Search Results (485)

Considerations of gender have long been overlooked in legal discourses and public debates on asylum. In more recent years, the right-wing narrative has taken a strategic U-turn, instead misappropriating gendered concerns including gender-based violence for the purposes of promoting racialised border controls on the grounds of cultural incompatibilities, and by painting refugees as a threat to British values, economy and security. This paper calls out the hypocrisy of such femonationalist framings for overlooking the ways in which Western institutions sustain refugee women’s ongoing vulnerabilities. Drawing from qualitative interviews and focus groups with refugee women survivors of female genital mutilation/cutting (FGM/C), this paper examines the continuities of harm in the lives of women who have fled gender-based persecution to Britain. The paper critically maps the way prolonged state control during the asylum process perpetuates a sense of violence as ongoing, and its damaging implications on survivors striving to navigate life after flight. In doing so, the findings contribute new insights into established scholarship on asylum harms by illuminating the gendered consequences of violence of waiting, and refugee women’s subtle individual and collective strategies to struggle against violent continuums. Full article

Background: Maternity care for vulnerable pregnant women presents a particular challenge within midwifery practice. In Germany, maternity services lack standardized frameworks to adequately address the specific needs of individuals who have experienced, among other factors, sexualized violence, poverty, female genital mutilation/cutting (FGM/C), or discrimination. Limited access to healthcare among these populations contributes to increased maternal and neonatal morbidity and mortality. Emerging evidence indicates that comprehensive medical and psychosocial support provided by midwives can substantially improve obstetric outcomes for marginalized pregnant women. Methods: An elective course, Antenatal Care for Vulnerable Women, was offered in the sixth semester of the Bachelor’s program in Midwifery Science at the University of Tübingen in 2025. The course provided insights into the psychosocial challenges faced by vulnerable pregnant women and prepared students for these specific aspects of midwifery practice. The curriculum incorporated foundational lectures and innovative teaching formats aimed at cultivating constructivist approaches to problem-solving. All sixth-semester midwifery students were asked to assess their knowledge and skills across five vulnerability categories: asylum-seeking, FGM/C, intimate partner violence, trauma, and racism. A pilot pre–posttest analysis using a 6-point Likert scale (1 = very good, 6 = poor) was conducted as hypothesis-generating and curriculum-guiding. The pretest included 38 respondents. The posttest included 11 respondents who attended the course. Results: Students who attended the course demonstrated observable gains in knowledge and skills across all categories, with the greatest improvements in asylum-seeking, median of 5 (IQR 4–5) vs. 2 (2–3); FGM/C, 5 (4–5) vs. 2 (2–3); and racism, 5 (3–5) vs. 2 (2–3). Conclusions: Innovative teaching methods may contribute to preparing midwifery students for targeted care of vulnerable pregnant women. Findings from the pre- and posttests provide preliminary insight into the potential value of experiential learning and may inform the further development of practice-oriented teaching methods. Full article

The cervicovaginal microbiome (CVMB) is pivotal in maintaining the homeostasis of the lower female genital tract and has emerged as a significant modulator of cervical carcinogenesis. Although persistent infection with high-risk human papillomavirus (HR-HPV) is a prerequisite for the development of cervical intraepithelial neoplasia (CIN) and subsequent cervical carcinoma, it remains insufficient alone to drive oncogenesis. Accumulating evidence suggests that alterations in the CVMB composition profoundly impact HPV persistence, local immune responses, and disease progression. A vaginal microbiota dominated by Lactobacillus species, most notably Lactobacillus crispatus, correlates with low microbial diversity, robust immune regulation, and facilitated HPV clearance. Conversely, microbial dysbiosis—characterized by Lactobacillus depletion and a concomitant proliferation of anaerobic taxa, typical of Community State Type (CST) IV and Lactobacillus iners-dominated profiles—is strongly associated with chronic inflammation, oxidative stress, epithelial barrier compromise, and an elevated risk of CIN progression. This review synthesizes current evidence regarding the multifaceted interactions among the cervicovaginal microbiome, HPV pathogenesis, immune dysregulation, and oxidative stress in the etiology of CIN. Elucidating these intricate host–microbiome dynamics may precipitate the discovery of novel microbiome-derived biomarkers, ultimately informing innovative prophylactic and therapeutic interventions for cervical cancer. Full article

