Chest Feminization and Masculinization Surgery: Part Two of the Plastic Surgeon's Perspective of Gender-Affirming Surgery.

Transgender individuals commonly feel significant distress and discomfort, termed gender dysphoria, as a result of the discrepancy between their gender assigned at birth and their gender identity. A major source of gender dysphoria stems from distinct anatomical differences between the male and female chest. Gender-affirming mastectomy of transmasculine patients and breast augmentation for chest feminization of transfeminine patients, also referred to as top surgery, are often the first surgical interventions and most commonly pursued physical modifications for the treatment of gender dysphoria among this patient population.

Integrating vocational supports into a transition clinic: A pilot program.

Objective: Pilot a clinical model and study to learn more about how employment impacts health in children and young adults with intellectual and developmental disabilities.

Background: As young individuals transition into adulthood, milestones such as independent living and gainful employment become paramount. However, for those with intellectual and developmental disabilities (IDD), these milestones can diverge notably from those of typically developing peers.

Digital health delivery in respiratory medicine: adjunct, replacement or cause for division?

Digital medicine is already well established in respiratory medicine through remote monitoring digital devices which are used in the day-to-day care of patients with asthma, COPD and sleep disorders. Image recognition software, deployed in thoracic radiology for many applications including lung cancer screening, is another application of digital medicine. Used as clinical decision support, this software will soon become part of day-to-day practice once concerns regarding generalisability have been addressed.

Imaging the Nerve "Allograft to Muscle Target" Technique in Neuroma Management.

Neuroma management has gained significant attention in the peripheral nerve literature in the past decade. Alongside techniques such as targeted muscle reinnervation and regenerative peripheral nerve interface, another technique known as the "allograft to nowhere" has emerged. This approach involves the placement of an extended allograft at the end of a nerve, creating a regrowth zone in cases where muscle or nerve targets are not available.

Top Ten Tips Palliative Care Clinicians Should Know About Diagnosing, Categorizing, and Addressing Fatigue.

Fatigue is a multifactorial symptom that is commonly faced by patients with cancer, chronic disease, and other serious illnesses. Fatigue causes suffering across biopsychosocial domains and affects patients and their loved ones. In this article, a consortium of professionals across cancer care, physical therapy, exercise, pharmacy, psychiatry, and palliative medicine offers tips and insights on evaluating, categorizing, and addressing fatigue in the setting of serious illness.

The rat telemetry assay and venous catheter access buttons for use in cardiovascular safety pharmacology assessments - Surgical methods, refinements and colony maintenance.

Introduction: Rat telemetry is the assay of choice to assess the potential effects of novel drug candidates on cardiovascular parameters during early drug discovery. Telemetry device implantation can be combined with venous catheter and access button implantation when intravenous administration of the drug substance is required.

Methods: Rats (Sprague Dawley or Han Wistar) were implanted with telemetry devices for arterial blood pressure measurement using either direct aortic catheterisation (n = 131) or aortic catheterisation via the femoral artery (n = 17).

Bariatric Surgery Is Highly Effective and Underutilized in Patients with ADHD: A 5-Year Retrospective Cohort Study.

Introduction: Obesity and ADHD have become increasingly common diagnoses. In the last decade, research has found that there is a high prevalence of obesity in patients with ADHD. The mainstays of management in the general population include lifestyle modifications, pharmacotherapies, and/or bariatric surgery.

Management of Maxillofacial Trauma in Pregnant Women.

Introduction: Trauma during pregnancy deserves special attention as management must be directed towards both the mother and the fetus. Management of maxillofacial fractures in pregnancy can adversely affect the well-being of the fetus by impinging on normal functions such as respiration, mastication, and nutrition. Pregnancy complicates the management of facial injury due to the maintenance of the patent airway, anesthesia considerations, and imaging restraints.

Longitudinal Monitoring of Clinician-Patient Video Visits During the Peak of the COVID-19 Pandemic: Adoption and Sustained Challenges in an Integrated Health Care Delivery System.

Background: Numerous prior opinion papers, administrative electronic health record data studies, and cross-sectional surveys of telehealth during the pandemic have been published, but none have combined assessments of video visit success monitoring with longitudinal assessments of perceived challenges to the rapid adoption of video visits during the pandemic.

Objective: This study aims to quantify (1) the use of video visits (compared with in-person and telephone visits) over time during the pandemic, (2) video visit successful connection rates, and (3) changes in perceived video visit challenges.

Methods: A web-based survey was developed for the dual purpose of monitoring and improving video visit implementation in our health care system during the COVID-19 pandemic.

PKHD1L1 is required for stereocilia bundle maintenance, durable hearing function and resilience to noise exposure.

Sensory hair cells of the cochlea are essential for hearing, relying on the mechanosensitive stereocilia bundle at their apical pole for their function. Polycystic Kidney and Hepatic Disease 1-Like 1 (PKHD1L1) is a stereocilia protein required for normal hearing in mice, and for the formation of the transient stereocilia surface coat, expressed during early postnatal development. While the function of the stereocilia coat remains unclear, growing evidence supports PKHD1L1 as a human deafness gene.

