Puberty Suppression in a Gender-Dysphoric Adolescent: A 22-Year Follow-Up

Puberty suppression by means of gonadotropin releasing hormone (GnRH) analogs is considered a diagnostic aid in gender dysphoric adolescents. However, there are also concerns about potential risks, such as poor outcome or post-surgical regret, adverse effects on metabolic and endocrine status, impaired increment of bone mass, and interference with brain development. This case report is on a 22-year follow-up of a female-to-male transsexual, treated with GnRH analogs at 13 years of age and considered eligible for androgen treatment at age 17, and who had gender reassignment surgery at 20 and 22 years of age. At follow-up, he indicated no regrets about his treatment. He was functioning well psychologically, intellectually, and socially; however, he experienced some feelings of sadness about choices he had made in a long-lasting intimate relationship. There were no clinical signs of a negative impact on brain development. He was physically in good health, and metabolic and endocrine parameters were within reference ranges. Bone mineral density was within the normal range for both sexes. His final height was short as compared to Dutch males; however, his body proportions were within normal range. This first report on long-term effects of puberty suppression suggests that negative side effects are limited and that it can be a useful additional tool in the diagnosis and treatment of gender dysphoric adolescents

Relationship between gene co-expression and probe localization on microarray slides

BACKGROUND: Microarray technology allows simultaneous measurement of thousands of genes in a single experiment. This is a potentially useful tool for evaluating co-expression of genes and extraction of useful functional and chromosomal structural information about genes. RESULTS: In this work we studied the association between the co-expression of genes, their location on the chromosome and their location on the microarray slides by analyzing a number of eukaryotic expression datasets, derived from the S. cerevisiae, C. elegans, and D. melanogaster. We find that in several different yeast microarray experiments the distribution of the number of gene pairs with correlated expression profiles as a function of chromosomal spacing is peaked at short separations and has two superimposed periodicities. The longer periodicity has a spacing of 22 genes (~42 Kb), and the shorter periodicity is 2 genes (~4 Kb). CONCLUSION: The relative positioning of DNA probes on microarray slides and source plates introduces subtle but significant correlations between pairs of genes. Careful consideration of this spatial artifact is important for analysis of microarray expression data. It is particularly relevant to recent microarray analyses that suggest that co-expressed genes cluster along chromosomes or are spaced by multiples of a fixed number of genes along the chromosome

Introduction to IPE: A School-Wide Orientation Initiative

Session Objectives: Present an innovative approach to orienting new students from various healthcare disciplines on Interprofessional Educa(on (IPE). Discuss strategies to shape incoming students’ attitudes toward working in teams. Discuss challenges and opportunities in coordinating a large-­‐scale IPE event. Synopsis Interprofessional experiences are a vital part of healthcare education, and early introduction can positively impact students’ attitudes and knowledge about their team members’ roles. While students at academic health centers (AHC’s) have opportunites to engage in IPE, such opportunites can be overwhelming given significant challenges to coordination and implementation. Addressing these challenges, an interprofessional team at Jefferson School of Health Professions in Philadelphia developed a large-­‐scale event where students could meet other healthcare students and be oriented to IPE as a community. This session discusses the pragmatic and conceptual challenges of the two month planning process of the orientation event, its implementation, and outcomes

The Precursors and Products of Justice Climates: Group Leader Antecedents and Employee Attitudinal Consequences

Drawing on the organizational justice, organizational climate, leadership and personality, and social comparison theory literatures, we develop hypotheses about the effects of leader personality on the development of three types of justice climates (e.g., procedural, interpersonal, and informational), and the moderating effects of these climates on individual level justice- attitude relationships. Largely consistent with the theoretically-derived hypotheses, the results showed that leader (a) agreeableness was positively related to procedural, interpersonal and informational justice climates, (b) conscientiousness was positively related to a procedural justice climate, and (c) neuroticism was negatively related to all three types of justice climates. Further, consistent with social comparison theory, multilevel data analyses revealed that the relationship between individual justice perceptions and job attitudes (e.g., job satisfaction, commitment) was moderated by justice climate such that the relationships were stronger when justice climate was high

Should Research Ethics Encourage the Production of Cost-Effective Interventions?