Background and Objectives: Müllerian duct anomalies (MDAs) are congenital malformations of the female genital tract for which several classification systems have been proposed. The objective of this study is to estimate the interrater reliability of the American Fertility Society (AFS), European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy (ESHRE/ESGE), American Society for Reproductive Medicine (ASRM) and Congenital Uterine Malformation by Experts (CUME) classification systems for Müllerian duct anomalies. Materials and Methods: This retrospective cohort study was conducted at a tertiary care hospital and included 71 patients aged up to 45 years who were assessed for a Müllerian duct anomaly between January 2000 and April 2023. Pelvic MRI images were independently evaluated by four readers, followed by a consensus meeting. The primary outcome was interrater reliability (Krippendorff’s α), and the secondary outcomes were the proportions of indeterminate and unclassifiable cases after consensus meeting. Results: The interrater reliability for MDA diagnosis was very low for all the classification systems (AFS α 0.63, 95% CI [0.57, 0.67]; ASRM α 0.46, 95% CI [0.41, 0.52]; ESHRE/ESGE α 0.33, 95% CI [0.29, 0.38]; CUME α 0.57, 95% CI [0.45, 0.72]). After consensus meeting, the ESHRE/ESGE system had more indeterminate cases (9.9%) and the ASRM system had more unclassifiable cases (20.6%). Conclusions: All the classification systems for Müllerian duct anomalies had a very low interrater reliability, with more indeterminate cases in the ESHRE/ESGE system and more unclassifiable cases in the ASRM system. We present our recommendations for the improvement of each classification system. The ultimate goal of future research should be the development of a single uniform system integrating the best features of these systems and with clinically relevant cut-off values, considering patients’ reproductive outcomes. Full article

Intravascular lymphoma (IVL) is an uncommon subtype of non-Hodgkin’s extranodal lymphoma, distinguished by the proliferation of neoplastic cells within the lumen of small- to medium-sized arteries, with various organs recorded as impacted. The objective of this study was to evaluate the current literature about IVL and its involvement in the female genital tract, including an overview of diagnostic methods, imaging, and pathological features, selected therapy modalities, and outcomes in patients afflicted by this malignancy. We performed a narrative review with a systematic identification and presentation of published cases of IVL affecting the female genital tract. A literature search was carried out across PubMed, Scopus, and Web of Science for relevant studies presenting data on IVL affecting the female genital tract. Case reports and series that met predefined inclusion and exclusion criteria specified by the modified PECOS (“Population,” “Exposure,” “Comparison,” “Outcomes,” and “Study design”) framework were included. Patients most commonly presented with abnormal vaginal bleeding, pelvic pain, and B symptoms. Fluorodeoxyglucose positron emission tomography computed tomography (FDG PET/CT), often performed alongside abnormal laboratory findings such as elevated lactate dehydrogenase (LDH), played a key role in raising suspicion for hematologic involvement of the female genital tract and guiding biopsy. Most cases represented B-cell intravascular lymphoma and were treated with Rituximab plus (CHOPR-CHOP) based chemotherapy, frequently combined with hysterectomy. Full article

The Siberian moth, Dendrolimus sibiricus Tschetverikov, is one of the most destructive conifer pests in Northern Asia, causing severe ecological and economic losses. In Russia, its range overlaps with that of the closely related pine-tree lappet Dendrolimus pini (L.), and this raises the potential for hybridization and complicates accurate identification, particularly in the context of the potential westward expansion of D. sibiricus. Here, we present the first comprehensive morphometric analysis of male genitalia aimed at distinguishing these two major forest pests and their hybrids. The study was based on D. sibiricus and D. pini specimens collected during the last 130 years (1894–2024) across Europe and Asia, including their hybrids reared indoors by crossing D. pini females with D. sibiricus males in 1956 and preserved in the collection of the Zoological Institute of the Russian Academy of Sciences (St. Petersburg, Russia). Overall, 70 permanent genitalia slides were prepared (33 D. sibiricus, 33 D. pini, and 4 hybrids), and the following genital structures were measured: valva and harpe length, aedeagus width and length, and cornuti length. Dendrolimus sibiricus had significantly larger genital structures compared to D. pini: 74% longer harpe, 32% longer valva, and a 28% wider and longer aedeagus. In contrast, in D. sibiricus cornuti were 21% shorter than in D. pini. Hybrids displayed intermediate values for valva, harpe, and aedeagus lengths, and for these parameters, they significantly differed from both parental species. The following diagnostic indices were suggested to distinguish between the two species and their hybrids: Harpe Length/Valva Length Index (HL/VL) and Cornuti Length/Aedeagus Length Index (CL/AL). Decision-tree analysis identified HL/VL as the strongest predictor for separating the parental species and the Combined Genital Proportion Index (CGPI), which integrates harpe, valva, aedeagus, and cornuti lengths, as the strongest predictor for identifying hybrids. The morphometric criteria developed here have practical applications for monitoring programs and quarantine diagnostics, particularly in sympatric zones and regions at risk of D. sibiricus expansion. Full article

