Original research publications

To examine sex differences in pain, symptom burden, and psychological distress among adolescents with and without temporomandibular disorders (TMD), and to evaluate these differences in youth reporting or not comorbid headache. In this cross-sectional case-control study ( N = 115; 57.4% females; age 14.6 ± 2.4 years), adolescents were classified as having TMD or non-TMD based on the validated 3 screening questions for TMD. Participants completed validated measures of pain intensity , symptom burden, and anxiety/depression and stress symptomatology. Sex differences were assessed using t-tests, chi-square tests, correlations, and two-way ANOVA. Compared to males, females reported higher pain intensity (30.7 ± 24.3 vs. 21. ± 21.9; p = .032), symptom burden (7.9 ± 3.8 vs. 1.2 ± 1.5; p = .006), anxiety/depression (16.3 ± 12.4 vs. 10.8 ± 9.8; p = .012) and stress (13.4 ± 5.4 vs. 11.3 ± 4.7; p = .030). Within the TMD group ( n = 65), females showed higher pain (45.8 ± 16.5 vs. 33.7 ± 19.6; p = .010), headache intensity (4.4 ± 2.7 vs. 3.0 ± 2.2, p = .036), and symptom burden (7.9 ± 3.8 vs. 1.2 ± 1.5, p = .017), whereas males with TMD demonstrated stronger correlations between pain and psychological symptoms (anxiety: r(47) = 0.399, p = .006; depression: r(47) = 0.312, p = .033). Anxiety/depression scores were higher in participants with TMD and in females, with similar TMD-related increases across sexes. Among youth reporting headache ( n = 50), females exhibited greater symptom burden ( p = .035), anxiety ( p = .017), and stress ( p = .040). Adolescent females show greater pain and psychosocial burden overall and among those with TMD or headache, while in males with TMD, pain intensity was more strongly correlated with anxiety and depression symptoms.

The objective of this review was to explore whether the association between meat consumption and cardiovascular disease (CVD) risk differs by sex in prospective cohort studies. Several cohort studies have investigated the relationship between red meat (RM) and processed meat (PM) consumption and cardiovascular health, but sex-specific outcomes are often not clearly reported or discussed. We searched PubMed, Embase, Scopus, and Google Scholar for prospective cohort studies published between January 1, 2000 and August 2, 2025, reporting sex-specific associations between RM and PM consumption and cardiovascular disease risk. Fourteen cohort studies met the inclusion criteria. Of these, 12 evaluated RM, including unprocessed RM (URM): 2 of 12 studies (17%) reported increased CVD risk in both sexes, 3 of 12 (25%) in men only, 2 of 12 (17%) in women only, 4 of 12 (33%) found no increased risk or reported inverse associations, and 1 of 12 (8%) reported an inverse association only. Processed meat (PM) showed more consistent harm: 6 of 9 studies (67%) in men and 6 of 9 studies (67%) in women reported higher risk, with 4 of 9 (44%) showing increases in both sexes. Poultry was largely neutral: 1 of 5 cohorts (20%) reported a modest increase in men, while all other sex-specific analyses were null. Consistently, PM consumption has been associated with an increased risk of CVD in both sexes, although studies differ on whether men or women are more affected. The URM results are heterogeneous: some cohorts show associations only in men, others only in women, and many report no significant effect. The findings for increased risk of CVD being associated with poultry consumption appear to be largely neutral. Future prospective studies should systematically provide results stratified by sex in order to enable more personalized dietary recommendations.

Sex disparity has been demonstrated within difficult-to-treat (difficult) asthma, with females reported to have greater disease severity and more comorbidities. Deeper understanding of these differences could help personalise management approaches. To assess differences in disease characteristics between males and females with difficult asthma. The Wessex AsThma CoHort study collected data from 500 patients across Southern England. Patient demographics, asthma and its treatment history, allergies, comorbidities, radiology, biological samples, lung function, and questionnaire data were subjected to univariable analyses to identify sex differences. Variables were then further assessed in multivariable regression models. Males were older at disease onset and were more often ex-smokers. In multivariable regression models they had higher serum immunoglobulin E (ratio 1.95, 95% CI 1.19 to 3.20) and plasma inflammatory cytokine expression (interleukin-17, tumour necrosis factor - alpha, C-C motif ligands 3 and 11 and chitinase 3-like 1). Males had poorer lung function (forced expiratory volume in 1 second effect -9.98, 95% CI -15.21 to -4.74) and more frequently had nasal polyps. Females had higher Body Mass Index, and in multivariable regression higher plasma adipokine (ratio 1.25, 95% CI 1.12 to 1.37) and interleukin-5 expression (effect 3.52, 95% CI 2.65 to 4.39), multimorbidity burden (score effect 0.60, 95% CI 0.29 to 0.92), anxiety/depression, and inducible laryngeal obstruction (odds ratio 2.38, 95% CI 1.20 to 4.76). They self-reported worse Hull Cough Hypersensitivity, Nijmegen and Sino-Nasal Outcome Test scores. We observed no difference in treatment and healthcare utilisation, or composite asthma severity score. Sex influences difficult asthma phenotype but contrasting factors are associated with similar overall disease severity in both sexes. Males have worse lung function and systemic inflammatory profiles, whilst females experience greater psychophysiological comorbidity and multimorbidity burden. Recognising differences and considering them clinically to fine-tune management may help improve difficult asthma outcomes.

