Comparing Gender Congruency in Nonsurgical versus Postsurgical Top Surgery Patients: A Prospective Survey Study.

Background: Gender dysphoria can result in reduced quality of life. Treatments include hormone replacement therapy (HRT) and gender-affirming surgery. Our study compared congruency, satisfaction, and discrimination in patients who underwent top surgery and HRT versus HRT alone. We hypothesized improved outcomes in top surgery patients but that lack of access is a common barrier. Methods: Transgender and nonbinary subjects who underwent at least 6 months of HRT were recruited and answered questions on gender congruency, discrimination, and barriers to care. Surgical patients were asked about postoperative satisfaction using the BREAST-Q. A Mann-Whitney test compared survey responses between study arms. Results: One hundred twelve eligible subjects completed the survey. Surgical subjects answered significantly more positively (P < 0.001) on all questions regarding gender congruency. The greatest difference was observed in how subjects' physical bodies represented their gender identity, where the surgery group rated higher on the five-point Likert scale by 2.0 points (P < 0.001). Surgical patients also reported less violence, verbal abuse, and discrimination (P < 0.003). Within the hormone arm, 87.1% stated desire for surgery and 62.5% declared barriers to surgery, with cost and insurance coverage representing the most common barriers. Finally, surgical subjects reported high satisfaction on the BREAST-Q, scoring more than 3.0 in all categories of breast augmentation and more than 2.6 for breast reduction on a four-point Likert scale. Conclusions: Top surgery, in addition to HRT, significantly improves gender congruency and decreases discrimination and abuse, compared with HRT alone. Unfortunately, barriers including cost and lack of insurance continue to be obstacles for care.

Seasonal overturn and stratification changes drive deep-water warming in one of Earth's largest lakes.

Most of Earth's fresh surface water is consolidated in just a few of its largest lakes, and because of their unique response to environmental conditions, lakes have been identified as climate change sentinels. While the response of lake surface water temperatures to climate change is well documented from satellite and summer in situ measurements, our understanding of how water temperatures in large lakes are responding at depth is limited, as few large lakes have detailed long-term subsurface observations. We present an analysis of three decades of high frequency (3-hourly and hourly) subsurface water temperature data from Lake Michigan. This unique data set reveals that deep water temperatures are rising in the winter and provides precise measurements of the timing of fall overturn, the point of minimum temperature, and the duration of the winter cooling period. Relationships from the data show a shortened winter season results in higher subsurface temperatures and earlier onset of summer stratification. Shifts in the thermal regimes of large lakes will have profound impacts on the ecosystems of the world's surface freshwater.

Dental students' preparation and study habits for the National Board Dental Examination Part I.

The purpose of this study was to assess dental students' study habits and level of preparation necessary to successfully prepare for the National Board Dental Examination (NBDE) Part I. Four hundred thirty-seven dental students from across the United States participated in a web-based survey about their goals, results, and study habits in preparation for taking the NBDE Part I. A majority of the respondents (76 percent; n=331) reported taking the web-based version of the exam. More than one-third (n=168) of the respondents indicated they wanted to achieve a scaled score of 90 or above, while only about one-quarter (n=120) actually achieved this target score. Students preferred to use the Dental Decks and released Part I exams to study for the exam, regardless of their score. No significant correlations between type of study source used and the score achieved on the exam were found.

Knowledge, attitudes, and perceptions of participants and instructors taking part in a dental school simulation course for potential dental students.

Four two-day dental school simulation courses were conducted over a two-year period for the purpose of allowing prospective dental students the opportunity to gain hands-on experience in a dental simulation lab. A total of 292 subjects from thirty-four colleges and universities participated in the courses. The courses were planned and taught by dental students attending the host school, with oversight by faculty members. Participants took pre- and posttests assessing their knowledge of dental practices and completed surveys before and after the course to assess their attitudes toward the dental profession. Student instructors completed a post-course survey of the experience. The simulation course was effective in increasing participants' desire (8 percent increase) to attend the host school. Dental knowledge improved 34 percent following the course. Thirty-four percent of student instructors indicated they were more likely to pursue a career in academics following this experience. Results suggest that a dental school simulation course can be a positive experience for both participants and student instructors.

Predental students' attitudes toward and perceptions of the dental profession.

The purpose of this study was to assess reasons students seek a career in dentistry, their perceptions of the dental school admissions process, and their expectations of the profession. Of 155 predental students participating in a dental school simulation course offered at a Nevada dental school, 152 participated in this study (68.4 percent [n=104] male, and 31.6 percent [n=48] female). When asked when they made the decision to pursue a career in dentistry, 52 percent (n=79) said they decided in college, while 33.6 percent (n=51) made the decision in high school. A slight majority of the respondents (52.6 percent; n=80) identified their family dentist as having the greatest influence in their decision. Nearly half (47.8 percent; n=64) expected to pursue a career in general dentistry, while the next largest subgroup expected to pursue orthodontics (16.4 percent; n=22). A significant majority of the respondents (72.8 percent; n=110) perceived the dental school admissions process to be fair. Males were significantly more likely to identify themselves as competitive applicants than did females (chi(2)=9.644; p<.01). Approximately half (47.4 percent; n=72) anticipate earning between $100,000 and $199,999 within five years after graduation, with 50.7 percent (n=77) anticipating working between thirty-five and forty hours a week. By understanding the applicant pool and their perceptions, admissions committees can better prepare to attract the applicants they desire.

Recent admissions trends at UNLV-SDM: perspectives on recruitment of female and minority students at a new dental school.

As the U.S. population continues to become more diverse, there has been a movement toward the recruitment of more diverse students into the dental profession. The purpose of this study was to assess the current and historical trends in diversity among dental school applicants and enrollees at a new dental institution, the University of Nevada, Las Vegas, School of Dental Medicine (UNLV-SDM). Applicant and enrollment data for the first four cohorts, sorted by gender and ethnicity, were retrieved and summarized by the Office of Admissions and Student Affairs at UNLV-SDM. The principal findings of this analysis revealed enrollment of females at UNLV-SDM was relatively consistent during this time interval, although significantly lower than the U.S. average of all dental schools. The enrollment of minorities at UNLV-SDM, however, was consistent and comparable to the U.S. average, although these percentages were disproportionately smaller than the percentage of minorities in the general population. Based upon these findings, a new model for outreach and recruitment of females and minorities was recently created, based in part upon evidence of successful strategies by dental educators at other institutions, in order to increase the enrollment of female and underrepresented minority students.