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Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we – a group of scholars and practitioners from Africa, America, Asia and Europe – argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action.

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flexion strength, 6,50 compared with similarly aged controls. There are 3 factors thought to contribute to knee extension and flexion weakness in those with knee OA: muscle atrophy, failure of voluntary muscle activity, and apparent weakness from increased antagonist muscle cocontraction. 5 Decreases in muscle cross-sectional area (CSA) have been established in subjects with early OA degenerative changes 22 and in those with severe knee OA. 10Ikeda et al 22 found that women with early degenerative changes in the knee joint had reductions in quadriceps CSA of up to 12%, compared with age-matched women without radiographic changes. Fink et al 10 found atrophy of type 2 fibers and type 1 fibers of the vastus medialis in patients undergoing total joint arthroplasty. Importantly, a smaller lean-muscle CSA in the diseased limb, compared to the contralateral limb, in subjects with OA contributes to muscle weakness but is not the only factor involved. 40Several investigators have examined failure of voluntary muscle activity as a contributing factor in reduced knee extension strength. 12,29,33,40,48 Failure of voluntary activity is the measure of an individual's ability to fully activate their muscles during maximal voluntary contractions. 20 Reductions in muscle activation are due to either an inability to recruit all motor units or a reduction in the motor unit discharge rate. 25 In healthy adults, simulated failure of voluntary activity by saline injection into the knee joint to cause effusion resulted in decreased isometric extension strength and knee extension torque during strength testing 23,31 and increased muscle cocon- Q uadriceps weakness is one of the most common and disabling impairments seen in individuals with knee osteoarthritis (OA).19 Sufficient quadriceps and hamstrings strength, both isometric and dynamic, is essential for undertaking basic activities of daily living such as standing and walking. 36 Muscle strength testing has revealed that those with knee OA have a 25% to 45% loss of knee extension strength 6,15,39 and a 19% to 25% loss of kneeControlled laboratory study, cross-sectional data.To investigate isometric knee flexion and extension strength, failure of voluntary muscle activation, and antagonist cocontraction of subjects with knee osteoarthritis (OA) compared with age-matched asymptomatic control subjects.Quadriceps weakness is a common impairment in individuals with knee OA. Disuse atrophy, failure of voluntary muscle activation, and antagonist muscle cocontraction are thought to be possible mechanisms underlying this weakness; but antagonist cocontraction has not been examined during testing requiring maximum voluntary isometric contraction.Fifty-four subjects with knee OA (mean SD age, 65.6 7.6 years) and 27 similarly aged control subjects (age, 64.2 5.1 years) were recruited for this study. Isometric knee flexion and extension strength were measured, and electromyographic data were recorded, from 7 muscles crossing the knee and used to calculate cocontraction ratios during maximal ef...

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