IntroductionWe conducted a pilot study of older cannabis users with problematic or frequent (i.e. ≥4/7 days/week) use as a preliminary test of the hypothesis that compared to men, women would demonstrate greater stress reactivity and dementia risk.Methods47 participants ages 50-75 (55.3% male, 68% with cannabis use disorder) completed the Trier Social Stress Test, neuropsychological testing, 3T brain MRI, and blood draw.ResultsMen demonstrated: greater salivary cortisol, systolic blood pressure, and craving post-stress induction; worse memory and executive function; greater risk of heart disease or stroke and white matter hyperintensity volumes. There were no sex differences in Alzheimer's disease plasma biomarkers.ConclusionsAmong non-treatment-seeking older adults with problematic or frequent cannabis use, men may have greater risk for dementia due to stress reactivity and vascular risk factors. Future work must replicate and verify this unexpected sex difference and the specificity of these effects to cannabis use.

Acute coronary syndrome (ACS) exhibits marked sex-related differences in clinical presentation and underlying pathophysiology. However, whether these differences translate into variations in culprit lesion prediction remains unclear. We investigated the sex-specific performance of conventional coronary computed tomography angiography (CCTA) and artificial intelligence-enabled quantitative coronary plaque and haemodynamic assessment (AI-QCPHA) for ACS culprit detection. In this sub-study of the EMERALD II trial (NCT03591328), patients with ACS who underwent CCTA 1 month to 3 years prior to the event were analysed. Culprit and non-culprit lesions were defined by invasive coronary angiography at the time of ACS. Diagnostic performance of obstructive stenosis (Coronary Artery Disease-Reporting and Data System ≥ 3) and high-risk plaque (HRP) criteria was compared between women and men. Information gain-based feature selection identified sex-specific AI-QCPHA best predictors across five feature clusters, and their incremental predictive value was evaluated using receiver operating characteristics reported as area under the curve (AUC). A total of 351 patients (90 women, 261 men) with 2451 lesions were included. Conventional CCTA performed similarly across sexes for obstructive stenosis, whereas HRP differed by sex. AI-QCPHA identified the same best features for ACS culprit prediction in both sexes, and integration of these features improved discriminatory performance beyond conventional CCTA (women AUC 0.84 vs. 0.78, P = 0.002; men 0.82 vs. 0.75, P < 0.001). Among individual predictors, delta fractional flow reserve from coronary computed tomography angiography yielded the highest discriminatory performance in both women and men. AI-QCPHA enhances culprit lesion prediction in obstructive ACS beyond conventional CCTA in both sexes, supporting its potential role for improved culprit lesion discrimination.

In Western industrialized nations, the sexes differ in suicide mortality and the prevalence of diagnosed depression. Men have a higher mortality from suicide than women (figures for Germany, 2024: 18.2 vs. 6.9 per 100 000), but the 12-month prevalence of clinically diagnosed depression in women is double that in men (10-12% vs. 5-6%). This situation has been called the sex-suicide paradox. In this article, we present a structured analysis of the relevant sex-specific epidemiology and the modifying factors that account for these findings. This narrative review was created according to the SANRA recommendations on the basis of publications retrieved by a selective search in the PubMed and Cochrane Library databases (2000–2026) and the cause-of-death statistics of the German Federal Statistical Office (2003–2024). In 2024, the suicide rate in Germany was 18.2 per 100 000 men (n = 7414) and 6.9 per 100 000 women (n = 2958). The relative risk for suicide in men is higher by a factor of 2.6 (95% CI: [2.5; 2.8]). Affective disorders are associated with ca. 90% of all suicides, although psychological autopsy studies are subject to methodological limitations, including recall bias. Men over age 85 are particularly vulnerable, with a suicide rate of 45.7 per 100 000. Modifying factors contributing to this sex disparity include the choice of more lethal means of suicide (e.g., hanging, which accounts for 50.5% of male suicides) and an often unrecognized, externalizing depression in men. It may be possible to lower mortality from suicide in men through greater sensitivity for sex-specific symptomatic presentations, greater attention to somatic risk factors in old age, and implementation of low-threshold, sex-sensitive preventive measures.

