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https://www.readbyqxmd.com/read/28448757/prevalence-and-types-of-gender-affirming-surgery-among-a-sample-of-transgender-endocrinology-patients-prior-to-state-expansion-of-insurance-coverage
#1
Maya Kailas, Hsun Ming Simon Lu, Emily F Rothman, Joshua D Safer
OBJECTIVE: Transgender individuals now have many options for medical intervention, including gender affirmation surgeries. However, it is unknown how common it is for transgender individuals to undergo these surgeries. The purpose of this cross-sectional study was to assess the prevalence of gender affirming surgeries among transgender patients in 2015, which was immediately prior to insurance changes that made gender affirming surgery more affordable for Massachusetts residents. DESIGN: A retrospective chart review of 99 transgender patients was performed at the Endocrinology Clinic at Boston Medical Center, an urban safety net hospital...
April 27, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28448318/two-state-collaborative-study-of-a-multifaceted-intervention-to-decrease-ventilator-associated-events
#2
Nishi Rawat, Ting Yang, Kisha J Ali, Mary Catanzaro, Mariah D Cohen, Donna O Farley, Lisa H Lubomski, David A Thompson, Bradford D Winters, Sara E Cosgrove, Michael Klompas, Kathleen A Speck, Sean M Berenholtz
OBJECTIVES: Ventilator-associated events are associated with increased mortality, prolonged mechanical ventilation, and longer ICU stay. Given strong national interest in improving ventilated patient care, the National Institute of Health and Agency for Healthcare Research and Quality funded a two-state collaborative to reduce ventilator-associated events. We describe the collaborative's impact on ventilator-associated event rates in 56 ICUs. DESIGN: Longitudinal quasi-experimental study...
April 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28447838/in-defense-of-commitment-the-curative-power-of-violated-expectations
#3
Sandra L Murray, Veronica M Lamarche, Sarah Gomillion, Mark D Seery, Cheryl Kondrak
A new model of commitment defense in romantic relationships is proposed. It assumes that relationships afford a central resource for affirming meaning and purpose in the world. Consequently, violating expectations about the world outside the relationship can precipitate commitment defense inside the relationship. A meta-analysis of 5 experiments, 2 follow-up correlational studies, and a longitudinal study of the transition to first parenthood supported the model. Experimentally violating conventional expectations about the world (e...
April 27, 2017: Journal of Personality and Social Psychology
https://www.readbyqxmd.com/read/28447413/laboratory-measurement-of-the-direct-oral-anticoagulants-indications-and-impact-on-management-in-clinical-practice
#4
REVIEW
C Wright, R Brown, A Cuker
Although the direct oral anticoagulants (DOACs) do not require routine laboratory monitoring, there may be special situations in which measurement of drug levels is desirable. There is a paucity of information on how measurement of DOAC levels is used in clinical practice. We conducted a retrospective cohort study of dabigatran, rivaroxaban, and apixaban levels measured at our institution. Of 9793 patients with an active prescription for dabigatran, rivaroxaban, or apixaban in the electronic medical record during the 2...
May 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28446164/core-information-sets-for-informed-consent-to-surgical-interventions-baseline-information-of-importance-to-patients-and-clinicians
#5
Barry G Main, Angus G K McNair, Richard Huxtable, Jenny L Donovan, Steven J Thomas, Paul Kinnersley, Jane M Blazeby
BACKGROUND: Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient's values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge the information needs of the individual patient...
April 26, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28445221/changes-in-personal-relationships-during-residency-and-their-effects-on-resident-wellness-a-qualitative-study
#6
Marcus Law, Michelle Lam, Diana Wu, Paula Veinot, Maria Mylopoulos
PURPOSE: Residency poses challenges for residents' personal relationships. Research suggests residents rely on family and friends for support during their training. The authors explored the impact of residency demands on residents' personal relationships and the effects changes in those relationships could have on their wellness. METHOD: The authors used a constructivist grounded theory approach. In 2012-2014, they conducted semistructured interviews with a purposive and theoretical sample of 16 Canadian residents from various specialties and training levels...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28442433/electronic-health-record-as-a-research-tool-frequency-of-exposure-to-targeted-clinical-problems-and-health-care-providers-clinical-proficiency
#7
Tim Wysocki, Maria Carmen G Diaz, James H Crutchfield, James P Franciosi, Lloyd N Werk
OBJECTIVES: The Electronic Health Record (EHR) could provide insight into possible decay in health care providers' (HCP) clinical knowledge and cognitive performance. Analyses of the contributions of variables such as frequency of exposure to targeted clinical problems could inform the development and testing of appropriate individualized interventions to mitigate these threats to quality and safety of care. MATERIALS/METHODS: Nine targeted clinical problems (TCP) were selected for further study, and de-identified, aggregated study data were obtained for one calendar year...
