 95%CI: 1.32, 2.00) were factors significantly associated with knowledge of emergency contraception among teenage women. This finding concluded that less than one in five teenage women knew about emergency contraception in Ethiopia. The knowledge of emergency contraception among teenage women in Ethiopia was substantially associated with women's age, education level, religion, media exposure, residency and community-level education. Hence, there is a need to implement comprehensive awareness programs and promotion of emergency contraception as a way of curbing cases of unintended pregnancies among teenage women. Government and non-governmental organizations should design targeted educational initiatives and media campaigns to improve emergency contraception knowledge among young teenagers, women with lower educational backgrounds, and rural teenagers.

Married and Divorced Women's Emotional and Social Issues

The emotional and social difficulties that married and divorced women encounter are examined in this article, with a focus on the unique but related problems that exist in both situations. Studies show that whereas divorced women usually experience feelings of grief, stigma, and adjusting to life as a single person, married women typically deal with stressors associated with marriage expectations and society norms. The influence of these emotional and social concerns on women's mental health, relationships, and general well- being is examined in this article through a qualitative review of current studies. To improve the quality of life for women in both marital statuses, it is imperative to comprehend these dynamics to build tailored support systems and treatments.

Association between husband's participation in household work and the onset of depressive symptoms in married women: A population-based longitudinal study in South Korea

An unequal distribution of household work by gender is prevalent. This study explored the association between husbands' participation in household work and the onset of depressive symptoms among married Korean women. A nationwide sample of 7024 married women was repeatedly followed up at 2-year intervals from 2014 to 2022 (20,343 observations). The daily household work hours of both the participants and their husbands were self-reported. Satisfaction with husbands' participation in household work was classified as satisfactory, neutral, or dissatisfactory. Depressive symptoms were assessed using the 10-item version of the Center for Epidemiologic Studies Depression. A generalized estimating equation was employed to determine how household work participation was associated with the onset of depressive symptoms in married women at the 2-year follow-up. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. The mean daily hours spent on household work were 2.62 h for married women and 0.35 h for husbands. A 1-h increase in the husbands' daily time spent on household work was negatively associated with the risk of onset of depressive symptoms in married women (RR: 0.88, 95% CI: 0.80–0.98). Compared with individuals with neutral responses, those satisfied with their husband's household work had a lower risk of depressive symptom onset (RR: 0.82, 95% CI: 0.74–0.90), whereas dissatisfaction was linked to increased risk (RR: 1.15, 95% CI: 1.04–1.27). Husbands' participation in household work was associated with a reduced risk of depressive symptom onset among married women. Achieving gender equality in the division of household work is important for women's mental health.

Ultrasound-Responsive Hydrogel Incorporated with TGF-β Mimetic Peptides for Endometrium Recovery to Restore Fertility.

Unavoidable damage to the basal layer of the endometrium has a huge negative impact on a woman's reproductive health and menstrual cycle. However, it is difficult for medicine to penetrate a series of biological barriers toward the basal layer in the deeper area of the endometrium. To meet this challenge, we developed an ultrasound-responsive hydrogel incorporated with a transforming growth factor-beta (TGF-β) mimetic peptide to enhance pregnancy outcomes by restoring the function of a wounded endometrium due to its deep-tissue-penetration capability. In vitro studies revealed that the TGF-β-mimetic-peptide-loaded hydrogel could achieve 64.35% of cell migration under ultrasound stimulation even in phosphate-buffered saline of pH 6.0. Upon in situ sonication at the uterus, carboxymethyl chitosan can be released from degraded hydrogel to open tight junctions with reduced interstitial pressure by ultrasound to promote deep penetration. Rat studies revealed that the penetration capability of TGF-β-mimetic-peptide-loaded hydrogel with sonication was 1.6 times higher than that of the control group. Besides the rat uterine model, ex vivo human uterine tissue was also collected and imaged, demonstrating up to ∼700 μm of tissue penetration depth. In addition, compared to control groups, effective uterus recovery without intrauterine stenosis and endometrial cavity fluid was observed from rats with severe uterine injury treated by TGF-β-mimetic-peptide-loaded hydrogel. In addition, fertility restoration in the endometrial injury model was observed after treatment with such an ultrasound-responsive hydrogel incorporated with TGF-β mimetic peptides. Overall, this work provides an effective approach to treating endometrial injury for enhanced pregnancy outcomes.

Towards women's digital health equity: A qualitative inquiry into attitude and adoption of reproductive mHealth services in Bangladesh.

Health equity in Bangladesh faces a large chasm over the economic conditions, socio-cultural factors and geographic location despite the push for digitalization of the health sector. While some research has been conducted assessing the viability of digital health solutions in Bangladesh, gender dynamics of digital healthcare have been absent. This study dived into healthcare equity for women with a focus on reproductive health services delivered through mobile devices. This paper reported the findings of a qualitative study employing in-depth interviews conducted among 26 women about their behavioral intention to use mHealth services for reproductive health and the underlying factors influencing this intention with the help of the Integrative Model of Planned Behavior (IMPB). A snowball sampling technique were used to interview those university educated women, aged 21-31, based on their familiarity and exposure of mHealth services from seven universities in Bangladesh. The findings suggested that users of mHealth services find it more convenient and secure compared to visiting healthcare facilities, especially for trivial issues and inquiries regarding their reproductive health. Although promoting such services is lagging behind traditional healthcare, the attitude toward reproductive health services in Bangladesh is generally favorable resulting increasing adoption and use. Because such information-related mobile services (apps, websites, and social media) served as a first base of knowledge on reproductive health among many young girls and women in Bangladesh, who are generally shy to share or talk about their menstruation or personal health problems with family members, peers, or even health professionals due to socio-cultural factors and stigmatization. Conversely, urban centric services, availability of experts, quality management, security of privacy, authenticity of the information, digital divide, lack of campaign initiatives, lack of equipment and technology, lack of sex education, and outdated apps and websites were identified as obstacles that constrain the widespread use of reproductive mHealth services in Bangladesh. This study also concluded that promotion will be crucial in reforming conservative norms, taboos, and misconceptions about women's health and recommended such endeavors to be initiated by the policy makers as there is a substantive need for a specific policy regulating emerging digital health market in Bangladesh. Notwithstanding, women-only sample, low sample size, narrow focus on mHealth users and absence of perspectives from healthcare providers were among shortcomings of this study which could be addressed in future research. Further quantitative explorations are must to determine the usage patterns of reproductive mHealth services and their effectiveness that would identify implementation challenges in terms of customization and personalization in reproductive healthcare in a developing country like Bangladesh.