Single-incision laparoscopic transabdominal preperitoneal repair in the treatment of adult female patients with inguinal hernia

BACKGROUND Women have a 3%lifetime chance of developing an inguinal hernia,which is not as common in men.Due to its cosmetic benefits,single-incision laparoscopic transabdominal preperitoneal(SIL-TAPP)inguinal hernia repair is becoming in-creasingly popular in the management of inguinal hernia in women.However,there are no studies comparing the safety and applicability of SIL-TAPP repair with conventional laparoscopic transabdominal preperitoneal(CL-TAPP)inguinal hernia repair for the treatment of inguinal hernia in women.AIM To compare the outcomes of SIL-TAPP and CL-TAPP repair in adult female patients with inguinal hernia and to estimate the safety and applicability of SIL-TAPP repair in adult female inguinal hernia patients.METHODS We retrospectively compared the clinical information and follow-up data of fe-male inguinal hernia patients who underwent SIL-TAPP inguinal hernia repair and those who underwent CL-TAPP inguinal hernia repair at the Affiliated Hos-pital of Nantong University from February 2018 to December 2020 and assessed the long-term and short-term outcomes of both cohorts.RESULTS This study included 123 patients,with 71 undergoing SIL-TAPP repair and 52 un-dergoing CL-TAPP repair.The two cohorts of patients and inguinal hernia charac-teristics were similar,with no statistically meaningful difference.The rate of intraoperative inferior epigastric vessel injury was lower in patients in the SIL-TAPP cohort(0,0%)than in patients in the CL-TAPP cohort(4,7.7%)and was significantly different(P<0.05).In addition,the median[interquartile range(IQR)]total hospitalization costs were significantly lower in patients in the SIL-TAPP cohort[$3287(3218-3325)]than in patients in the CL-TAPP cohort[$3511(3491-3599)].Postoperatively,the occurrence rate of trocar site hernia was lower in the SIL-TAPP cohort(0,0%)than in the CL-TAPP cohort(4,7.7%),and the median(IQR)cosmetic score was significantly higher in the SIL-TAPP cohort[10(10-10)]than in the CL-TAPP cohort[9(9-10)].CONCLUSION SIL-TAPP repair did not increase the incidence of intraoperative and postoperative complications in female in-guinal hernia patients.Moreover,female inguinal hernia patients who underwent SIL-TAPP repair had a lower probability of trocar site hernia and inferior epigastric vessel injury than female inguinal hernia patients who un-derwent CL-TAPP repair.In addition,female inguinal hernia patients who underwent SIL-TAPP repair reported a more aesthetically pleasing postoperative abdominal incision.Therefore,SIL-TAPP repair is a better option for the treatment of inguinal hernias in women.

Female Warriors in the MCU and Wuxia Films:A Comparative Study

This essay offers a comprehensive comparative analysis of female warriors in the Marvel Cinematic Universe(MCU)and Wuxia films.Both genres portray powerful and empowered female characters who defy societal expectations and embody resilience,effectively challenging gender norms and promoting female empowerment.However,despite their strength,many of these women warriors face certain narrative factors,such as the male gaze and a predetermined fate,which can restrict their agency and curtail their full potential.And it is within the realm of Wuxia films that the captivating element of cross-dressing among female warriors emerges,providing a nuanced exploration of identity and the constraints imposed by society.

Traumatized Interpretations of Female Characters in American Southern Culture in The Glass Menagerie

Tennessee Williams is the most famous Southern playwright in the history of 20th century American literature,and southern identity is a thread that runs throughout Williams’work.The Glass Menagerie is one of his highly representative dramatic works.The play tells the story of how an ordinary family in deep identity crisis escapes the harsh reality and cultural trauma during the Great Depression in the United States.Using trauma theory as a tool,this paper explores the complex relationship between the deep-seated causes of the tragedy of the two female characters in the play and the historical context through the traumatic events experienced by the characters in the play and the different attitudes they show in the face of trauma.Through this,the vulnerability and identity crisis of individuals during the period of social change and cultural breaks are analyzed.The purpose of the paper is to arouse human beings’thoughts on how to cope with cultural integration and foreign cultural invasion,and how to obtain salvation when they are amid an identity crisis.

