Prevalence of hormone prescription and education for cis and trans women by medical trainees

PREVALENCE OF HORMONE PRESCRIPTION AND EDUCATION FOR CIS AND TRANS WOMEN BY MEDICAL TRAINEES AUTHORS Madison Meister, BA Candidate; Emily J Noonan, PhD, MA; Laura A. Weingartner, PhD, MS BACKGROUND Hormone replacement therapy is a common healthcare practice for contraception, hormone control, and menopause treatment. Transgender patients may also take hormones to affirm their gender identity, such as feminizing hormones (estrogen), for transgender women. Studying how trainees discuss hormone risks for both cis and trans women can demonstrate if disparities exist and how we may address them to overcome healthcare barriers. METHODS Fifty videos were analyzed of third-year medical students taking patient histories from standardized patients, including 28 cis women and 22 trans women. Students had previously completed LGBTQ clinical skills training, and patients reported taking estrogen purchased online for acne control (cis) or gender-affirming (trans) purposes. Videos were analyzed for the presence and context of hormone health risk discussion, student knowledge, and whether the student agreed to prescribe hormones. RESULTS Of the 90% (n=43) of students who agreed to prescribe hormones, 47% (n=20) prescribed conditionally. Conditions included: pending lab results, desire to research hormones, or checking with attending physicians. A larger proportion of trans women were prescribed hormones (95% or 21/22) compared to cisgender women (79% or 22/28). While similar proportions of students discussed hormone risks between patient groups, students discussed their knowledge or discomfort prescribing hormones more frequently with trans women (27% or n=6/22) than cis women (18% or n=5/28). DISCUSSION We expected students to prescribe combined estrogen-progestin oral contraception to cis women. These data show students more readily prescribed estrogen for gender-affirming purposes, suggesting that LGBTQ clinical skills interventions may help prepare students to provide gender-affirming care

Scaling of Self-Avoiding Walks in High Dimensions

We examine self-avoiding walks in dimensions 4 to 8 using high-precision Monte-Carlo simulations up to length N=16384, providing the first such results in dimensions $d > 4$ on which we concentrate our analysis. We analyse the scaling behaviour of the partition function and the statistics of nearest-neighbour contacts, as well as the average geometric size of the walks, and compare our results to $1/d$-expansions and to excellent rigorous bounds that exist. In particular, we obtain precise values for the connective constants, $\mu_5=8.838544(3)$, $\mu_6=10.878094(4)$, $\mu_7=12.902817(3)$, $\mu_8=14.919257(2)$ and give a revised estimate of $\mu_4=6.774043(5)$. All of these are by at least one order of magnitude more accurate than those previously given (from other approaches in $d>4$ and all approaches in $d=4$). Our results are consistent with most theoretical predictions, though in $d=5$ we find clear evidence of anomalous $N^{-1/2}$-corrections for the scaling of the geometric size of the walks, which we understand as a non-analytic correction to scaling of the general form $N^{(4-d)/2}$ (not present in pure Gaussian random walks).Comment: 14 pages, 2 figure

Cancer evolution: mathematical models and computational inference.

Cancer is a somatic evolutionary process characterized by the accumulation of mutations, which contribute to tumor growth, clinical progression, immune escape, and drug resistance development. Evolutionary theory can be used to analyze the dynamics of tumor cell populations and to make inference about the evolutionary history of a tumor from molecular data. We review recent approaches to modeling the evolution of cancer, including population dynamics models of tumor initiation and progression, phylogenetic methods to model the evolutionary relationship between tumor subclones, and probabilistic graphical models to describe dependencies among mutations. Evolutionary modeling helps to understand how tumors arise and will also play an increasingly important prognostic role in predicting disease progression and the outcome of medical interventions, such as targeted therapy.FM would like to acknowledge the support of The University of Cambridge, Cancer Research UK and Hutchison Whampoa Limited.This is the final published version. It first appeared at http://sysbio.oxfordjournals.org/content/early/2014/10/07/sysbio.syu081.short?rss=1

Temperature dependence of surface reconstructions of Au on Pd(110)

Surface reconstructions of Au film on Pd(110) substrate are studied using a local Einstein approximation to quasiharmonic theory with the Sutton-Chen interatomic potential. Temperature dependent surface free energies for different coverages and surface structures are calculated. Experimentally observed transformations from $(1\times1)$ to $(1 \times 2)$ and $(1 \times 3)$ structures can be explained in the framework of this model. Also conditions for Stranski-Krastanov growth mode are found to comply with experiments. The domain of validity of the model neglecting mixing entropy is analyzed.Comment: 7 pages, REVTeX two-column format, 3 postscript figures available on request from [email protected] To appear in Phys. Rev. Letter