This study examined sex-related differences in lower-limb surface electromyographic (sEMG) characteristics during prolonged overground walking and their sensitivity to signal processing. Publicly available recordings from 31 healthy adults (19 females, 12 males), comprising 13,465 gait cycles, were analyzed. Root mean square amplitude (RMS), peak amplitude, integrated EMG (iEMG), and stride-to-stride RMS coefficient of variation (CV) were evaluated. Raw and band-pass-filtered features were compared with filtered features normalized to the peak of each participant-side-muscle ensemble-mean walking envelope. Two channels with signal-quality concerns were excluded from the QC-screened dataset and retained in an inclusive sensitivity analysis. Mixed-effects models adjusted for height and body weight included 28 participants, contributing 278 and 280 participant-side-muscle summaries, respectively. In the QC-screened dataset, males had higher tibialis anterior (TA) and gastrocnemius lateralis (GL) peak amplitudes and higher GL RMS across all processing variants after Holm correction. The TA RMS contrast was significant only in the raw analysis; a hamstring-region peak contrast was significant only after task-reference normalization. No muscle-specific iEMG comparison survived Holm correction. Including the two excluded channels produced limited changes in TA and GL amplitude estimates, whereas CV findings were sensitive to processing and channel exclusions. Sex-related sEMG associations depended on muscle, outcome, and processing approach. Selected amplitude contrasts persisted on a task-relative scale, but these findings do not establish differences in neural drive, maximal activation capacity, or walking function. Key words Surface electromyography " Gait analysis " Sex differences " Human locomotion " Lower limb.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder and is the most common form of dementia. Women are differentially affected by AD, and several sex-specific mechanisms have been explored, including hormonal differences (eg, estrogen). Glucagon-like peptide-1 (GLP-1R) are located in brain regions implicated in the pathogenesis of AD and shows preliminary evidence of modulating sex-specific pathways that may underlie differential disease risk and progression. Herein, we synthesize the extant literature on the mechanisms of GLP-1 in neurobiological systems relevant to AD pathology. Metabolic signalling (eg, GLP-1, insulin) intersects with known sex-specific pathways hypothesized to subserve AD progression in women. The preceding effects may be attributable to the disruption of estrogen signalling during the postmenopausal period, which impairs hippocampal insulin receptor function and exacerbates mitochondrial dysfunction. In addition, these mechanisms provide an explanation for AD comorbidities (eg, type 2 diabetes mellitus [T2DM]). The multidimensional effects demonstrated in GLP-1 paradigms provide a compelling rationale for further investigation of the role of metabolic signalling on sex-specific alterations in AD. Evidence across preclinical and early clinical studies suggests that GLP-1RAs may differentially influence neurobiological pathways implicated in AD pathogenesis, particularly those that interact with hormonal and metabolic systems.

Women's health (WH) is recognized as a core competency in internal medicine (IM) residency programs, yet residents report inadequate training and low comfort across WH topics. Some IM residencies have established tracks to meet this need, but no comprehensive review of their implementation and structure exists. We describe the current state and best practices for WH tracks in IM residency programs. We reviewed current WH tracks within U.S. categorical IM residency programs. Program websites were reviewed for information on leadership, clinical focus, and requirements. Track leaders were contacted for verification and additional information. Four well-established tracks were selected as case studies. There are 12 WH tracks in IM residencies. Key common elements among successful tracks include regular educational sessions, dedicated clinical training blocks, at least two core WH practicing general IM faculty, faculty salary support, and administrative support. Clinical training blocks consistently include focused primary care experiences and subspecialist clinical partnerships. Educational activities often include both faculty- and resident-led sessions. Resident participation ranges from 0 to 8 per postgraduate year. Successful tracks cultivate community through social events and mentorship. Challenges include financial and administrative support and recruiting and retaining core faculty. WH tracks offer a solution to IM training limitations. Successful tracks are characterized by consistent clinical training, didactic education, and mentorship. They effectively build community, establish robust primary care training, support residents across various career interests, and cultivate strong faculty teams and subspecialist partnerships. Dedicated faculty time and administrative support are key to sustained success and growth.

