npj women's health最新文献

Autonomic symptoms are common in Parkinson's disease and vary according to patterns of dopaminergic neurodegeneration. The impact of sex and striatal denervation asymmetry are interesting avenues for observing distinct patient phenotypes from the early stages of the disease. This exploratory study investigates how striatal denervation asymmetry and sex influence autonomic dysfunction profiles in early-stage, treatment-naive Parkinson's disease. Using data from the Parkinson's Progression Markers Initiative (n = 759), we applied generalized linear mixed models to assess SCOPA-AUT scores across subtypes of striatal denervation (left-predominant, right-predominant, symmetric), modeling the interaction with sex. Patients with symmetric striatal denervation exhibited significantly greater overall autonomic dysfunction, particularly in sexual domains (p = 0.045). Sex-specific effects emerged: women showed more pronounced thermoregulatory symptoms (p = 0.001), whereas men exhibited more severe urinary and sexual dysfunction, especially in the symmetric group (p < 0.0001). These findings suggest the potential of integrating striatal denervation asymmetry and sex into Parkinson's disease subtype characterization, with implications for personalized symptom management.

In this study, we assessed if women with endometriosis have greater odds than matched controls of receiving an autoimmune diagnosis within two-years of their endometriosis diagnosis. We conducted a retrospective cohort study using two large-scale administrative claims databases (2010-2017), identifying 332,409 patients with endometriosis and 1,220,932 matched controls. Compared to matched controls, patients with endometriosis had an increased risk of being diagnosed with rheumatoid arthritis, Hashimoto's disease, systemic lupus erythematosus, multiple sclerosis, pernicious anemia, Sjogren's syndrome or myositis within two-years of their endometriosis diagnosis. The odds of receiving a diagnosis of at least one of the autoimmune conditions among patients with endometriosis were approximately two times greater than matched controls. Our study is the first to show a significant association between endometriosis and autoimmune conditions within a two-year diagnosis window, adding to growing evidence suggesting a potential link between endometriosis and autoimmunity, warranting investigation into shared mechanisms.

Bacterial vaginosis (BV) is associated with HIV transmission and pre-term birth, yet the etiology of BV remains unknown. Our analysis addressed that knowledge gap by comparing diagnostic techniques and using Bayesian inference to find species-specific associations with clinical indicators. We also assessed the effect of sequencing methodology on the results of molecular BV profiling. We observed significant differences in microbial diversity within BV-associated CSTs based on clinical diagnosis. CST assignments were substantially influenced by sequencing methodology, with concordance between methods as low as 59% for metatranscriptomic and metataxonomic-based CST assignment. We also found that Gardnerella has a strain-dependent association with individual Amsel's criteria, and that Dialister micraerophilus and Parvimonas micra are positively associated with Amsel's criteria while Lactobacillus is negatively associated. These results highlight the challenge of characterizing a condition without a single etiological agent, reinforcing the need for more granular diagnoses and treatments that are sensitive to BV variability.

Approximately half of U.S. women giving birth annually receive Pitocin, a synthetic form of oxytocin (OXT), yet the optimal dosing remains challenging due to significant individual variability in response. To address this, we developed a mathematical model examining the effects of five OXT receptor (OXTR) variants (V45L, P108A, L206V, V281M, and E339K) on OXT-OXTR binding dynamics in human embryonic kidney cells (HEK293T) and myometrial smooth muscle cells. The model was parameterized using experimentally derived, cell-specific OXTR surface localization measurements and literature-reported OXT-OXTR-binding kinetics. The model revealed differences in time to equilibrium between HEK293T and myometrial cells, distinct dynamics among genetic variants, and that early increases in OXT could partially rescue diminished responses in V281M and E339K variants. This model provides key insights into how genetic variants influence OXT dose responses and offers a framework for tailoring OXT dosing to patient-specific genetic profiles.

Pregnant adolescents often face social, emotional and physical challenges, compounded by inadequate support. Drawing on a Straussian grounded theory approach, we explored the social processes and perspectives that influence adolescent pregnancy experiences in Zambia. Semi-structured interviews were conducted with adolescents (n = 26), partners (n = 8), parents/legal guardians of adolescents (n = 8), healthcare workers (n = 6), and key stakeholders (n = 5). Data were subjected to open, axial and selective coding, and a core category 'Support me like a child, respect me like an adult', generated. Bronfenbrenner's socio-ecological framework was also used as a theoretical lens to aid understanding of the social interactions between three interlinked categories feeling vulnerable and alone, age discrimination, and lack of agency and autonomy. Narratives highlighted social disapproval, influenced by cultural values, beliefs and social norms. Trying to navigate systems and spaces in which adolescents (and others) believed they did not belong, was illuminated. The need for an inclusive and supportive environment in which adolescents can feel cared for whilst also being respected for their own positionality and decisions, is critical.

