Gender-Affirming Voice Training for Trans Women: Effectiveness of Training on Patient-Reported Outcomes and Listener Perceptions of Voice.

Purpose: Although speech-language pathologists have provided gender-affirming voice training for trans women since the 1970s, evidence for this training's effectiveness remains weak. Our study aimed to redress limitations of earlier studies and evaluate voice training effects on outcomes important to trans women.

Method: Seventy-four trans women (19-54 years old) who wanted a more female-sounding voice were recruited through two health facilities and provided with an eight- to 12-session voice training program based on contemporary literature, usual clinical practice, and client-centered care principles.

Age-related differences in ventral striatal and default mode network function during reciprocated trust.

Social relationships change across the lifespan as social networks narrow and motivational priorities shift to the present. Interestingly, aging is also associated with changes in executive function, including decision-making abilities, but it remains unclear how age-related changes in both domains interact to impact financial decisions involving other people. To study this problem, we recruited 50 human participants (N = 26, ages 18-34; N = 24, ages 63-80) to play an economic trust game as the investor with three partners (friend, stranger, and computer) who played the role of investee.

Divide and Conquer.

We assessed the ability of preschool children to assign the most difficult tasks to a symbolic helper. First, children were taught that a toy "helper" could aid them in remembering the location of a hidden item. Children preferentially assigned the helper to the objectively most difficult locations to remember.

Effects of Gender-confirming Pitch-raising Surgery in Transgender Women a Long-term Follow-up Study of Acoustic and Patient-reported Data.

Objectives: Transgender women often seek to feminize their voice so that it becomes congruent with their gender identity. Many receive voice therapy (VT) with good results. Some also need pitch-raising surgery.

The Distribution of Road Salt in Private Drinking Water Wells in a Southeastern New York Suburban Township.

We used a GIS analysis of sodium and chloride concentrations in private water wells in a southeastern New York township to describe the pattern of distribution of road salt in aquifers tapped for drinking water. The primary source of road salt was sodium chloride, and sodium and chloride concentrations were significantly correlated ( = 0.80, < 0.

Technology Use, Preferences, and Capacity in Injured Patients at Risk for Posttraumatic Stress Disorder.

Objective: This investigation comprehensively assessed the technology use, preferences, and capacity of diverse injured trauma survivors with posttraumatic stress disorder (PTSD) symptoms.

Method: A total of 121 patients participating in a randomized clinical trial (RCT) of stepped collaborative care targeting PTSD symptoms were administered baseline one-, three-, and six-month interviews that assessed technology use. Longitudinal data about the instability of patient cell phone ownership and phone numbers were collected from follow-up interviews.

Trip Database: Turning Research into Practice for Evidence-Based Care.

Trip Database is a freely available search engine based in the United Kingdom. Trip directs users to journal articles, practice guidelines, and other research to support evidence-based medical practice. This column includes sample searches in both the free version and in the subscription Pro version.

α integrin cytoplasmic tails can rescue the loss of Rho-family GTPase signaling in the C. elegans somatic gonad.

Integrin signaling relies on multiple, distinct pathways to impact a diverse set of cell behaviors. The Rho family of GTPases are well-established downstream signaling partners of integrins that regulate cell shape, polarity, and migration. The nematode C.

Donor verification using Short Tandem Repeat (STR) analysis directly from blood collected in PAXgene RNA tubes.

Biorepository processing includes nucleic acid extractions in batch mode from a large number of blood samples from many different donors. Handling such a large number of biospecimens presents the challenge of ensuring that samples are not switched or mislabeled during processing. One approach for confirming donor identity from DNA samples is the use of multiplexed fluorescent PCR for detecting Short Tandem Repeat (STR) allelic-size polymorphisms for a set of common autosomal loci.

Preparedness for a natural disaster: how Coriell planned for hurricane Sandy.

When a biological specimen is donated to a biobank such as the nonprofit Coriell Institute for Medical Research, regardless of whether that submission is sent directly or through a physician, scientist, foundation, or patient-centered advocacy organization, the donor expects their biomaterial to be processed effectively and stored in proper conditions until distribution to researchers answering scientific questions. The donor and scientific researchers rarely, if ever, consider what might happen to those specimens if the biobank experiences an adverse event, such as a disaster that compromises its business operations, including handling of samples. Management of biomaterials is not simply a laboratory process; their long-term survival is dependent on both the laboratory preparation and the infrastructure designed for maintenance, safety, and security.

Choosing wisely: the American College of Rheumatology's Top 5 list of things physicians and patients should question.

Objective: We sought to develop a list of 5 tests, treatments, or services commonly used in rheumatology practice whose necessity or value should be questioned and discussed by physicians and patients.