Experiencing the Abject Female Body and Writing the Female Self:Body Narrative of In the Heart of the Country

In the Heart of the Country,the second novel by J.M.Coetzee,has been traditionally read as a disembodied writing that focuses on the problem of writing per se instead of the reality.This paper contends that the work is actually a body narrative that explores the visceral pain suffered by Magda whose infertile body impedes her being a qualified subject.As the heroine in a postcolonial novel,Magda is not just a body that is restricted and constructed by the politics of the body,but also a thinking and writing body that consciously questions and resists the gendered bodily norms under whose yardstick her subjecthood is barred.Written in the metafictional manner,Magda’s narrative of the body is not just a record of her corporeal experience,but also a self-conscious negotiation with,and challenge of,the bodily norms under whose yardstick her body has been debased or,in terms of Judith Butler,abjected.Taking her female bodily experience as the starting point,Magda writes a feminine text that values passion,fluidity and non-linearity to disrupt the patriarchal discourse underpinned with logical reasoning.The feminine body narrative endeavors to achieve a new way of communication through which a reciprocal cross race/gender relationship might be established.

Writing the Silenced Female Body, Scrutinizing the Grand Narrative of Colonization and Decolonization: The Body in Zoë Wicomb’s David’s Story

David’s Story by Zoë Wicomb addresses the complexities of representing female suffering and the limitations of traditional historical narratives in capturing the experiences of marginalized bodies.It challenges the grand narratives of national history by emphasizing the indispensable role of women’s experiences.Through characters like Dulcie and Rachael,Wicomb portrays the female body as a site of resistance and resilience,highlighting the need for more nuanced and inclusive ways of documenting history.Underscoring the inexpressibility of trauma and the limitations of language and representation,the novel self-reflexively acknowledges its own aporia of completing the narrative,embodying the ongoing struggle to capture the full breadth of human experience.

An Exploration of the British Army Female Nursing Service during World War I

After the outbreak of World War I,the British War Office decided to dispatch female nursing personnel to the front lines due to the severe casualties among soldiers,the underdeveloped military medical services of the allied forces,and the maturity of the British Army female nursing service.Despite the harsh working conditions and the complexities of nurse-patient relationships under wartime restrictions,the female nursing staff also experienced moments of leisure that allowed them to relax and recuperate.The wartime British Army Female Nursing Service had a positive effect in reducing casualties and promoting the development of the official nurse registration movement.

Generation of mitochondrial replacement monkeys by female pronucleus transfer

Mutations in mitochondrial DNA(mtDNA)are maternally inherited and have the potential to cause severe disorders.Mitochondrial replacement therapies,including spindle,polar body,and pronuclear transfers,are promising strategies for preventing the hereditary transmission of mtDNA diseases.While pronuclear transfer has been used to generate mitochondrial replacement mouse models and human embryos,its application in non-human primates has not been previously reported.In this study,we successfully generated four healthy cynomolgus monkeys(Macaca fascicularis)via female pronuclear transfer.These individuals all survived for more than two years and exhibited minimal mtDNA carryover(3.8%–6.7%),as well as relatively stable mtDNA heteroplasmy dynamics during development.The successful establishment of this nonhuman primate model highlights the considerable potential of pronuclear transfer in reducing the risk of inherited mtDNA diseases and provides a valuable preclinical research model for advancing mitochondrial replacement therapies in humans.

Where is the optimal plane to mobilize the anterior rectal wall in female patients undergoing total mesorectal excision?

BACKGROUND Since Heald proposed the total mesorectal excision(TME)procedure,the prognosis of patients with rectal cancer has been significantly improved.But Heald did not specifically describe the anterior surgical plane in female patients.And the surgical plane for mobilizing the anterior rectal wall during TME surgery in female patients remains controversial.AIM To investigate the anatomy of the female pelvis and identify the optimal plane for mobilizing the anterior rectal wall.METHODS We retrospectively collected surgical procedure videos and clinical data of female patients diagnosed with middle or low rectal cancer who underwent the TME procedure between January 2020 and October 2022 across six hospitals.The patients were divided into two groups based on the surgical approach used to mobilize the anterior rectal wall:The experimental group was to open the peritoneum at the lowest point of the peritonea reflection and enter the plane for mobilizing,while the control group was cut at 0.5-1 cm above the peritoneal reflection and enter another plan.Then,we compared the preoperative and postoperative information between the two groups.We also dissected and observed ten adult female pelvises to analyze the anatomic structure and compare the entry plane between the two approaches.Finally,we researched the pathological structure between the rectum and the vagina.RESULTS Finally,77 cases that met the criteria were included in our study.Our observations revealed that the experimental group underwent a smooth procedure,entering the plane amidst the mesorectal fascia and adventitia of the vagina,whereas the control group entered the plane between the vaginal adventitia and muscle layers.Compared to the control group,the experimental group showed a significant decrease in intraoperative bleeding[22.5(19.5-50)mL vs 17(5-20)mL,P=0.01],as well as a shorter duration of hospitalization[9(7-11.25)d vs 7(6-10)d,P=0.03].Through the examination of surgical videos and cadaveric studies,we discovered that Denonvilliers'fascia is absent in females.Additionally,pathological sections further revealed the absence of Denonvilliers'fascia in females,with only loose connective tissue present between the mesorectal fascia and adventitia of the vagina.CONCLUSION The plane amidst the mesorectal fascia and vaginal adventitia is the optimal surgical plane to mobilize the anterior rectal wall for female patients undergoing the TME procedure.