April 22, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28439181/perspective-hope-for-health-equity
#8
EDITORIAL
George Rust
Times like these test the soul. We are now working for health equity in a time of overt, aggressive opposition. Yet, hope in the face of overwhelming obstacles is the force that has driven most of the world's progress toward equity and justice. Operationalizing real-world hope requires an affirmative vision, an expectation of success, broad coalitions taking action cohesively, and frequent measures of collective impact to drive rapid-cycle improvement.
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28438260/more-is-better-lymph-node-harvesting-in-colorectal-cancer
#9
S O'Boyle, K Stephenson
INTRODUCTION: We sought to determine if lymph node harvesting and survival for CRC were comparable between laparoscopic and open resections in a community hospital setting. METHODS: A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resection for CRC between January 2008 and September 2013 was performed. RESULTS: Three hundred seventy-one patients had open and 110 had laparoscopic resections...
March 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28434612/tracking-nitrate-sources-in-groundwater-and-associated-health-risk-for-rural-communities-in-the-white-volta-river-basin-of-ghana-using-isotopic-approach-%C3%AE-15-n-%C3%AE-18-ono3-and-3-h
#10
Geophrey Anornu, Abass Gibrilla, Dickson Adomako
In this study, we present a first attempt on the use of integrated hydro-chemical and isotopic technique to trace the sources of groundwater nitrate contamination in the Upper East Region of Ghana to aid the sustainable management of this vital resource. The objectives of the study are (1) assess the present status and spatial distribution of the nitrate contamination (2) identify and distinguish the most likely sources of nitrate , (3) identify the relationship between (3)H and NO3(-) and F(-), and (4) ascertain the potential human risk from exposure to nitrate contamination...
April 21, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28429385/risk-factors-proximate-to-suicide-and-suicide-risk-assessment-in-the-context-of-denied-suicide-ideation
#11
Alan L Berman
Health care providers have significant opportunities to identify individuals at near-term risk for suicide, but lack empirical data on near-term risk factors. This study aimed to identify dynamic, state-related risk factors observed by clinical practitioners within the last 30 days of life of 157 patients who died by suicide and to compare these near-term risk factors among patients who denied versus responded positively to having suicide ideation (SI) when last asked by a clinical practitioner prior to their death...
April 21, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/28427205/mns16a-tandem-repeat-minisatellite-of-human-telomerase-gene-functional-studies-in-colorectal-lung-and-prostate-cancer
#12
Philipp Hofer, Cornelia Zöchmeister, Christian Behm, Stefanie Brezina, Andreas Baierl, Angelina Doriguzzi, Vanita Vanas, Klaus Holzmann, Hedwig Sutterlüty-Fall, Andrea Gsur
MNS16A, a functional polymorphic tandem repeat minisatellite, is located in the promoter region of an antisense transcript of the human telomerase reverse transcriptase gene. MNS16A promoter activity depends on the variable number of tandem repeats (VNTR) presenting varying numbers of transcription factor binding sites for GATA binding protein 1. Although MNS16A has been investigated in multiple cancer epidemiology studies with incongruent findings, functional data of only two VNTRs (VNTR-243 and VNTR-302) were available thus far, linking the shorter VNTR to higher promoter activity...
March 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28426223/over-destabilization-of-protein-protein-interaction-in-generalized-born-model-and-utility-of-energy-density-integration-cutoff
#13
Yukinobu Mizuhara, Dan Parkin, Koji Umezawa, Jun Ohnuki, Mitsunori Takano
The generalize Born (GB) model is frequently used in MD simulations of biomolecular systems in aqueous solution. The GB model is usually based on the so-called Coulomb field approximation (CFA) for the energy density integration. In this study, we report that the GB model with CFA overdestabilizes the long-range electrostatic attraction between oppositely-charged molecules (ionic bond forming two-helix system and kinesin-tubulin system) when the energy density integration cutoff, rmax, which is used to calculate the Born energy, is set to a large value...
April 20, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28425687/patient-protection-and-affordable-care-act-market-stabilization-final-rule
#14
(no author information available yet)
This rule finalizes changes that will help stabilize the individual and small group markets and affirm the traditional role of State regulators. This final rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year; standards related to network adequacy and essential community providers for qualified health plans; and the rules around actuarial value requirements.
April 18, 2017: Federal Register
https://www.readbyqxmd.com/read/28425311/later-adults-cultural-life-scripts-of-middle-and-later-adulthood
#15
Azriel Grysman, Sarah Dimakis
The cultural life script (CLS) refers to expected prototypical life events, often including life transitions overwhelmingly occurring at ages 11-30. This study outlined CLS events at ages after the majority of these events typically occur. Participants, age 38-76, nominated events they expected a person of their age to experience in the future. Participants rated each event's valence, importance, prevalence, and expected age of occurrence. Events were coded into three categories: the normative CLS for events listed by previous CLS studies, offspring's CLS for experiencing CLS events of offspring, and later adulthood CLS for other events nominated by at least 4% of participants...