In the Women's Health Initiative (WHI) Dietary Modification (DM) randomized trial, a low-fat dietary pattern intervention reduced breast cancer mortality (P = 0.02). Higher dietary advanced glycation end-products (dAGE) may be associated with higher breast cancer incidence. In this report, we examined whether the WHI dietary intervention influenced dAGE consumption. Of 48,835 postmenopausal women randomized (40:60) to dietary intervention versus usual diet comparison, 40,209 had food frequency questionnaires at baseline, and serially through 5-7 years, which were used to estimate dAGE scores (kilo Unit/1000 kilocalories [kU/1000 kcal]) using a commonly referenced database. Multivariate regressions with repeated dAGE measures were examined by randomization group. Baseline mean dAGE scores were similar for intervention (7542 kU/1000 kcal, standard deviation (SD) = 912) and comparison (7514 kU/1000 kcal, SD = 917) groups. Through 5-7 years, dAGE scores were persistently lower in intervention versus comparison groups (mean range 5361-6236 kU/1000 kcal versus 7159-7669 kU/1000 kcal (P < 0.0001). The WHI low-fat dietary pattern intervention substantially reduced dAGE consumption. NCT00000611; Date: 10/28/1999.

Pre-eclampsia, a high-risk pregnancy complication, poses significant threats to maternal and fetal health. Globally, little is known about how women navigate a pre-eclampsia diagnosis or their perceptions of the pathology, unpredictable course, and treatment. Guided by the Health Belief model, this study explores pregnant women's beliefs about pre-eclampsia in Ghana's most populous region. A qualitative descriptive study was conducted at a district hospital in the Ashanti Region of Ghana to explore pregnant women's narratives of their health beliefs and perceptions regarding pre-eclampsia. Sixteen participants were purposively selected, and one-on-one semi-structured interviews were conducted in October 2021. Data were analyzed using qualitative content analysis. Categories were developed inductively from participants' accounts and subsequently interpreted in relation to the constructs of the Health Belief Model. Pregnant women's risk perceptions of pre-eclampsia varied, with some not perceiving personal risk, while a few felt vulnerable based on community experiences and observations of other women. Pre-eclampsia was widely regarded as a serious condition, with many expressing fears of adverse maternal and fetal outcomes. Participants recognized the benefits of antenatal care and lifestyle modifications in reducing risk and empowering care-seeking, while previous experiences with pre-eclampsia and guidance from health providers served as key cues to action. However, several barriers to care were identified, including financial constraints, mistrust of the health system, and inadequate communication from health providers. This study highlights the need for context-specific approaches to address health beliefs related to pre-eclampsia. Strengthening maternal health literacy, effective risk communication, and respectful care can improve early recognition, care-seeking, and outcomes for pre-eclampsia.

Women's health includes many biological and social challenges, such as reproductive disorders, maternal complications, osteoporosis, and gynecological cancers. Many current treatments have limitations like poor drug solubility, side effects, and lack of targeted delivery for female physiology. Metal-organic frameworks (MOFs), which are crystalline porous materials made of metal nodes and organic linkers, are being studied as advanced drug delivery systems to solve these problems. This review explains how MOF-based systems can be used in women's healthcare. MOFs like UiO-66 and ZIF-8 are used in targeted chemotherapy for breast and ovarian cancers. These systems are pH-responsive and ligand-functionalized, which improves treatment efficiency and reduces side effects. MOFs are also useful in bone health, where they help deliver calcium, vitamin D 3 , and other osteogenic ions for treating postmenopausal osteoporosis. MOFs are being explored for hormonal regulation, non-hormonal contraception, and treatment of gynecological infections. However, there are still challenges such as long-term safety, metal ion leakage, and the need for proper testing in maternal-fetal conditions. With further research on safe synthesis methods and toxicity evaluation, MOFs can become an important platform for personalized and effective treatments in women's health.

Somalia has one of the highest maternal mortality ratios and low coverage of maternal health services. Evidence on socioeconomic and geographic inequalities across maternal care continuum remains limited. This study examined wealth-related inequalities and determinants of maternal health service utilisation in Somalia. We analysed data from the 2020 Somali Health and Demographic Survey (SHDS), including 8,598 ever-married women aged 15-49 years with a recent live birth. Outcomes were at least one antenatal care visit (ANC), health facility childbirth, and postnatal care (PNC) within 2 days of birth. Multilevel mixed-effects logistic regression examined associations with socioeconomic, geographic, and empowerment-related factors, while Erreygers Concentration Indices (ECIs) assessed wealth-related inequalities. Results are presented as adjusted odds ratios (aORs), ECIs, and 95% confidence intervals (CIs). Coverage was low: 32.4% attended at least one ANC visit, 24.2% delivered in a health facility, and 10.9% received PNC. Nomadic women were less likely to deliver in a health facility (aOR = 0.45; 95% CI: 0.35, 0.58) and receive early PNC (aOR = 0.49; 95% CI: 0.32, 0.75). Rural residence, the Northeastern and Southcentral zones, and higher parity were associated with lower service utilisation, whereas higher education, mobile phone ownership, household wealth, and media exposure increased utilisation. Pro-rich inequalities were observed for ANC (ECI: 0.40), health facility childbirth (ECI: 0.38), and early PNC (ECI: 0.19). Maternal health service utilisation remains critically low with socioeconomic and geographic inequalities. Equity-focused strategies targeting rural, remote, and nomadic populations are needed to accelerate universal health coverage. Main findings : Coverage of antenatal care, facility childbirth, and early postnatal care in Somalia remains critically low, with substantial inequalities by wealth, geography, and community type. Added knowledge : Using nationally representative survey data, this study shows that women from nomadic, and poorer remote communities are consistently less likely to access essential maternal health services across the maternal care continuum. Global health impact for policy and action : Reducing maternal health inequalities in fragile settings will require targeted outreach, financial protection, stronger primary health care, and sustained investment in women’s education and empowerment.