Small Extracellular Vesicles Secreted by Peri-urethral Tissues Regulate Fibroblast Function and Contribute to the Pathogenesis of Female Stress Urinary Incontinence

Objective:This study aimed to explore the existence of small extracellular vesicles(sEVs)in peri-urethral tissues and the role of abnormal expression of sEVs in the pathogenesis of female stress urinary incontinence(SUI).Methods:sEVs were extracted from peri-urethral vaginal wall tissues using differential centrifugation and were observed by transmission electron microscopy(TEM).The number of sEVs and their protein contents were compared between SUI and control groups using nanoparticle tracking analysis(NTA)and bicinchoninic acid(BCA)protein assay.Fibroblasts were cultured separately with SUI(SsEVs group)and normal tissue sEVs(NsEVs group).Proliferation and migration of fibroblasts were compared between groups using CCK-8 and wound healing assays,respectively.Expression levels of collagenⅠandⅢwere compared among blank control(BC),NsEVs,and SsEVs groups using real-time PCR.Protein mass spectrometry was used to test the differentially expressed proteins contained in sEVs between groups.Results:sEVs were extracted and found under the electron microscope.There were significantly more sEVs extracted from the SUI group compared to the normal group.Fibroblasts showed increased proliferative and decreased migratory abilities,and expressed more collagen in the SsEVs group compared to the NsEVs and BC groups.Protein spectrum analysis demonstrated several differentially expressed targets,including components of microfibrils,elastin polymer,and anti-inflammatory factors.Conclusion:sEVs were detected in the peri-urethral tissues.SUI tissues expressed more sEVs than control.The abnormal expression of sEVs and their protein contents may contribute to the pathogenesis and progression of SUI.

Small Cell Neuroendocrine Carcinoma of the Vulva: Case Report and Literature Review

Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.

Health promotion and education proposal among Chinese female college students:eliminating cervical cancer is no longer a dream

Cervical cancer is a serious threat to women’s health.Persistent high-risk human papillomavirus(HPV)infection is a necessary factor for cervical cancer development and has become a serious public health threat to women.At present,young women have become a high-risk group for potential HPV infection.HPV vaccination is an effective method to prevent HPV infection and related diseases and is a primary preventive measure for HPV infection-related diseases.This study explores the influencing factors of female college students’willingness to receive HPV vaccination,their ability to understand college students’HPV awareness,their motivation for HPV vaccination,their behavioral skills related to HPV vaccination,their willingness to receive HPV vaccination and their vaccination rate.The aim of this study was to increase the HPV vaccination rate of Chinese female college students through health education programs and thus reduce the incidence of cervical cancer.

A Content Analysis Study Describing Information Regarding Female Genital Mutilation Present in US Medical Textbooks

This study examines the depth of information regarding Female Genital Mutilation (FGM)/Female Cutting (FC) present in US medical textbooks. According to Klein et al. (2018) [1], despite substantial attention regarding the effects of FGM, this practice is still ongoing all over the world. Healthcare providers are very important actors who need to understand FGM in order to provide care to girls and women subjected to it, but the small amount of existing work in this area shows a low level of knowledge and training about FGM/FC among U.S. physicians. The Center for Disease Control and Prevention (CDC) first published the estimated number of girls at risk of FGM/FC in the U.S. to be about 168,000 in 1997;that number had increased to 513,000 girls in the US by 2012 (according to Goldberg et al.) In this study, a small sample of medical textbooks were analyzed for the degree to which the textbooks include information regarding FGM/FC. The results of this study show that US medical textbooks do not include information regarding FGM/FC, suggesting that most medical providers don’t have knowledge and training about FGM/FC. The inadequate information on FGM/FC in medical textbooks reflects a culturally biased lack of recognition of the number of girls and women affected in the US. This maintains an ongoing pattern of silence that reinforces gender inequality. Considering the inadequate information covered in US medical textbooks on FGM/FC, and the concordant lack of provider training to provide advice and care to affected girls and women, incorrect and missed diagnoses may lead to harm to victims of FGM/FC. Providers would be better equipped to care for women and girls if their medical training included information regarding FGM/FC.