This project considers whether and how research ethics can contribute to the provision of cost-effective medical interventions. Clinical research ethics represents an underexplored context for the promotion of cost-effectiveness. In particular, although scholars have recently argued that research on less-expensive, less-effective interventions can be ethical, there has been little or no discussion of whether ethical considerations justify curtailing research on more expensive, more effective interventions. Yet considering cost-effectiveness at the research stage can help ensure that scarce resources such as tissue samples or limited subject popula- tions are employed where they do the most good; can support parallel efforts by providers and insurers to promote cost-effectiveness; and can ensure that research has social value and benefits subjects. I discuss and rebut potential objections to the consideration of cost-effectiveness in research, including the difficulty of predicting effectiveness and cost at the research stage, concerns about limitations in cost-effectiveness analysis, and worries about overly limiting researchers’ freedom. I then consider the advantages and disadvantages of having certain participants in the research enterprise, including IRBs, advisory committees, sponsors, investigators, and subjects, consider cost-effectiveness. The project concludes by qualifiedly endorsing the consideration of cost-effectiveness at the research stage. While incorporating cost-effectiveness considerations into the ethical evaluation of human subjects research will not on its own ensure that the health care system realizes cost-effectiveness goals, doing so nonetheless represents an important part of a broader effort to control rising medical costs

Faculty Development As a Tool to Impact Culturally Competent Care of Sexual and Gender Minorities

Presentation: 5:39 Background: This poster focuses on the integration of faculty development of sexual and gender identity health knowledge and skill into health education. There is a gap in inclusion of this content in health professional curriculum. While awareness of LGBTQ+ population health has been indirectly addressed within curriculum, a consistent approach targeting all coursework and faculty can increase culturally competent care of patients that identify as LGBTQ+. Faculty confidence, awareness, and experience regarding knowledge, respectful terminology, and skill directly impacts the likelihood of students becoming culturally competent practitioners. Objectives: The objectives of this poster are to share outcomes of faculty development. This poster will: ● Discuss integration of faculty roles in academia and health profession accreditation standards with theories of cultural competence and humility inclusive of sexual and gender minorities; ● Describe a faculty development program to build foundational understanding of respectful terminology to optimize trust and respect when conversing with/about individuals within sexual and gender minority populations; ● Demonstrate changes in knowledge, awareness, skill, and perceived comfort with sexual and gender minority communities following participation in the program. Methods/ Research: Monthly structured learning sessions were paired with 20-30 minute mentoring check-ins with Sexual and Gender Minorities Education and Training (SG-MET) faculty to address components of LGBTQ+ inclusive curriculum. Pre, mid, and post surveys, composed of open and close-ended questions, assessed satisfaction and changes in knowledge, awareness, and perception of skills. Standardized assessments of sexual and gender minority knowledge, experience and clinical skills were completed and collected anonymously through an electronic survey system to protect the faculty’s identification. Conclusions/ Impact: This faculty development program provides pilot data to suggest that this is an effective way to increase knowledge, awareness, and skills in the area of sexual and gender minority health content delivery and practice to impact healthcare disparities in these populations.https://jdc.jefferson.edu/sexandgenderhealth/1001/thumbnail.jp

Human RIF1 and protein phosphatase 1 stimulate DNA replication origin licensing but suppress origin activation

We thank David Stead at the Aberdeen Proteomics Service for help in mass spectrometry interpretation, and Raif Yücel and his team at the University of Aberdeen Iain Fraser Cytometry Centre for assistance with flow cytometry. We thank Robert Alver and Julian Blow at University of Dundee for advice on the use of tautomycetin. Peter Cherepanov of the Francis Crick Institute gifted XL413. Daniel Durocher of Lunenfeld-Tanenbaum Research Institute gifted DNA constructs. Work by ADD and SH was supported by Cancer Research UK Grant A13356, Cancer Research UK Programme Award A19059, and BBSRC grant (BB/K006304/1). AIL was supported by Wellcome Trust Awards (108058/Z/15/Z & 105024/Z/14/Z). This work was also supported by JSPS KAKENHI Grant # 16H04739, 25116004 to CO and 16J04327 to YO.Peer reviewedPublisher PD

Topological Machine Learning with Persistence Indicator Functions

Techniques from computational topology, in particular persistent homology, are becoming increasingly relevant for data analysis. Their stable metrics permit the use of many distance-based data analysis methods, such as multidimensional scaling, while providing a firm theoretical ground. Many modern machine learning algorithms, however, are based on kernels. This paper presents persistence indicator functions (PIFs), which summarize persistence diagrams, i.e., feature descriptors in topological data analysis. PIFs can be calculated and compared in linear time and have many beneficial properties, such as the availability of a kernel-based similarity measure. We demonstrate their usage in common data analysis scenarios, such as confidence set estimation and classification of complex structured data.Comment: Topology-based Methods in Visualization 201