Maternal health literacy (MHL) plays a critical role in ensuring positive maternal and neonatal health outcomes; however, limited evidence exists on the functional aspect of MHL among pregnant women in Ghana. This study assessed the level of functional MHL, associated demographic factors, and perceived barriers among pregnant women attending antenatal care (ANC) at a university hospital in Ghana. A hospital-based cross-sectional study was conducted among 235 pregnant women attending ANC from November 2024 to February 2025. Participants were selected using simple random sampling. Data were collected through a structured questionnaire adapted from validated health literacy tools and analyzed using Stata/SE version 17.0. Descriptive statistics were used to summarize the data. Associations were assessed using chi-square and Wilcoxon rank-sum tests, while logistic regression was used to identify associated factors. The median age of participants was 29 years (IQR: 24-33), and 55.3% had tertiary education. Overall, 54.9% of the women demonstrated high MHL. Educational level, age, employment status, and parity were associated with MHL at the bivariate level; however, only education remained independently associated with MHL in the adjusted model. Women with primary [aOR = 0.02, 95% CI: 0.01-0.11] and secondary education [aOR = 0.27, 95% CI: 0.14-0.54] were less likely to have high MHL compared to those with tertiary education. The most reported barriers were poor communication from healthcare providers (47.2%) and lack of resources (34%). Nearly half of pregnant women demonstrated low functional MHL, with educational attainment identified as a factor associated with MHL. Strengthening health-literacy-responsive communication and integrating group antenatal care may enhance comprehension and informed decision-making.

Maternal health utilization in fragile states is hindered by complex social and structural barriers. This study examined socio-digital stratification and explored the threshold effects of digital inclusion on antenatal care (ANC) utilization in Somalia. Using data from the 2020 Somalia Demographic and Health Survey ( N = 8,940), we constructed a Digital Inclusion Index (0-3) and employed survey-adjusted logistic regression models to estimate the odds of achieving four or more ANC visits (ANC 4+). Only 8.4% of the women achieved the ANC 4+ threshold, with pronounced disparities between urban (14.0%) and rural/nomadic (5.5%) residents. Evidence consistent with a threshold effect was observed, whereby the initial transition from digital exclusion to basic connectivity (score = 1) was associated with the largest marginal gain in health seeking probability (OR = 1.55, p = 0.013). While mobile money penetration is high (85.2%), internet access remains deeply stratified by wealth (22.0% among the rich versus 1.0% among the poor). Interaction analysis suggests that digital inclusion complements but does not substitute for physical health infrastructure, partially mitigating distance-related barriers without eliminating the need for physical proximity to healthcare facilities. Digital inclusion is a critical entry point for improving maternal health access in Somalia. Policies should prioritize universal basic connectivity and SMS-based interventions, while simultaneously addressing persistent physical and socioeconomic inequities. Main findings: This study identifies a significant threshold effect where the initial transition to basic mobile connectivity provides the largest marginal gain in maternal health service utilization. Added knowledge: While mobile financial services have achieved broad penetration, a deep data divide persists, and digital tools function as complements to, rather than substitutes for, physical health infrastructure. Global health impact for policy and action: Public health interventions in fragile states should prioritize universal basic connectivity and text-based communication over data-intensive applications to avoid widening health inequalities.