A Study on the Impact of Cheerleading on the Psychological Health of Female College Students

This study investigates the effects of technical cheerleading and dance cheerleading on the psychological health of female college students by utilizing the Symptom Checklist-90(SCL-90),the Comprehensive Diagnostic Scale for Interpersonal Relationships,and the Social Adaptability Diagnostic Scale.The findings indicate the following:(1)Technical cheerleading has a highly significant impact on sensitivity in interpersonal relationships,paranoia,and psychoticism,and a significant effect on anxiety and hostility;dance cheerleading has a highly significant effect on paranoia;(2)Both technical and dance cheerleading have minimal impact on the overall score distribution of interpersonal relationships among female college students,but the dimensions of their effects differ;(3)The impact of technical cheerleading on the social adaptability of female college students is more pronounced than that of dance cheerleading.

Female anterior wall onlay urethroplasty with lower lip buccal mucosal graft: Importance of the laterally extended incision

Objective:To describe the outcome of female anterior wall(pubic side)onlay urethroplasty with buccal mucosal graft using laterally extended surgical dissection in patients with previously failed minimally invasive techniques.Methods:From January 2016 to April 2018,17 symptomatic patients with previously failed minimally invasive procedures were enrolled in the study.The diagnosis of urethral stricture was confirmed based on a combination of patients’symptoms,post-void residual urine,video-urodynamics,and cystoscopy.Urethroplasty with lower lip mucosal graft was performed using the modified laterally extended dissection.Patients were evaluated pre-operatively and 12-month post-operatively with the American Urological Association symptom score,post-void residual urine,and maximum flow rate.Results:Despite the previously failed minimally invasive procedures,urethroplasty with lower lip buccal graft and laterally extended dissection resulted in favorable outcomes(success rateZ94%).The mean
standard deviation of American urological association symptom score improved from pre-operative levels at the 12-month post-operative follow-up(25.82
3.97 to 10.88
5.57);so did postvoid residual urine(71.12
74.98 mL to 15.00
28.30 mL),and maximum flow rate(7.88
1.72 mL/s to 25.82
5.59 mL/s)with all statistically significant(p<0.05).Conclusion:The current study showed that female urethroplasty with buccal graft could be highly successful in experienced hands.An anterior approach could be superior to the posterior one due to higher mechanical support and lower sacculation rate.A laterally extended incision may improve visualization and better graft placement by providing wider working space.The results should be evaluated in the future studies with larger sample size.

Female directors in the boardroom and intellectual capital performance:Does the“critical mass”matter?

This research aims to investigate the influence of female directors on Intellectual Capital Performance(ICP)using a sample of manufacturing-listed companies in China.Our study investigates the link between having two or more female directors and the Modified Value-Added Intellectual Coefficient(MVAIC)methodology,employing the critical mass theory from 2004–2017.We find that having a critical mass of female directors(three or more)shows a significant positive impact on MVAIC and its components,including human capital efficiency,structural capital efficiency,relational capital efficiency,and physical capital efficiency,with physical capital being the critical driver.Our study reveals that the critical mass participation of female directors substantially influences the IC efficiency of privately owned companies compared to state-owned companies.Moreover,the number of female directors also affects the IC performance of manufacturing companies in multiple regions.Our findings support the validity of group classification identified by Kanter and Critical Mass Theory.To the best of our knowledge,this is one of the few pieces of research that studies the role of female board directors in IC performance and Chinese manufacturing firms using MVAIC as an IC measure.

Isolating the female agency‑driven development factor in external sovereign emerging market debt

The underlying literature hypothesises and provides randomised evidence for the positive impact of promoting the broad-based inclusion,empowerment,and representation of women on regional ecosystems.This study seeks to isolate a female agencydriven development factor in external sovereign emerging market debt and finds evidence for superior risk-adjusted returns from tilting towards female agency leaders.We propose the female agency factor as an additional scope in the modern investor’s toolbox of holistic credit assessment,allowing investors to isolate the issuers which are the most effective sovereign transmission mechanisms of sustainable development capital.This contribution to the corpus supports the notion of integrating sustainability factors into portfolio construction and reinforces the argument for supporting femaleled development from a financial markets’perspective.