Spherically Symmetric Solutions in Macroscopic Gravity

Schwarzschild's solution to the Einstein Field Equations was one of the first and most important solutions that lead to the understanding and important experimental tests of Einstein's theory of General Relativity. However, Schwarzschild's solution is essentially based on an ideal theory of gravitation, where all inhomogeneities are ignored. Therefore, any generalization of the Schwarzschild solution should take into account the effects of small perturbations that may be present in the gravitational field. The theory of Macroscopic Gravity characterizes the effects of the inhomogeneities through a non-perturbative and covariant averaging procedure. With similar assumptions on the geometry and matter content, a solution to the averaged field equations as dictated by Macroscopic Gravity are derived. The resulting solution provides a possible explanation for the flattening of galactic rotation curves, illustrating that Dark Matter is not real but may only be the result of averaging inhomogeneities in a spherically symmetric background.Comment: 14 pages, added and updated references, some paragraphs rewritten for clarity, typographical errors fixed, results have not change

Complete Experimental Structure Determination of the p(3x2)pg Phase of Glycine on Cu{110}

We present a quantitative low energy electron diffraction (LEED) surface-crystallograpic study of the complete adsorption geometry of glycine adsorbed on Cu{110} in the ordered p(3×2) phase. The glycine molecules form bonds to the surface through the N atoms of the amino group and the two O atoms of the de-protonated carboxylate group, each with separate Cu atoms such that every Cu atom in the first layer is involved in a bond. Laterally, N atoms are nearest to the atop site (displacement 0.41 Å). The O atoms are asymmetrically displaced from the atop site by 0.54 Å and 1.18 Å with two very different O-Cu bond lengths of 1.93 Å and 2.18 Å. The atom positions of the upper-most Cu layers show small relaxations within 0.07 Å of the bulk-truncated surface geometry. The unit cell of the adsorbate layer consists of two glycine molecules, which are related by a glide-line symmetry operation. This study clearly shows that a significant coverage of adsorbate structures without this glide-line symmetry must be rejected, both on the grounds of the energy dependence of the spot intensities (LEED-IV curves) and of systematic absences in the LEED pattern

Optimizing tuning masses for helicopter rotor blade vibration reduction including computed airloads and comparison with test data

The development and validation of an optimization procedure to systematically place tuning masses along a rotor blade span to minimize vibratory loads are described. The masses and their corresponding locations are the design variables that are manipulated to reduce the harmonics of hub shear for a four-bladed rotor system without adding a large mass penalty. The procedure incorporates a comprehensive helicopter analysis to calculate the airloads. Predicting changes in airloads due to changes in design variables is an important feature of this research. The procedure was applied to a one-sixth, Mach-scaled rotor blade model to place three masses and then again to place six masses. In both cases the added mass was able to achieve significant reductions in the hub shear. In addition, the procedure was applied to place a single mass of fixed value on a blade model to reduce the hub shear for three flight conditions. The analytical results were compared to experimental data from a wind tunnel test performed in the Langley Transonic Dynamics Tunnel. The correlation of the mass location was good and the trend of the mass location with respect to flight speed was predicted fairly well. However, it was noted that the analysis was not entirely successful at predicting the absolute magnitudes of the fixed system loads

Women and Illegal Activities: Gender Differences and Women's Willingness to Comply Over Time

In recent years the topics of illegal activities such as corruption or tax evasion have attracted a great deal of attention. However, there is still a lack of substantial empirical evidence about the determinants of compliance. The aim of this paper is to investigate empirically whether women are more willing to be compliant than men and whether we observe (among women and in general) differences in attitudes among similar age groups in different time periods (cohort effect) or changing attitudes of the same cohorts over time (age effect) using data from eight Western European countries from the World Values Survey and the European Values Survey that span the period from 1981 to 1999. The results reveal higher willingness to comply among women and an age rather than a cohort effect. Working Paper 06-5

A Characterisation of Strong Wave Tails in Curved Space-Times

A characterisation of when wave tails are strong is proposed. The existence of a curvature induced tail (i.e. a Green's function term whose support includes the interior of the light-cone) is commonly understood to cause backscattering of the field governed by the relevant wave equation. Strong tails are characterised as those for which the purely radiative part of the field is backscattered. With this definition, it is shown that electromagnetic waves in asymptotically flat space-times and fields governed by tail-free propagation have weak tails, but minimally coupled scalar fields in a cosmological scenario have strong tails.Comment: 17 pages, Revtex, to appear in Classical and Quantum Gravit