Sexual dysfunction (SD), more specifically vasculogenic erectile dysfunction (ED) in men and female sexual arousal disorder (FSAD) in women, is increasingly recognized as a marker of cardiovascular disease (CVD). While extensive literature documents vasculogenic ED as an early warning sign of coronary artery disease (CAD) and other atherosclerotic manifestations, the evidence for analogous phenomena in women is emerging but less mature. This perspective explores epidemiologic associations, shared pathophysiologic mechanisms, clinical implications, and screening paradigms for ED and FSAD as cardiovascular (CV) risk-enhancing conditions. This perspective endorses that clinicians should incorporate genital vasculogenic SD into CV risk stratification and that multidisciplinary care (primary care, cardiology, urology/gynecology) is warranted. A summary table outlines key features and actionable steps. Full article

Background: The labia minora are cutaneous folds richly innervated along their entire edge and are important for the protection of internal structures. Several studies have emphasized the wide interindividual variability in labia minora appearance. Aim: We aimed to conduct a systematic review and meta-analysis of research that has quantitatively described labia minora in healthy premenopausal adult women. Methods: Following Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) guidelines, we searched PubMed, Scopus, and Web of Science without date or language restrictions using the following terms and Boolean operators: (“labia minora” OR “vulva”) AND (anatom*) AND (measure* OR morphometr*). The search was last conducted on 27 October 2025. Observational studies reporting clinical measurements of labia minora length and/or width in women undergoing routine gynecological care were included. Results: The total number of records identified was 567. Seven cross-sectional studies comprising 991 women met the inclusion criteria. All studies collected measurements in hospital or outpatient clinical settings in Europe, Asia and the Middle East. All the measurements were conducted in the lithotomy position using standardized instruments. The range of labia minora length across studies varied from 36.5 mm to 60.6 mm. The labia minora width ranged from 14.7 mm to 21.8 mm. All studies described marked interindividual variability, with wide, overlapping ranges between samples. An important limitation concerns the incomplete assessment of measurement reliability in two of the included studies. A total of three studies, encompassing 307 women, provided the necessary data to permit meta-analysis. The pooled mean labia minora length was 53.23 mm (95% CI: 43.50–62.96), while the pooled mean labia minora width was 18.28 mm (95% CI: 14.93–21.64). The analysis of between-study variability revealed statistically significant heterogeneity (Cochran’s Q test, p < 0.001) and considerable heterogeneity (I² > 75%) for both outcomes, i.e., labia minora length and width. Conclusions: The findings demonstrate substantial variability in labia minora dimensions. The integration of these data into medical education and clinical guidelines may be useful to reduce unnecessary interventions. Register: PROSPERO (registration number: CRD420251174590). Full article