Monte Carlo calculation of the exposure of Chinese female astronauts to earth’s trapped radiation on board the Chinese Space Station

With the development of China’s crewed space mission,the space radiation risk for astronauts is increasingly prominent.This paper describes a simulation of the radiation doses experienced by a Chinese female voxel phantom on board the Chinese Space Station(CSS)performed using the Monte Carlo N-Particle(MCNP)software.The absorbed dose,equivalent dose,and effective dose experienced by the voxel phantom and its critical organs are discussed for different levels of shielding of the Tianhe core module.The risk of space-radiation exposure is then assessed by comparing these doses with the current risk limits in China(the skin dose limit for short-term low-earth-orbit missions)and the NASA figures(National Council on Radiation Protection and Measurements Report No.98)for female astronauts.The results obtained can be used to guide and optimize the radiation protection provided for manned space missions.

Research on the Walkability Potential of Wangjing East Metro Station from the Perspective of Young Female

This paper mainly evaluates the road space adaptability of the streets around Wangjing East Metro Station(hereinafter referred to as“Wangjing East Station”),and studies the impact of the road space adaptability of Wangjing East Street on the walking activities of young female residents.Through literature survey,POI data analysis and street view photo scoring,the street characteristics that young female residents are suitable for walking and like walking are analyzed.The paper includes 3 parts:determination of functional types of streets around Wangjing East Station;the characteristics of young women’s group walkability activities and the establishment of evaluation system;spatial adaptability assessment of the existing roads around Wangjing East Station.

Culture, Beliefs, Attitude and Peer Group Influence on Female Genital Mutilation in Southeast Nigeria

Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of Culture, Beliefs, attitude and Peer Group Influence on the persistence Female Genital Mutilation practice in the State especially in the rural areas. Materials and Methods: Qualitative study that used Focused Group Discussion and In-depth interviews for data collection. Those willing and given consent were recruited into the group discussion according to age, marital status, educational level and their location in the state. In-depth interviews were used with the Stake Holders, Opinion Leaders, Traditional Rulers and the Clergy. Result: A total of 454 participants were recruited from the 13 local government areas of Ebonyi State but only 420 (92.5%) participated. The age ranges of participants were 25 to 35 years for single males and females while the married participants male and female were aged 35 to 70 years. One hundred single females (23.8%) and 94 single males (21.4%) participated while 97 (23.1%) married women and 95 (22.6%) married men participated. Out of the 26 health workers recruited only 22 (5.2%) participated. Four traditional rulers, 4 women leaders, 4 youth leaders and 2 clergy 12 (2.9%) in number had in-depth interviews. All the participants had knowledge of FGM and its practice. Rural health workers are getting more involved. ‘Female Genital Crushing’ is replacing actual cutting. The participants all agreed there is no benefit and the practice should stop. Conclusion: Female Genital Mutilation is secretly practiced and is getting replaced by “Female Genital Crushing” perpetrated by rural health workers as well as mothers, fathers, traditional birth attendants and the peer group playing a major role with low knowledge of the Law against Female genital mutilation.

Factors Influencing the Resumption of Postpartum Female Sexuality in Women Who Have Given Birth Once or Several Times at the Ignace Deen Maternity Hospital of the Conakry University Hospital Centre (Guinea)

Introduction: Sexuality in the postpartum period is a taboo subject that raises many questions, especially among women. The aim of this study was to evaluate the influence of factors such as mode of delivery, parity, type of household and level of education on the resumption of sexuality, by comparing our results with those in the literature. Methods: This is a prospective descriptive and analytical study, which took place from 3 April to 2 June 2023 in the maternity ward of the Ignace Deen National Hospital of the University Hospital Centre of Conakry. The sample included married women who had given birth once or several times. Results: Of 118 married women who had given birth once or several times and who were questioned about their sexuality in the postpartum period, 75.42% (89 cases) stated that they had resumed sexual activity in the postpartum period. (The majority were aged 20 - 29 years (46.61%), pauci pares (51.69%), living in a monogamous household (88.14%), with secondary education (44.92%) and self-employed (38.98%). More than half (58.47%) of these women had a normal vaginal delivery with vulvo-perineal tear (5.80%), episiotomy (15.94%) and instrumental extraction (8.69%). The main reasons for resuming sexual activity were the desire to satisfy their partner (50.56%) and to maintain the harmony of the couple (29.21%). Resumption of sexual activity was more common in patients who had given birth by caesarean section (p = 0.007) and in patients with a higher level of education (p = 0.03). However, it was not influenced by parity or household type. Conclusion: Sexuality remains a taboo subject, and its resurgence in the postpartum period is influenced by the mode of delivery and the level of education and perception of women. Certain practices and complications related to childbirth can also influence the resumption of sexuality in the postpartum period.