Early onset preeclampsia is a placental disorder characterized by shallow implantation, whereas placenta accreta spectrum is a placental disorder of deep placental attachment. This study compares the transcriptome of these two obstetric syndromes. By integrating available microarray and single-cell placenta/decidua transcriptomic datasets, we demonstrated that early onset preeclampsia genes are inversely expressed in placenta accreta, with the most marked differences noted in cell types of decidua, endothelial, and extravillous trophoblasts. Our findings highlight the key functions of trophoblast cell migration and invasion, decidua cell signaling, hypoxia pathways, and global growth factor and collagen contributions to these pregnancy disorders. This research provides new insights into the mechanisms of placentation and unifies these clinical siloes of disease by focusing on the fundamental biology of placental development at the maternal-fetal interface.

Endometriosis is a chronic inflammatory condition requiring surgical or imaging visualization for definitive diagnosis. How endometriotic lesion characteristics relate to circulating inflammatory markers remains unclear. We evaluated 11 inflammatory biomarkers, including interleukin (IL)-1β, -6, -8, -10, -16, tumor necrosis factor (TNF)-α, thymus and activation regulated chemokine (TARC), monocyte chemotactic protein (MCP)-1, -4, and Interferon gamma-induced protein (IP)-10, in 566 participants with endometriosis from the Women's Health Study: From Adolescence to Adulthood (A2A), Endometriosis Oxford Care & Research (CaRe) study (ENDOX) and Endometriosis: Natural History, Diagnosis, and Outcome (ENDO) study to evaluate associations with endometriosis characteristics, including macrophenotype (superficial lesions only, versus endometrioma and/or deep lesions), lesion appearance (color, vascularity), and anatomic location. We observed nominally statistically significant variation in circulating inflammatory markers by lesion color, vascularity, and location but no significant associations between circulating inflammatory markers and rASRM stage or macrophenotype, which could be due to a small number of participants with non-superficial lesions.

To improve preclinical studies and their translation, patient-derived xenografts (PDXs) are increasingly used. They have human-specific tumor characteristics and reflect intra and inter-tumor heterogeneity. However, the endocrine milieu differs between humans and host mice. In light of sex-specific cancer biology and a rise in endocrine-related cancers there is an urgent need to correctly reflect the hormonal milieu in PDX models. We show that female mice of NOD.Cg-Prkdc ^scid Il2rg ^tm1Wjl /SzJ (NSG) strain widely used for PDXs has 17-β-estradiol (E2) and testosterone (T) levels comparable to C57Bl6 females but higher progesterone (P4) levels. E2 levels are comparable, T levels are lower and P4 levels higher than those observed in postmenopausal women. Ovariectomy increases T to levels observed in postmenopausal women. Subcutaneous E2 and combined E2/P4 silicon pellets provide NSG females with premenopausal ovarian hormone levels. These procedures humanize the endocrine environment of experimental animals, improving PDX relevance in women's health-related research.

Metabolites influencing miscarriage outcomes remain understudied. We hypothesized that aberrant metabolism impacts threatened miscarriage outcomes and that understanding these pathways could offer new management strategies. This case-control study analyzed serum metabolomics from 80 women between 5 and 12 weeks' gestation at KK Women's and Children's Hospital, Singapore, comparing three groups: women with threatened miscarriage who miscarried (TM_MC), those with ongoing pregnancies (TM_O), and women with normal pregnancies (NP). Using untargeted liquid chromatography-mass spectrometry and pathway analysis through MetaboAnalyst 5.0 and the Kyoto Encyclopedia of Genes and Genomes, 267 metabolites across 12 enriched pathways were identified. Dysregulations in steroid (AUC 0.82), folate (AUC 0.59), fatty acid (AUC 0.70), and glucosaminoglycan (AUC 0.64) pathways distinguished women who miscarried from those with ongoing pregnancies (TM_MC vs TM_O). We provide initial insights into the metabolic profile associated with miscarriage, highlighting disruptions in steroid hormone, fatty acid, folate, and glucosaminoglycan biosynthesis. Further validation may support biomarker development for prognostication.

This scoping review examines the use of artificial intelligence (AI) in sexual and reproductive health (SRH) to guide future research and policymaking. We conducted searches across four electronic databases in October 2023. We included primary research studies applying AI on any SRH topic, regardless of language and timeframe. Our search retrieved 12,823 articles, of which abstracts and full texts were independently screened by two reviewers, yielding 2666 studies for final analysis. The predominant health topics were maternal health (44.9%; n = 1198); reproductive cancers (29.2%; n = 779), mainly cervical cancer; and infertility and fertility care (12.6%; n = 337). AI tools were primarily used to facilitate screening and diagnosis (74.2%, n = 1980), support treatment and care management (8.7%, n = 233), and understand health trends (8.6%, n = 230). While substantial progress has been made in certain domains, significant gaps remain in geographic representation, methodological rigor, and deployment studies with external validity.