The increasing prevalence of non-communicable diseases like chronic kidney disease signals the need for a deeper understanding of the impact of the intra-uterine milieu on developmental programming and its impact on health outcomes through the lifespan of an individual. Maternal health in the pre-gestational and gestational phases, including nutrition, exposure to drugs, environmental toxins, infectious and non-infectious diseases, and socio-economic conditions influence the overall development of the fetus as well as the fetal kidney. The small, vulnerable newborn, born from an adverse developmental environment, is predisposed to low nephron number and is at risk for acute kidney injury in the neonatal period. Developmental programming has far-reaching consequences, including a higher risk for cardio-kidney-metabolic diseases, including hypertension and chronic kidney disease, and pregnancy complications, which perpetuates an intergenerational cycle of non-communicable disease risk. This risk can be mitigated by optimizing the care of individuals in the reproductive age group, identifying high-risk pregnancies early, and providing optimal treatment and monitoring. Care of the small vulnerable neonate includes prevention of acute kidney injury and life-long surveillance and modulation of cardio-kidney-metabolic risk. The review focuses on highlighting the influence of maternal health in the pre-gestational and gestational phases on kidney health from the neonatal period to adulthood.

The Ludeman Family Center for Women' s Health Research (Ludeman Center) at the University of Colorado (cwhr@ucdenver.edu) organized its 4th National Conference at The Broadmoor Hotel in Colorado Springs, CO. The research presentations and discussions from the three-day October 2024 conference addressed sex differences across the life span with a focus on cardio-metabolism and mental health. Over one hundred thirty participants, including scientists, clinicians, policy makers, advocacy group leaders and federal agency representatives participated in the meeting. In this manuscript, we briefly summarize the conference scientific presentations made at the 2024 meeting which were organized into 3-day sessions as well as poster sessions.

The global transformations in health care system, directed from reactive medicine to proactive and preventive model bring to the forefront issues of protection of female health. The health of woman is not only fundamental basis, but also key factor of social economic well-being of society, demographic stability and health of future generations. The traditional fragmented model of provision of obstetric gynecological care, focused mainly on treatment of already occurred pathologies and pregnancy management, demonstrates its inefficiency in the context of modern challenges: increase of chronic noncommunicable diseases, psycho-emotional loads and need of integration of reproductive health into general context of well-being of woman at all stages of her life. In the Russian Federation, the problem of modernization of obstetric gynecological service and, in particular, women consultations, is especially acute. Historically, The historically established system is often criticized for bureaucratization, insufficient focus on prevention and disparity between various levels of medical care. In this regard, emergence and implementation of new regional standards, in particular, metropolitan standard of obstetric gynecological care and Centers of Female Health is unique case requiring detailed scientific analysis and comparison with international advanced experience. The actuality of the study is conditioned by increasing need in developing new paradigm of medical care support of women, built on principles of complexity, continuity, personalization and orientation on prevention. The Centers of Female Health, integrating large spectrum of services, from screenings and diagnostics to psychological support and training programs, are considered by world community as gold standard of organization of such care. Глобальные трансформации в системе здравоохранения, устремленные от реактивной медицины к проактивной, превентивной модели, выдвигают на первый план вопросы охраны женского здоровья. Здоровье женщины является не только фундаментальной основой, но и ключевым фактором социально-экономического благополучия общества, демографической стабильности и здоровья будущих поколений. Традиционная фрагментированная модель оказания акушерско-гинекологической помощи, сфокусированная преимущественно на лечении уже возникших патологий и ведении беременности, демонстрирует свою неэффективность в контексте современных вызовов: росте хронических неинфекционных заболеваний, психоэмоциональных нагрузок и необходимости интеграции репродуктивного здоровья в общем контексте благополучия женщины на всех этапах жизни. В Российской Федерации проблема модернизации акушерско-гинекологической службы, в частности женских консультаций, стоит особенно остро. Исторически сложившаяся система часто критикуется за бюрократизацию, недостаточный фокус на профилактике и разобщенность различных уровней медицинской помощи. В этой связи появление и внедрение новых региональных стандартов, в частности столичного стандарта акушерско-гинекологической помощи и Центров женского здоровья, представляет собой уникальный кейс, требующий детального научного анализа и сравнения с передовым мировым опытом. Актуальность данного исследования обусловлена нарастающей потребностью в создании новой парадигмы оказания медицинской помощи женщинам, построенной на принципах комплексности, непрерывности, персонализации и ориентации на профилактику. Центры женского здоровья, интегрирующие в себе широкий спектр услуг, от скринингов и диагностики до психологической поддержки и образовательных программ, рассматриваются мировым сообществом как золотой стандарт организации такой помощи.

