Using mobile technology to engage sexual and gender minorities in clinical research.

IntroductionHistorical and current stigmatizing and discriminatory experiences drive sexual and gender minority (SGM) people away from health care and clinical research. Being medically underserved, they face numerous disparities that make them vulnerable to poor health outcomes. Effective methods to engage and recruit SGM people into clinical research studies are needed.ObjectivesTo promote health equity and understand SGM health needs, we sought to design an online, national, longitudinal cohort study entitled The PRIDE (Population Research in Identity and Disparities for Equality) Study that enabled SGM people to safely participate, provide demographic and health data, and generate SGM health-related research ideas.MethodsWe developed an iPhone mobile application ("app") to engage and recruit SGM people to The PRIDE Study-Phase 1. Participants completed demographic and health surveys and joined in asynchronous discussions about SGM health-related topics important to them for future study.ResultsThe PRIDE Study-Phase 1 consented 18,099 participants. Of them, 16,394 provided data. More than 98% identified as a sexual minority, and more than 15% identified as a gender minority. The sample was diverse in terms of sexual orientation, gender identity, age, race, ethnicity, geographic location, education, and individual income. Participants completed 24,022 surveys, provided 3,544 health topics important to them, and cast 60,522 votes indicating their opinion of a particular health topic.ConclusionsWe developed an iPhone app that recruited SGM adults and collected demographic and health data for a new national online cohort study. Digital engagement features empowered participants to become committed stakeholders in the research development process. We believe this is the first time that a mobile app has been used to specifically engage and recruit large numbers of an underrepresented population for clinical research. Similar approaches may be successful, convenient, and cost-effective at engaging and recruiting other vulnerable populations into clinical research studies

IDENTIFICATION AND ANALYSIS OF ADVERSE DRUG REACTIONS ASSOCIATED WITH CANCER CHEMOTHERAPY IN HOSPITALIZED PATIENTS

Objective: To analyze the incidence of adverse drug reactions (ADRs) associated with chemotherapeutic drugs and study its management. Methods: A prospective observational study was carried out on hospitalized patients undergoing cancer chemotherapy. The identified ADRs were assessed for causality, severity and preventability. Results: Among 120 patients followed 100 patients developed 161 ADRs. Most common ADRs were anemia, leucopenia, mucositis fever, and chills. As per the WHO causality assessment 87(54.0%) ADRs were probable whereas with the Naranjo's scale 98(60.9%) were probable. Moderate reactions were 59.62%. Majority 122 (75.8%) of the ADRs were not preventable. Most of ADRs were implicated with cisplatin followed by 5-Fluro-uracil and the combination drugs which included FAC (Flurouracil, adriyamycin, cyclophosphamide) regimen, Paclitaxel, and Carboplatin (PC) regimen.Conclusion: Patients undergoing cancer chemotherapy have higher chances to develop ADRs. Those patients on chemotherapy with cisplatin followed by 5-Fu and combination drugs which include FAC and PC regimen should be strictly monitored for the early detection and prompt management of the ADR to prevent morbidity and mortality.Keywords: Adverse drug reactions, Cancer, Chemotherapy, Predictable, Management

Ultrafast Electron Holes in Plasma Phase Space Dynamics

Electron holes (EH) are localized modes in plasma kinetic theory which appear as vortices in phase space. Earlier research on EH is based on the Schamel distribution function (df). A novel distribution function is proposed here, generalizing the original Schamel df in a recursive manner. Nonlinear solutions obtained by kinetic simulations are presented, with velocities twice the electron thermal speed. Using 1D-1V kinetic simulations, their propagation characteristics are traced and their stability is established by studying their long-time evolution and their behavior through mutual collisions.Comment: 5 pages, 6 figures, accepted in Scientific Report

Transgender men and pregnancy

Transgender people have experienced significant advances in societal acceptance despite experiencing continued stigma and discrimination. While it can still be difficult to access quality health care, and there is a great deal to be done to create affirming health care organizations, there is growing interest around the United States in advancing transgender health. The focus of this commentary is to provide guidance to clinicians caring for transgender men or other gender nonconforming people who are contemplating, carrying, or have completed a pregnancy. Terms transgender and gender nonconforming specifically refer to those whose gender identity (e.g., being a man) differs from their female sex assigned at birth. Many, if not most transgender men retain their female reproductive organs and retain the capacity to have children. Review of their experience demonstrates the need for preconception counseling that includes discussion of stopping testosterone while trying to conceive and during pregnancy, and anticipating increasing experiences of gender dysphoria during and after pregnancy. The clinical aspects of delivery itself fall within the realm of routine obstetrical care, although further research is needed into how mode and environment of delivery may affect gender dysphoria. Postpartum considerations include discussion of options for chest (breast) feeding, and how and when to reinitiate testosterone. A positive perinatal experience begins from the moment transgender men first present for care and depends on comprehensive affirmation of gender diversity