Methods: We used a multistage process combining consensus methodology and literature reviews to arrive at the American College of Rheumatology's (ACR) Top 5 list. Rheumatologists from diverse practice settings generated items using the Delphi method.

Novel small molecule therapeutics in rheumatoid arthritis.

A new wave of emerging therapies for the treatment of autoimmune and inflammatory diseases is under development. These therapies interrupt intracellular signalling through kinase inhibition. By interrupting one or more kinases it is possible to modulate the function of cellular structures such as surface receptors, signalling proteins and transcription of nuclear proteins and thus influence the behaviour of the cell types targeted.

Pegloticase and the patient with treatment-failure gout.

Gout is an inflammatory arthritis characterized by sudden, painful inflammation. Gout can affect any joint in an asymmetric distribution. Gouty attacks may be isolated or can be followed by years of recurrent flares.

Introducing GRADE across the NICE clinical guideline program.

Objectives: Grading of Recommendations Assessment, Development and Evaluation (GRADE) is a system for rating the confidence in estimates of effect and grading guideline recommendations. It promotes evaluation of the quality of the evidence for each outcome and an assessment of balance between desirable and undesirable outcomes leading to a judgment about the strength of the recommendation. In 2007, the National Institute for Health and Clinical Excellence began introducing GRADE across its clinical guideline program to enable separation of judgments about the evidence quality from judgments about the strength of the recommendation.

Emerging indirect and long-term road salt effects on ecosystems.

Widespread use of salts as deicing agents on roads has been perceived as a significant source of environmental and economic damage. Early studies focused on near-road and short-term effects where concentrations can exceed several grams per liter. Evidence is accumulating that the use of salts has significant effects over broader areas, longer time frames, and is affecting a range of ecological processes.

Modeling and therapy of human liver diseases using induced pluripotent stem cells: how far have we come?

. Modeling inherited metabolic disorders of the liver using human induced pluripotent stem cells. J Clin Invest.

Dax1 up-regulates Oct4 expression in mouse embryonic stem cells via LRH-1 and SRA.

Dax1 (Nr0b1) is an atypical orphan nuclear receptor that has recently been shown to play a role in mouse embryonic stem (mES) cell pluripotency. Here we describe a mechanism by which Dax1 maintains pluripotency. In steroidogenic cells, Dax1 protein interacts with the NR5A nuclear receptor steroidogenic factor 1 (Nr5a1) to inhibit transcription of target genes.

LRH-1 and Nanog regulate Dax1 transcription in mouse embryonic stem cells.

Dax1, an atypical orphan nuclear receptor expressed in steroidogenic tissues, has recently been shown to be expressed in mouse embryonic stem (mES) cells and is required for pluripotency. While the mechanisms of transcriptional regulation of Dax1 in steroidogenic organs have been well characterized, those in mES cells have not. Here we report that 500 bp of the Dax1 gene promoter sequence are sufficient to drive expression in mES cells.

Obstetric outcomes in women with multiple sclerosis and epilepsy.

Objective: To estimate the national occurrence of pregnancies in women with multiple sclerosis (MS) and epilepsy and to compare these pregnancy outcomes cross-sectionally with those in women with pregestational diabetes mellitus (DM) and the general obstetric population.

Methods: We studied the 2003-2006 Nationwide Inpatient Sample, of the Healthcare Cost and Utilization Project, to estimate the number of deliveries in women with MS, epilepsy, DM, and the general obstetric population. Pregnancy outcomes included length of hospital stay, hypertensive disorders including preeclampsia (HTN), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), and cesarean delivery.

Effect of climate change between 1984 and 2007 on precipitation chemistry at a site in northeastern U.S.A.

Climate change predictions for the northeastern US call for an increase in tropical storms and a decrease in extra tropical cyclones including continental storms. We ran 24-h back trajectories for each precipitation event that occurred at the Cary Institute of Ecosystem Studies in southeastern New York, U.S.

In search of adrenocortical stem and progenitor cells.

Scientists have long hypothesized the existence of tissue-specific (somatic) stem cells and have searched for their location in different organs. The theory that adrenocortical organ homeostasis is maintained by undifferentiated stem or progenitor cells can be traced back nearly a century. Similar to other organ systems, it is widely believed that these rare cells of the adrenal cortex remain relatively undifferentiated and quiescent until needed to replenish the organ, at which time they undergo proliferation and terminal differentiation.

Long-term sodium chloride retention in a rural watershed: legacy effects of road salt on streamwater concentration.

Sodium and chloride concentrations and export increased from 1986 to 2005 in a rural stream in southeastern New York. Concentrations increased 1.5 mg/L per year (chloride) and 0.