Nigeria continues to experience high maternal and child mortality, despite extensive health reforms and international investment. Missed opportunities across the continuum of care, antenatal care (ANC), skilled birth attendance, facility-based delivery, and child immunization, contribute to these outcomes. Children who receive no vaccines (zero-dose) reflect a key vulnerability in service delivery. To identify factors associated with zero-dose immunization and patterns of maternal healthcare utilization among women in six Nigerian states. A cross-sectional household survey was conducted in Gombe, Kaduna, Kano, Katsina, Lagos, and Niger states. A total of 1,958 women aged 15-49 years with recent live births were interviewed. Structured questionnaires captured data on ANC attendance, delivery location and attendant, immunization status, and socio-demographic characteristics. Descriptive statistics, chi-square tests, and multinomial logistic regression were used to assess predictors of maternal and child health service utilization. Only 31% of women received complete care; 58% received partial care, and 11% received none. Zero-dose prevalence was significantly higher among children whose mothers had fewer than four ANC visits (35%), delivered at home (35%), or were attended by unskilled providers (39%). Lower zero-dose rates were found among those delivered in facilities (16%) or by skilled attendants (19%). Key predictors included maternal and paternal education, socioeconomic status, geographic location (notably Kano and Katsina), and maternal age. Significant disparities in maternal and child health service utilization remain. Expanding ANC coverage, increasing skilled facility-based deliveries, and ensuring postnatal immunization linkage are essential to reduce zero-dose prevalence and promote equity in low-resource settings. Main findings: Women who received fewer than four antenatal care visits, delivered at home, or used unskilled birth attendants were significantly more likely to have children who received no routine vaccinations. Added knowledge: This study uniquely links maternal healthcare utilization across the continuum of care with zero-dose immunization outcomes, highlighting compounded service gaps in low-resource settings. Global health impact for policy and action: Targeted, equity-focused interventions that integrate maternal health services with immunization efforts are essential to reducing zero-dose prevalence and achieving universal health coverage in underserved populations.

Disparities in women's health have been identified in clinical outcomes, research, and medical education. However, women's health education remains inconsistent in internal medicine training. Longitudinal women's health training tracks have proven positive impacts on trainees' confidence with women's health clinical practice, and graduates of these tracks go on to become leaders who further expand these efforts. Our objective was to update the 2023 Directory of Internal Medicine Residency and Fellowship Programs in Women's Health to provide trainees and clinician educators with a centralized list of U.S. internal medicine residency and fellowship women's health training programs. We contacted women's health education program leaders from the 2023 directory to update their program information. We sent a recruitment email to the Sex-and Gender-Based Women's Health Education Interest Group listserv of the Society of General Internal Medicine and used snowball sampling to identify new programs. New program leaders were sent an electronic Qualtrics survey to confirm current program status, contact information, website, capacity, educational offerings, and program highlights. This directory describes 29 graduate medical education training programs in women's health for internists, with 12 residency programs and 17 fellowship programs identified. This is an overall increase from the 25 programs in the 2023 directory. This directory is a practical resource for trainees seeking educational experiences and for medical educators seeking opportunities for collaboration and leadership in women's health. The increase in training opportunities is a step toward comprehensive medical education and equitable, high-quality care and research in women's health.

Prescribed aerobic exercise is the recommended treatment for athletes with sport-related concussion (SRC) who present with exercise intolerance. A recent randomized controlled trial (RCT) found that higher volumes of aerobic exercise, compared with lower volumes, may not be as efficacious in adolescent females with SRC compared with adolescent males. We reanalyzed data from our previously published randomized controlled trials (RCT) and hypothesized that prescribed aerobic exercise, and not stretching, within 10 days of injury would result in faster recovery after SRC in males compared with females. The first RCT ( n = 103) recruited from 2015 to 2018 and the second RCT ( n = 115) recruited from 2018 to 2020. Sexes were compared in each RCT, then samples were stratified by sex, and intervention groups were compared using a Log-rank test. There were no significant differences in recovery times between males and females in either RCT, regardless of intervention. When stratified by sex and comparing intervention groups, males in RCT1 who were prescribed aerobic exercise ( n = 28) recovered 6 days faster than males prescribed stretching ( n = 27, p = 0.004) but there was no significant difference for females (aerobic exercise [ n = 24] vs. stretching [ n = 24, 3-day difference, p = 0.564]). In RCT2, males prescribed aerobic exercise ( n = 39) recovered 8 days faster than the stretching group ( n = 34, p = 0.020), whereas there was no significant difference for females (aerobic exercise [ n = 22] vs. stretching [ n = 20, 3-day difference, p = 0.587]). This reanalysis of prior RCT data revealed that male adolescents after SRC recovered significantly faster by 7-8 days when prescribed aerobic exercise within 10 days of injury, whereas female adolescents had a nonsignificant improvement of 3 days. Future adequately powered studies should account for variability between sexes.

