International study to develop a patient-reported outcome measure to evaluate outcomes of gender-affirming care - the GENDER-Q.

Background: To meaningfully understand outcomes of gender-affirming care, patient-reported outcome measures (PROMs) that are grounded in what matters to individuals seeking care are urgently needed. The objective of this study was to develop a comprehensive PROM to assess outcomes of gender-affirming care in clinical practice, research, and quality initiatives (the GENDER-Q).

Methods: Internationally established guidelines for PROM development were used to create a field test version of the GENDER-Q.

Redo phalloplasty and/or urethraplasty after previous flap failure in phalloplasty in transgender men: surgical considerations and outcomes.

Background: Primary phalloplasty in transgender men can be performed using a single or double free or pedicled flap to reconstruct the shaft and, if desired, the urethra. Vascular complications may result in total or partial loss of the used flap(s). Surgical management after flap loss in primary phalloplasty presents a challenge to the reconstructive surgeon.

Expectations and Experienced Outcomes Regarding Gender-Affirming Surgeries: A Pilot Study.

Purpose: This study aimed to explore in what ways the preoperative expectations of transgender individuals regarding gender-affirming surgery (GAS) align with experienced postoperative outcomes and, subsequently, how these expectations can best be managed to support optimal outcomes.

Methods: In the parent study, interviews were conducted to understand the health care experiences of a group of trans individuals that had or wanted to have gender-affirming surgical care. In this secondary analysis, we focused specifically on the individuals' expectations and experiences about the gender-affirming procedures they desired or underwent.

Waiting for transgender care and its effects on health and equality: a mixed-methods population study in the Netherlands.

Background: Access to gender-affirming medical care has life-saving effects on transgender and gender diverse (TGD) individuals. An increasing number of TGD individuals seek care which led to waiting times of years. We assessed the duration and effects of excessive waiting for gender-affirming care.

Sexual Wellbeing according to Transgender Individuals.

Objective: Sexual wellbeing is an important aspect of quality-of-life. In transgender individuals who seek gender affirming treatment, various aspects of sexuality have been assessed. However, not much is known on how transgender individuals themselves perceive sexual wellbeing.

What Parents of Children Born with a Cleft Lip and/or Palate Want to Know About the Care for their Child.

Objective: Adequate health information that matches the needs of care recipients is a prerequisite for patient-centered care. To facilitate the provision of tailored and timely information, it isimportant to understand the information needs of parents of children and adolescents with cleft lip and/or palate (CL/P) themselves, and in addition they were asked how they experienced the provided care-related information.

Design: A cross-sectional study employing questionnaires and semi-structured interviews.

Trans, gender non-conforming and non-binary individuals' perspectives on experienced sexuality during medical transition.

How gender-affirming treatments (GAT) influence the experienced sexuality of transgender, gender non-conforming, and non-binary (TGNB) individuals remains understudied. The aim of this research was to discern factors contributing to a satisfying sexual experience for TGNB individuals, explore the influence of GAT on this process, and identify potential areas for improvement in transition-related care. We conducted interviews with 21 participants at various stages of GAT.

Clinical significance of diastasis recti: Literature review and awareness amongst health care professionals.

Background: A variety of physical complaints have been related to chronic diastasis recti (DR), including back pain, pelvic pain, and urinary incontinence. However, its clinical significance is still subject of debate, leaving many patients to feel unheard when experiencing symptoms. This study aims to assess current knowledge on DR, its potential treatments, and the awareness of this condition amongst involved health care professionals.

A usability evaluation of the perceived user friendliness, accessibility, and inclusiveness of a personalized digital care pathway tool.

Objective: This study aimed to acquire insight into the perceived user friendliness, accessibility and inclusiveness of a personalized digital care pathway.

Materials & Methods: Usability of the tool was tested in an experimental setting. Mixed methods data collection consisted of scenario-based eye tracking tests in a web- or mobile-based prototype of the tool, followed by a questionnaire assessing user friendliness (System Usability Scale; SUS) and a structured interview.

Identifying Coping Strategies Used by Transgender Individuals in Response to Stressors during and after Gender-Affirming Treatments-An Explorative Study.

Background: Gender-affirming treatments are reported to improve mental health significantly. However, a substantial number of transgender individuals report a relapse in, or persistence of, mental health problems following gender-affirming treatments. This is due to multiple stressors occurring during this period, and in general as a consequence of widespread stigma and minority stress.

Stakeholders barriers and facilitators for the implementation of a personalised digital care pathway: a qualitative study.

Objective: A prerequisite for patient-centredness in healthcare organisations is offering patients access to adequate health information, which fits their needs. A personalised digital care pathway (PDCP) is a tool that facilitates the provision of tailored and timely information. Despite its potential, barriers influence the implementation of digital tools in healthcare organisations.

Comparative analysis of virus pathogenicity and resistance-breaking between the P- and A-type from the beet necrotic yellow vein virus using infectious cDNA clones.

The A-type of beet necrotic yellow vein virus (BNYVV) is widely distributed in Europe and is one of the major virus types causing rhizomania disease in sugar beet. The closely related P-type is mainly limited to a small region in France (Pithiviers). Both virus types possess four RNAs (RNA1-4), but the P-type harbours an additional fifth RNA species (RNA5).