April 20, 2017: Neuropsychology, Development, and Cognition. Section B, Aging, Neuropsychology and Cognition
https://www.readbyqxmd.com/read/28421354/perceived-barriers-and-facilitators-to-integrating-hiv-prevention-and-treatment-with-cross-sex-hormone-therapy-for-transgender-women-in-lima-peru
#16
Sari L Reisner, Amaya G Perez-Brumer, Sarah A McLean, Javier R Lama, Alfonso Silva-Santisteban, Leyla Huerta, Jorge Sanchez, Jesse L Clark, Matthew J Mimiaga, Kenneth H Mayer
Transgender women (TW) represent a vulnerable population at increased risk for HIV infection in Peru. A mixed-methods study with 48 TW and 19 healthcare professionals was conducted between January and February 2015 to explore barriers and facilitators to implementing a model of care that integrates HIV services with gender-affirmative medical care (i.e., hormone therapy) in Lima, Peru. Perceived acceptability of the integrated care model was high among TW and healthcare professionals alike. Barriers included stigma, lack of provider training or Peruvian guidelines regarding optimal TW care, and service delivery obstacles (e...
April 18, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28415404/macrophage-phagocytosis-of-biomedical-mg-alloy-degradation-products-prepared-by-electrochemical-method
#17
Jian Zhang, Sachiko Hiromoto, Tomohiko Yamazaki, Hua Huang, Gaozhi Jia, Haiyan Li, Guangyin Yuan
Biomedical Mg alloy is promising for its widespread use clinically. In vitro and in vivo studies showed that the degradation products of biomedical Mg alloy were composed of O, P, Ca, Mg and other alloying elements. However, little is known about the metabolism of the degradation products. In this study, the in vitro macrophage phagocytosis of the degradation products of a biomedical Mg-Nd-Zn-Zr alloy was directly observed. This result affirms the necessity to investigate the long-term fate of Mg alloy degradation products in physiological environments...
June 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28414038/modulation-of-staphylococcus-epidermidis-rp62a-extracellular-polymeric-layer-by-marine-cyclic-dipeptide-cyclo-l-leucyl-l-prolyl-thwarts-biofilm-formation
#18
Shanmugaraj Gowrishankar, Shunmugiah Karutha Pandian
Staphylococcus epidermidis is the most frequent cause of biofilm mediated implant-associated infections. Extracellular polymeric substance (EPS) is a key component of most biofilms and in pathogens it specifically protects the entrenched-bacterial cells from antibiotics and hosts immune response, and thereby makes the infection ineradicable. Recently, the prominence of cyclic dipeptides in interfering with biofilms and the associated virulence factors of pathogens has offered an alternative to eliminate difficult-to-treat infections...
April 14, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28413121/characterisation-of-cell-cycle-arrest-and-terminal-differentiation-in-a-maximally-proliferative-human-epithelial-tissue-lessons-from-the-human-hair-follicle-matrix
#19
Talveen S Purba, Lars Brunken, Michael Peake, Asim Shahmalak, Asuncion Chaves, Enrique Poblet, Ralf Paus
Human hair follicle (HF) growth and hair shaft formation require terminal differentiation-associated cell cycle arrest of highly proliferative matrix keratinocytes. However, the regulation of this complex event remains unknown. CIP/KIP family member proteins (p21(CIP1), p27(KIP1) and p57(KIP2)) regulate cell cycle progression/arrest, endoreplication, differentiation and apoptosis. Since they have not yet been adequately characterized in the human HF, we asked whether and where CIP/KIP proteins localise in the human hair matrix and pre-cortex in relation to cell cycle activity and HF-specific epithelial cell differentiation that is marked by keratin 85 (K85) protein expression...
April 2, 2017: European Journal of Cell Biology
https://www.readbyqxmd.com/read/28411271/neural-correlates-of-semantic-prediction-and-resolution-in-sentence-processing
#20
Luigi Grisoni, Tally McCormick Miller, Friedemann Pulvermüller
Most brain imaging studies of language comprehension focus on activity following upon meaningful stimuli. Testing adult human participants with high-density EEG, we show that, already before the presentation of a critical word, context-induced semantic predictions are reflected by a neurophysiological index, which we therefore call the Semantic Readiness Potential (SRP). The SRP precedes critical words if previous sentence context constrains the upcoming semantic content (High-constraint contexts), but not in unpredictable (Low-constraint) contexts...
April 14, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
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