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Background Knee osteoarthritis (KOA) is highly prevalent in older women, and previous studies suggest the involvement of hormonal factors play a role in the pathogenesis of osteoarthritis. KOA causes musculoskeletal impairment, resulting in decreased physical activity, muscle mass, and strength, which leads to sarcopenia and further increases the burden on healthcare systems. Oestrogen replacement therapy (ERT) improves joint pain and muscle performance in early menopausal women. Muscle resistance exercise (MRE) is a non-pharmacological method that preserves the physical functions of patients with KOA. However, data on short-term oestrogen administration combined with MRE in postmenopausal women, especially in those aged > 65 years, are limited. Therefore, this study presents a protocol of a trial aimed to examine the synergistic effect of ERT and MRE on lower-limb physical performance in older women with KOA. Methods We will conduct a double-blinded, randomised placebo-controlled trial in 80 Japanese women aged > 65 years living independently with knee pain. The participants will be randomly categorised into two groups: (1) 12-week MRE programme with transdermal oestrogen gel containing 0.54 mg oestradiol per push and (2) 12-week MRE programme with placebo gel. The primary outcome measured using the 30-s chair stand test, and secondary outcomes (body composition, lower-limb muscle strength, physical performance, self-reported measure of knee pain, and quality of life) will be measured at baseline, 3 months, and 12 months, and these outcomes will be analysed based on the intention-to-treat. Discussion The EPOK trial is the first study to focus on the efficacy of ERT on MRE among women aged > 65 years with KOA. This trial will provide an effective MRE to prevent KOA-induced lower-limb muscle weakness, confirming the benefit of short-term oestrogen administration. Trial registration Japan Registry of Clinical Trials: jRCTs061210062. Registered 17th December 2021, https://jrct.niph.go.jp/en-latest-detail/jRCTs061210062.

No recent studies have explicitly focused on predicting the well-being of pregnant women during the novel coronavirus disease (COVID-19) pandemic. This study used data from an extensive online survey in Japan to examine predictors of the subjective well-being of pregnant women during the COVID-19 pandemic. We developed and validated a machine learning model using data from 400 pregnant women obtained in 2020 to identify three factors that predict subjective well-being. The results confirmed that the model could predict pregnant women's subjective well-being with 84% accuracy. The variables that contributed significantly to this prediction were "partner help," "hopelessness," and "health status." The machine learning model was built again using these three factors, trained and validated using data from 400 pregnant women in 2020, and predicted using data from 1,791 pregnant women in 2021, with an accuracy of 88%. These were also significant risk factors for subjective well-being in regression analysis adjusted for maternal age, region, parity, education level, and presence of mental illness. This model would help identify pregnant women with low subjective well-being during the COVID-19 pandemic, and appropriate interventions can then be initiated.

Background: Among Organization for Economic Co-operation and Development countries, Japan has one of the lowest cervical cancer screening rates. The cancer screening rate has reportedly worsened with the coronavirus disease of 2019 (COVID-19) pandemic. This study investigated the COVID-19 history and socioeconomic background of people who did not undergo on-time cervical cancer screening (CCS) during the two years of COVID-19-related restrictions in Japan. Methods: We used data from the Japan COVID-19 and Society Internet Survey, a nationwide, internet-based, self-report, cohort observational study conducted in 2022. The outcome variable was identified by asking whether the respondent had undergone on-time CCS within the last two years. This study used multivariate log-binomial regression models to evaluate inequalities during regular checkups for CCS. Adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs) were estimated to incorporate socioeconomic background variables. Results: Of 12,066 respondents, 6469 (53.6%) had yet to undergo CCS within two years. The prevalence ratio (PR) of on-time CCS was 0.70 (95% CI: 0.63–0.79) for those in their 20s and 0.78 (95%CI:0.70-0.87) for those in their 60s, compared to their 40s. Moreover, socioeconomic inequities were found in the following groups: unemployed/student, unmarried, high school graduate or lower, and household income below 4 million yen. PR of on-time CCS with a history of COVID-19, unvaccinated status, or fear of COVID-19 was not significantly different from that of respondents who underwent CCS. However, the PR of those who had not undergone on-time CCS was significantly lower than that of respondents who had undergone breast cancer screening (PR: 0.29, 95% CI: 0.28–0.31). Conclusion: the relationship between socioeconomic inequalities and CCS hesitancy was prevalent among the younger respondents. Our findings will help policymakers identify problems and strategies to improve CCS screening rates in Japan.