Müllerian anomalies are anatomical variations of the female reproductive tract resulting from the incomplete development of the embryonic Müllerian ducts. The molecular mechanisms driving Müllerian duct development are complex and poorly understood, resulting in the largely unexplained aetiology of these conditions. WNT5A is a critical regulator of key developmental processes, including patterning, cell proliferation, and migration. Mutations of WNT5A have been associated with Robinow syndrome, a congenital condition characterized by skeletal and genital anomalies. In the mouse, WNT5A is necessary for the posterior development of the Müllerian duct, and ablation of Wnt5a results in vaginal agenesis. However, Wnt5a-/- uterine horns are hypoplastic and over 60% shorter than the wild type, suggesting specific functions in anterior Müllerian duct development. To better understand the role of Wnt5a, we performed single-cell RNA sequencing of developing Müllerian ducts. We found that the non-canonical Wnt PCP pathway was dysregulated in Wnt5a-/- mice. In addition, Wnt5a-/- Müllerian ducts were enriched in oviductal mesenchymal cells due to the transformation of the anterior uterine horns into oviducts. Our results indicate additional roles for Wnt5a during Müllerian duct development, prompting further investigations into uterine functions and anatomy in complex clinical cases of Müllerian anomalies including Robinow syndrome. Full article

Body size is a key trait influencing life history and ecological adaptation, and sexual size dimorphism (SSD) reflects divergent selective pressures acting on males and females. In morphologically conserved insect groups such as Cassidinae leaf beetles, the external similarity between sexes often impedes accurate dimorphism assessment. To address this, we conducted a systematic morphometric study of ten Cassidinae species from the Nanling Mountains—the largest east–west mountain system in southern China—where we definitively assigned sex via genital dissection. We measured body weight, body length, body width, length–width ratio, and corresponding wing traits. Across all species, SSD was consistently female biased, with statistically significant but subtle differences in most traits; body weight exhibited the greatest relative disparity. While this pattern aligns with the fecundity advantage hypothesis, direct fecundity data were not collected. Crucially, interspecific allometric analyses revealed that the scaling of male and female body sizes was statistically indistinguishable from that of isometry, providing no significant support for Rensch’s rule in this female-biased system. Our findings offer foundational insights into SSD evolution in cryptically dimorphic, herbivorous beetles and highlight the need for phylogenetically informed studies across broader geographic and taxonomic scales. Full article

Background/Objectives: Infertility is a major public health concern, affecting one in six individuals worldwide and nearly one-quarter of couples in France. While a male, female, or combined factor can be identified in approximately 75% of cases, infertility remains unexplained in 10–25%. Genital tract infections account for roughly 15% of male infertility cases and are often asymptomatic, being detected incidentally during routine evaluation prior to assisted reproductive technology (ART). Emerging evidence suggests that the seminal microbiota may contribute to sperm quality and male reproductive health. This systematic review aims to evaluate whether specific microbial profiles are associated with alterations in semen parameters. Methods: A comprehensive literature search was conducted in PubMed and ScienceDirect, yielding 165 and 1418 records, respectively. In the end, 20 articles were included in this systematic review. Results: Men with normal semen parameters commonly exhibited a higher abundance of Lactobacillus and Bifidobacterium, whereas Prevotella was more frequently observed in individuals with impaired semen quality. Several taxa—such as Gardnerella, Corynebacterium, and Staphylococcus spp.—were detected in both normal and altered semen profiles, suggesting that their impact on sperm quality may depend on reaching a pathogenic threshold. Conclusions: Current evidence supports an association between seminal microbiota composition and sperm quality. However, the heterogeneity of available studies and the lack of standardized methodologies limit the ability to draw firm conclusions. Further well-designed studies are required to clarify causal relationships and to determine the clinical relevance of seminal microbiota assessment in male infertility. Full article

Genitourinary syndrome of menopause (GSM), which includes vulvovaginal atrophy (VVA) and other bothersome genitourinary symptoms, affects over half of postmenopausal women and has a considerable impact on quality of life. This study aimed to evaluate the efficacy and safety of an injectable combination of hyaluronic acid and amino acids for treating GSM-related symptoms. In this prospective, multicenter study, 84 women aged 46–60 with moderate to severe VVA confirmed by gynecological examination received three intradermal treatments at 21-day intervals, targeting the vestibule, introitus, lower vaginal wall, and labia majora. Symptom severity was assessed using a visual analog scale (VAS), while tolerability and satisfaction were evaluated via a five-point Likert scale. Quality of life was measured using the Satisfaction With Life Scale (SWLS). Assessments were conducted at baseline, after each injection, and at 3- and 6-month follow-up visits. After three months, significant improvements were noted in vaginal dryness, itching, burning, and dyspareunia (all p < 0.001). Patient satisfaction increased from 59.0% to 80.7%, and SWLS scores rose from 4.57 ± 1.76 to 6.53 ± 1.10, reflecting enhanced quality of life. The treatment was well tolerated and demonstrated a favorable safety profile. These findings suggest that this injectable formulation may represent an effective, non-hormonal option for women with VVA, particularly those who are not candidates for hormone therapy. Full article

