Impact on patient satisfaction and importance of medical intake and office staff in a multidisciplinary, one-stop shop transgender program in Indianapolis, Indiana

Background: Historically, the transgender population has postponed seeking primary care due to discrimination within social and medical settings. Very few studies have considered patient satisfaction with transgender care and whether there are differences in staff satisfaction. This cross-sectional study focuses on the satisfaction of transgender patients who receive primary care at a comprehensive, “one-stop shop” program in Indianapolis, IN, USA. Methods: Sixty-two patients completed a patient satisfaction survey. Items consisted of 5-point Likert scales with anchors of satisfaction, caring, competence, and doctor recommendation. Results: Overall, there were positive responses to all items, ranging from moderately high to very high. There was high overall satisfaction in the program’s trans-friendliness, office visits, and “one-stop shop” model. Lower scoring items concerned medical intake with appointment making and timing. There were no statistical differences across age, gender, education, duration at the program, and number of visits in the past 12 months. There were clear differences between how respondents viewed the care and competence of the program’s staff. In particular, the doctor was viewed most positively and office staff least positively with medical staff rated in-between. Conclusion: There is high patient satisfaction with this comprehensive, “one-stop shop” care model among the transgender population. We recommend that transgender programs routinely conduct quality improvement measures, maintain sufficient workforce coverage, and provide cultural competency training which should include appropriate care standards and patient-centered concerns regarding appointment making and burdens associated with timing, traveling, and cost

Kink stability, propagation, and length scale competition in the periodically modulated sine-Gordon equation

We have examined the dynamical behavior of the kink solutions of the one-dimensional sine-Gordon equation in the presence of a spatially periodic parametric perturbation. Our study clarifies and extends the currently available knowledge on this and related nonlinear problems in four directions. First, we present the results of a numerical simulation program which are not compatible with the existence of a radiative threshold, predicted by earlier calculations. Second, we carry out a perturbative calculation which helps interpret those previous predictions, enabling us to understand in depth our numerical results. Third, we apply the collective coordinate formalism to this system and demonstrate numerically that it accurately reproduces the observed kink dynamics. Fourth, we report on a novel occurrence of length scale competition in this system and show how it can be understood by means of linear stability analysis. Finally, we conclude by summarizing the general physical framework that arises from our study.Comment: 19 pages, REVTeX 3.0, 24 figures available from A S o

Sex Differences in the Subjective Effects of Oral Δ\u3csup\u3e9\u3c/sup\u3e-THC in Cannabis Users

Previous studies suggest that there are sex differences in endocannabinoid function and the response to exogenous cannabinoids, though data from clinical studies comparing acute cannabinoid effects in men and women under controlled laboratory conditions are limited. To further explore these potential differences, data from 30 cannabis users (N=18 M, 12 F) who completed previous Δ9-tetrahydrocannabinol (Δ9-THC) discrimination studies were combined for this retrospective analysis. In each study, subjects learned to discriminate between oral Δ9-THC and placebo and then received a range of Δ9-THC doses (0, 5, 15 and a “high” dose of either 25 or 30 mg). Responses on a drug-discrimination task, subjective effects questionnaire, psychomotor performance tasks, and physiological measures were assessed. Δ9-THC dose-dependently increased drug-appropriate responding, ratings on “positive” visual analog scale (VAS) items (e.g., Good Effects, Like Drug, Take Again), and items related to intoxication (e.g., High, Stoned). Δ9-THC also dose-dependently impaired performance on psychomotor tasks and elevated heart rate. Sex differences on VAS items emerged as a function of dose. Women exhibited significantly greater subjective responses to oral drug administration than men at the 5 mg Δ9-THC dose, whereas men were more sensitive to the subjective effects of the 15 mg dose of Δ9-THC than women. These results demonstrate dose-dependent separation in the subjective response to oral Δ9-THC administration by sex, which might contribute to the differential development of problematic cannabis use

Annealing schedule from population dynamics

We introduce a dynamical annealing schedule for population-based optimization algorithms with mutation. On the basis of a statistical mechanics formulation of the population dynamics, the mutation rate adapts to a value maximizing expected rewards at each time step. Thereby, the mutation rate is eliminated as a free parameter from the algorithm.Comment: 6 pages RevTeX, 4 figures PostScript; to be published in Phys. Rev.

Control Plane Compression

We develop an algorithm capable of compressing large networks into a smaller ones with similar control plane behavior: For every stable routing solution in the large, original network, there exists a corresponding solution in the compressed network, and vice versa. Our compression algorithm preserves a wide variety of network properties including reachability, loop freedom, and path length. Consequently, operators may speed up network analysis, based on simulation, emulation, or verification, by analyzing only the compressed network. Our approach is based on a new theory of control plane equivalence. We implement these ideas in a tool called Bonsai and apply it to real and synthetic networks. Bonsai can shrink real networks by over a factor of 5 and speed up analysis by several orders of magnitude.Comment: Extended version of the paper appearing in ACM SIGCOMM 201

Beyond single-photon localization at the edge of a Photonic Band Gap

We study spontaneous emission in an atomic ladder system, with both transitions coupled near-resonantly to the edge of a photonic band gap continuum. The problem is solved through a recently developed technique and leads to the formation of a ``two-photon+atom'' bound state with fractional population trapping in both upper states. In the long-time limit, the atom can be found excited in a superposition of the upper states and a ``direct'' two-photon process coexists with the stepwise one. The sensitivity of the effect to the particular form of the density of states is also explored.Comment: to appear in Physical Review

Renormalization Group Theory for a Perturbed KdV Equation

We show that renormalization group(RG) theory can be used to give an analytic description of the evolution of a perturbed KdV equation. The equations describing the deformation of its shape as the effect of perturbation are RG equations. The RG approach may be simpler than inverse scattering theory(IST) and another approaches, because it dose not rely on any knowledge of IST and it is very concise and easy to understand. To the best of our knowledge, this is the first time that RG has been used in this way for the perturbed soliton dynamics.Comment: 4 pages, no figure, revte

Computational models for inferring biochemical networks

Biochemical networks are of great practical importance. The interaction of biological compounds in cells has been enforced to a proper understanding by the numerous bioinformatics projects, which contributed to a vast amount of biological information. The construction of biochemical systems (systems of chemical reactions), which include both topology and kinetic constants of the chemical reactions, is NP-hard and is a well-studied system biology problem. In this paper, we propose a hybrid architecture, which combines genetic programming and simulated annealing in order to generate and optimize both the topology (the network) and the reaction rates of a biochemical system. Simulations and analysis of an artificial model and three real models (two models and the noisy version of one of them) show promising results for the proposed method.The Romanian National Authority for Scientific Research, CNDI–UEFISCDI, Project No. PN-II-PT-PCCA-2011-3.2-0917

The Commercial Open Source Business Model

Commercial open source software projects are open source software projects that are owned by a single firm that derives a di- rect and significant revenue stream from the software. Commercial open source at first glance represents an economic para- dox: How can a firm earn money if it is making its product available for free as open source? This paper presents the core properties of commercial open source business models and discusses how they work. Using a commercial open source ap- proach, firms can get to market faster with a superior product at lower cost than possible for traditional competitors. The pa- per shows how these benefits accrue from an engaged and self-supporting user community. Lacking any prior comprehensive reference, this paper is based on an analysis of public statements by practitioners of commercial open source. It forges the various anecdotes into a coherent description of revenue generation strategies and relevant business functions