Trends in Gender-Affirming Surgeries in the United States from 2010 to 2021.

 In 2017, an estimated 1.6 million adults and 150,000 teenagers identified as transgender in the United States. With ever-changing legislative developments regarding health care benefits for this population and the increasing number of patients presenting for gender-affirming surgery (GAS), there is a scarcity of literature on the temporal trends within the past decade.

Environmental drivers of biogeography and community structure in a Mid-Atlantic estuary.

Estuaries include some of the most productive yet anthropogenically impacted marine ecosystems on the planet, and provide critical habitat to many ecologically and economically important marine species. In order to elucidate ecological function in estuaries, we must understand what factors drive community dynamics. Delaware Bay is the third largest estuary in the United States and hosts over 200 species of migrant and resident fishes and invertebrates.

Techniques and Outcomes in Microsurgical Treatment of Posttraumatic Lymphedema: A Systematic Review.

Background:  The microsurgical treatment of lymphedema has been well-studied and has been shown to be effective, especially in cancer-related lymphedema. Posttraumatic lymphedema (PTL) is a debilitating condition that remains understudied and underreported, and surgical techniques for PTL treatment are not well-represented in the literature. The purpose of this study was to systematically review all published reports of physiologic surgical interventions for PTL.

Correction Notice: Microscopy and Plate Reader-based Methods for Monitoring the Interaction of Platelets and Tumor Cells in vitro.

Platelets and their activation status play an essential role in cancer metastasis. Therefore, the anti-metastatic potential of antiplatelet drugs has been investigated for many years. However, the initial screening of these antiplatelet drugs to determine which agents can inhibit the interactions of platelets and tumor cells is very limited due to reliance upon expensive, time-consuming, and low-throughput animal experiments for screening.

The heart of it all: Body dysmorphic disorder in cosmetic surgery.

Background: Body Dysmorphic Disorder (BDD) represents a prevalent mental health condition characterized by distress arising from self-perceived physical imperfections. BDD serves as a contraindication to aesthetic surgery. Recognizing BDD holds paramount importance for plastic surgeons, as it is instrumental in averting the exacerbation of this condition while ensuring appropriate referrals.

Researching Eyesight Trends IN ADHD (RETINA).

Background: There has been limited exploration of the relationship between ADHD and vision impairment, especially in relation to ADHD medication regimens and age. This study aims to examine trends in visual disorders in young patients with ADHD.

Methods: We analyzed deidentified patient records from TriNetX database.

Dopamine D1-like receptors modulate synchronized oscillations in the hippocampal-prefrontal-amygdala circuit in contextual fear.

Contextual fear conditioning (CFC) is mediated by a neural circuit that includes the hippocampus, prefrontal cortex, and amygdala, but the neurophysiological mechanisms underlying the regulation of CFC by neuromodulators remain unclear. Dopamine D1-like receptors (D1Rs) in this circuit regulate CFC and local synaptic plasticity, which is facilitated by synchronized oscillations between these areas. In rats, we determined the effects of systemic D1R blockade on CFC and oscillatory synchrony between dorsal hippocampus (DH), prelimbic (PL) cortex, basolateral amygdala (BLA), and ventral hippocampus (VH), which sends hippocampal projections to PL and BLA.

Co-occurring ASD Mediates Impact of ADHD on Atopic Dermatitis and Acne: A Retrospective Cohort Study.

Background: ADHD and ASD are associated with dermatologic manifestations, yet little research investigates co-occurring ADHD/ASD and common dermatologic conditions.

Objective: To investigate associations between ADHD, ASD, acne vulgaris, and atopic dermatitis.

Methods: Using de-identified patient records from the TriNetX database, we created four cohorts on ADHD diagnosis, ASD diagnosis, both, neither.

Preventing and treating delirium in clinical settings for older adults.

Delirium is a serious consequence of many acute or worsening chronic medical conditions, a side effect of medications, and a precipitant of worsening functional and cognitive status in older adults. It is a syndrome characterized by fluctuations in cognition and impaired attention that develops over a short period of time in response to an underlying medical condition, a substance (prescribed, over the counter, or recreational), or substance withdrawal and can be multi-factorial. We present a narrative review of the literature on nonpharmacologic and pharmacologic approaches to prevention and treatment of delirium with a focus on older adults as a vulnerable population.

Pharmacological modulation of Kv3 voltage-gated potassium channels regulates fear discrimination and expression in a response-dependent manner.

Various psychiatric diseases are characterized by aberrant cognition and emotional regulation. This includes inappropriately attributing affective salience to innocuous cues, which can be investigated using translationally relevant preclinical models of fear discrimination. Activity in the underpinning corticolimbic circuitry is governed by parvalbumin-expressing GABAergic interneurons, which also regulate fear discrimination.