Singapore remains vulnerable to the evolving international drug abuse situation. According to data from the Central Narcotics Bureau of Singapore, 3122 drug abusers were arrested in 2023, of whom 15% were female. We undertook a comprehensive literature search from inception to April 2021 on a range of illicit drugs, including the commonly abused drugs in Singapore-methamphetamine, heroin, new psychoactive substances, cannabis, cocaine and 3,4-methylenedioxymethamphetamine. Our objective was to provide an overview of the effects of these drugs on maternal health, enabling healthcare providers to holistically manage maternal well-being. Notably, the extent of these effects depends on the type of drug involved, and there is no one-size-fits-all approach. Drug abuse in pregnancy is a complex medical problem that requires a comprehensive management strategy addressing physical, emotional and social aspects.

Hallux valgus is a common structural deformity due to misalignment of the first metatarsophalangeal joint that can lead to functional impairment, pain, and difficulties with shoe wear. There are drastic differences in the epidemiology between men and women. Women have a significantly higher prevalence of hallux valgus deformities. The etiology and progression of the deformity is highly intricate due to the interplay of anatomic considerations, hormonal changes, behaviors, and genetics. Based on risk factors, a patient-specific treatment algorithm is necessary. Future studies should address the underrepresentation of males seen in the currently-available research.

Data on sex differences in out-of-hospital cardiac arrest (OHCA) are well described in developed countries, but scarce in developing countries. This prospective, multicenter, population-based observational cohort study used data from the Baseline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA) study collected between January 1, 2020, and December 31, 2020. Differences in outcomes were assessed using multivariable hierarchical logistic regression, with prespecified subgroup analyses and interaction tests. The age-standardized incidence rate of emergency medical system (EMS)-treated OHCA was higher in males than in females (48.1 vs 20.8 per 100,000 person-years, IRR = 2.31, 95% CI: 2.26-2.36) in China. Among 33,650 EMS-treated OHCA patients, 10,793 (32.1%) were females. Females had less favorable resuscitation characteristics and prehospital care than males. In multivariable models, females had significantly higher odds of prehospital return of spontaneous circulation (adjusted odds ratio [OR] = 1.21, 95% CI: 1.06-1.38) and survival to hospital admission (adjusted OR = 1.33, 95% CI: 1.15-1.55). However, no significant sex difference was observed for survival to hospital discharge or 30 days (adjusted OR = 0.85, 95% CI: 0.66-1.10), or favorable neurological outcome (adjusted OR = 0.84, 95% CI: 0.62-1.14). In subgroup analyses, females had lower odds of survival and favorable neurological outcome than males among patients aged ≥50 years, those with shockable rhythm, and those without prehospital epinephrine administration. In China, females demonstrated better prehospital resuscitation outcomes. However, this early advantage was lost by discharge. These findings highlight the need for integrated evaluation across prehospital and in-hospital care to inform disparity-reduction strategies.

Sex-specific differences in complications and outcomes among patients with Wilms tumor (WT) during treatment and follow-up remain poorly understood. This study aimed to investigate these differences, hypothesizing that outcomes may be improved through sex-based management considerations. We conducted a retrospective, single-center comparative study of patients treated between 2009 and 2024 at a pediatric tertiary care center. One hundred thirty-four patients with WT were included. No significant sex differences were observed in age, weight, height, or presenting symptoms. Bilateral WT was significantly more frequent in females (13 [18%] vs. 2 [3%], P = 0.011), whereas left-sided WT in males (35 [57%] vs. 28 [38%], P = 0.037). At diagnosis, no sex-related differences were noted in imaging findings (metastases, renal or caval vein thrombus, tumor size) or laboratory values. A caval thrombus was identified in 9 patients (7%), with no initial sex difference. After neoadjuvant therapy, persistent thrombus was significantly more common in females (6 [8%] vs. 0 [0%], P = 0.007). No sex differences were found in intraoperative renal vein thrombosis, but intraoperative caval thrombosis occurred significantly more often in females (6 [8%] vs. 0 [0%], P = 0.007). Tumor rupture/spillage, nodal sampling, and nodal involvement were comparable between groups. Histologic subtype and risk distribution were comparable between sexes, whereas local stage differed significantly, with stage III disease more frequent in females (45% vs. 17%, P = 0.001) and stage II disease more frequent in males (34% vs. 12%, P = 0.004). Follow-up included 131 patients (3 lost). Median age at last follow-up was 9.2 years (range: 2.3 to 25.7). Event-free survival (EFS) was significantly higher in males than in females (56 boys [94%] vs. 57 girls [80%], P = 0.040). Females experienced significantly more events (14 [20%] vs. 4 [6%], P = 0.040), although no differences were observed in event type, relapse site, overall survival (OS), or mortality. Female patients with WT may experience a more complex clinical course, reflected by higher rates of bilateral disease, persistent and intraoperative caval thrombus, inferior EFS, and a greater frequency of events during follow-up.