A pragmatic approach for implementation of value-based healthcare in Amsterdam UMC, the Netherlands.

Background: The emphasis on implementation of value-based healthcare (VBHC) has increased in the Dutch healthcare system. Yet, the translation of the theoretical principles of VBHC towards actual implementation in daily practice has been rarely described. Our aim is to present a pragmatic step-by-step approach for VBHC implementation, developed and applied in Amsterdam UMC, to share our key elements.

The impact of incisional negative pressure wound therapy on scar quality and patient-reported outcomes: A within-patient-controlled, randomised trial.

Literature provides a moderate level of evidence for the beneficial effects of incisional negative pressure wound therapy (iNPWT) on scar quality. The purpose of this study was to establish if iNPWT results in improved scar outcomes in comparison to the standard of care. Therefore, a within-patient randomised controlled, open-label trial was conducted in transgender men undergoing gender-affirming mastectomies.

The assessment of sexual wellbeing in treatment-seeking transgender individuals: a systematic review of the medical literature.

Sexual-wellbeing is recognized as an important aspect of quality-of-life. Yet, no overview exists of which aspects of sexual-wellbeing have been assessed in trans individuals seeking or undergoing medical treatment, nor is it clear what tools are used to evaluate the effect of medical treatment on sexual-wellbeing. First, to identify which topics pertaining to sexual-wellbeing have been assessed in transgender individuals in a medical context.

Long-Term Changes in Free Nipple Graft Morphology and Patient-Reported Outcomes in Gender-Affirming Mastectomies.

Background: After gender-affirming mastectomies with free nipple grafts, satisfaction with nipples tends to fall short behind chest outcomes. This might be related to changes in nipple areolar complex (NAC) dimensions over time. Therefore, the aim of this study is to establish the long-term changes in NAC morphology and compare these to cisgender male NAC outcomes.

An external validation of a novel predictive algorithm for male nipple areolar positioning: an improvement to current practice through a multicenter endeavor.

The correct positioning of nipple-areolar complexes (NAC) during gender-affirming mastectomies remains a particular challenge. Recently, a Dutch two-step algorithm was proposed predicting the most ideal NAC-position derived from a large cisgender male cohort. We aimed to externally validate this algorithm in a Belgian cohort.

The development of burn scar contractures and impact on joint function, disability and quality of life in low- and middle-income countries: A prospective cohort study with one-year follow-up.

Objective: The aim of this study was to assess the development of burn scar contractures and their impact on joint function, disability and quality of life in a low-income country.

Methods: Patients with severe burns were eligible. Passive range of motion (ROM) was assessed using lateral goniometry.

How Sensitive Is the Neophallus? Postphalloplasty Experienced and Objective Sensitivity in Transmasculine Persons.

Introduction: Tactile and erogenous sensitivity of the neophallus after phalloplasty is assumed to affect the sexual well-being of transmasculine persons and, ultimately, their quality of life. The experienced and objective sensation of the neophallus and their association are largely unknown.

Aim: This study evaluated experienced tactile and erotic sensation of the neophallus in transmasculine persons and investigated how this was related to objective tactile sensitivity.

Manipulation of auxin signalling by plant viruses.

Compatible plant-virus interactions result in dramatic changes of the plant transcriptome and morphogenesis, and are often associated with rapid alterations in plant hormone homeostasis and signalling. Auxin controls many aspects of plant organogenesis, development, and growth; therefore, plants can rapidly perceive and respond to changes in the cellular auxin levels. Auxin signalling is a tightly controlled process and, hence, is highly vulnerable to changes in the mRNA and protein levels of its components.

Within-patient randomized clinical trial comparing incisional negative-pressure wound therapy with suction drains in gender-affirming mastectomies.

Background: Incisional negative-pressure wound therapy (iNPWT) is widely adopted by different disciplines for multiple indications. Questions about the most appropriate uses and value of iNPWT have been raised.

Methods: An open-label within-patient RCT was conducted in transgender men undergoing gender-affirming mastectomies.

Patient-Reported Outcomes After Genital Gender-Affirming Surgery With Versus Without Urethral Lengthening in Transgender Men.

Background: In our institution, genital Gender-Affirming Surgery (gGAS;phalloplasty or metoidioplasty) in transgender men is offered with or without Urethral Lengthening (UL).

Aim: The aim of this cross-sectional and retrospective study was to assess the effect of gGAS with or without UL on several Patient-Reported Outcomes (PROs), and to identify predictors of overall patient satisfaction at follow-up.

Methods: A self-constructed Patient-Reported Outcome Measure (PROM) was sent to transgender men who were ≥1 year after gGAS.

The ideal location of the male nipple-areolar complex: A pinpointing algorithm.

Background: In the treatment of gender dysphoria, appropriate nipple-areola complex (NAC) positioning is essential for achieving a natural appearing male chest after subcutaneous mastectomy. An accurate predictive model for the ideal personalized position of the NAC is still lacking. The aim of this study is to determine the anthropometry of the male chest to create individualized guidelines for appropriate NAC positioning in the preoperative setting.