Many species within the genus Tabidia Snellen, 1880 exhibit significant differences in wing pattern and genital morphology, which are inconsistent with the definition of Tabidia, indicating that the genus is not monophyletic. To address this, the present study revises the taxonomy of the Chinese species previously placed in Tabidia based on wing morphological characteristics, differences in male and female genitalia, and phylogenetic relationships inferred from the mitochondrial COI gene and mitochondrial genomes. As a result, two new genera are established: Melanoleucagen. nov. and Scintillagen. nov. These new genera are confirmed to belong to the tribe Agroterini Acloque, 1897. Furthermore, three cryptic new species are discovered: Melanoleuca luteamacula sp. nov., Melanoleuca qianshanensis sp. nov., and Melanoleuca yingshanensis sp. nov. Based on the morphological characteristics of adult appearance and genitalia, an identification key to the species of these two new genera is provided. Illustrations of adult specimens and their genital structures are provided, along with a world catalog of the species for the three relevant genera: Tabidia, Melanoleuca, and Scintilla. Full article

Our objective was to conduct a scoping review and narrative synthesis of qualitative studies that examined experiences of partners of cancer patients. We searched MEDLINE, Embase, CINAHL, PsycINFO, and Scopus for qualitative studies involving adult (≥18 years) partners (e.g., in a romantic relationship) of patients diagnosed with cancer and published in English. We extracted findings from included studies, along with key study and participant characteristics, and applied a narrative summary approach, a process that allowed us to identify synthesized themes across studies. Our search identified 15,729 records, of which 159 met the inclusion criteria. Included studies primarily collected data through interviews, with participants being predominantly female and middle-aged (55.2 ± 8.3 years). Partners were commonly in relationships with patients diagnosed with breast, genital–urinary, or gastrointestinal cancer. Our synthesis identified four conceptual themes—transformation of relationship dynamics and roles, distress and burden, coping strategies, and unmet needs and support gaps—which reflect the emotional, relational, and practical challenges partners navigate throughout the cancer trajectory. These findings highlight the need to better recognize and support the role of partners within the cancer care landscape as their wellbeing impacts care and experiences of patients with cancer. Full article

Background/Objectives: Self-collection devices are more widely used than ever for detecting sexually transmitted infections and cervical cancer. Despite this, we still lack a clear understanding of how well these tools actually collect and release the necessary molecular samples. This study compared the in vitro uptake and release performance of commonly used self-sampling devices for total proteins, nucleic acids, and episomal human papillomavirus type 16 (HPV-16) DNA. Methods: An artificial cervicovaginal fluid composed of phosphate-buffered saline supplemented with serum and nucleic acid extracts was serially diluted 2-fold. Each dilution was applied for 5 min to the external surfaces of a vaginal veil (Vaginal Veil Collector V-Veil UP2^TM device), a flocked swab (FLOQSwabs^®), and a commercial vaginal tampon. Non-woven surgical tissue and plastic film served as controls. Total proteins and nucleic acids were quantified by spectrophotometry, and HPV-16 DNA by real-time quantitative PCR. Results: Recovery rates for proteins and nucleic acids were highest for the vaginal veil (81% and 91%), followed by the swab (66% and 70%) and non-woven tissue (44% and 47%). In contrast, the tampon and plastic film performed poorly, releasing less than 30% of proteins and negligible amounts of nucleic acids. Episomal HPV-16 DNA release was highest for the veil (89%), compared with the swab (57%), non-woven tissue (37%), tampon (4%), and plastic film (2%). Conclusions: The vaginal veil demonstrated superior uptake and release of proteins, nucleic acids, and HPV-16 DNA at physiological concentrations. Its non-absorbent structure allows high saturation with efficient release of genital components, including microbial genomes, whereas vaginal tampons retained these components, limiting analytical recovery. Full article