Experience of Induced Lactation in a Transgender Woman: Analysis of Human Milk and a Suggested Protocol.

Background: A growing number of diverse familial structures wish to colactate their infant. For transgender and gender diverse (TGD) individuals, chestfeeding or breastfeeding may be within their goals of parenthood. There is limited evidence on how to induce lactation for a nongestational parent on gender affirming estrogen treatment. Case Presentation: We report the case of a transgender woman who successfully underwent lactation induction following a protocol using the galactogue domperidone plus use of a breast pump. The patient had modifications to her hormone therapy with estrogen and progesterone while remaining on antiandrogen therapy with spironolactone. A description of the protocol, medications, laboratory monitoring, human milk analysis including macronutrients, oligosaccharides, and hormones is presented. Discussion: This is the fourth case to date known in the literature of a transgender woman with successful lactation induction, and the third case to remain on antiandrogen therapy during this process. Our report is the second to demonstrate comparable macronutrients, and the first to report on human milk oligosaccharides and hormones in induced milk compared with term human milk of a gestational parent. Conclusions: The opportunity to chestfeed or breastfeed an infant can be profound for many parents. Further research is needed to meet the needs of TGD individuals who wish to induce lactation as part of their parental goals.

Preliminary Pilot-Testing of Intimate Partner Violence Screening for Transgender and Gender Diverse (TGD) Individuals in Med-Peds and Family Medicine.

INTRODUCTION: Transgender and gender diverse (TGD) individuals, comprised of those whose gender identity does not correspond with the sex they were assigned at birth, represent approximately 1.4 million people in the U.S., with a higher prevalence among those 18-24 years old. TGD individuals experience high levels of intimate partner violence (IPV), which leads to disproportionately negative mental and physical health outcomes for this population. As a result, there is a resounding need to connect TGD populations to health-promoting services, supports and resources. Med-Peds and Family Medicine clinics may be particularly well-positioned to support these efforts due to physicians' focus on transitional-aged youth and young adults under 30. METHODS: The current manuscript reports on processes and outcomes related to a quality improvement (QI) initiative that aimed to test the feasibility and acceptability of implementing IPV screening within both a Med-Peds and a Family Medicine specialty clinic serving TGD populations in Los Angeles, CA. This QI initiative included screeners that capture IPV in cisgender/non-TGD populations (Humiliation, Afraid, Rape, Kick [HARK]) as well as in TGD populations specifically (IPV-T). We utilized a mixed-methods approach to both quantify and qualify responses to existing IPV screening as well as informal feedback from clinic "champions" in each clinic. RESULTS: Quantitative and qualitative findings from this QI initiative, featuring both general and TGD-specific IPV screening measures with 140 TGD individuals, elucidated several important processes that can support effective IPV screening and referral to supports and services. These include the importance of interdisciplinary teams, the utility of an iterative approach to screener roll-out, and the essential role of solidifying a referral process in these efforts. This project additionally shed light on the potential utility and challenges of implementing both general and TGD-specific IPV screening measures. Our pilot test did not support the necessity of a TGD-specific IPV screener for identifying and responding to IPV in this population, yet additional data is critical to generate more conclusive recommendations. CONCLUSION: We recommend larger-scale data collection efforts to evaluate the utility of integrating general and TGD-specific screeners into clinic workflows to ensure optimal health promotion for the TGD population in Med-Peds and Family Medicine clinics.

Structural Characterization and Thermoelectric Properties of Br-Doped AgSnm[Sb0.8Bi0.2]Te2+m Systems.

Herein, we report the synthesis, structural and microstructural characterization, and thermoelectric properties of AgSnm[Sb0.8Bi0.2]Te2+m and Br-doped telluride systems. These compounds were prepared by solid-state reaction at high temperature. Powder X-ray diffraction data reveal that these samples exhibit crystal structures related to the NaCl-type lattice. The microstructures and morphologies are investigated by scanning electron microscopy, energy-dispersive X-ray spectroscopy (EDS), and high-resolution transmission electron microscopy (HRTEM). Positive values of the Seebeck coefficient (S) indicate that the transport properties are dominated by holes. The S of undoped AgSnm[Sb0.8Bi0.2]Te2+m ranges from +40 to 57 µV·K-1. Br-doped samples with m = 2 show S values of +74 µV·K-1 at RT, and the Seebeck coefficient increases almost linearly with increasing temperature. The total thermal conductivity (κtot) monotonically increases with increasing temperature (10-300 K). The κtot values of undoped AgSnm[Sb0.8Bi0.2]Te2+m are ~1.8 W m-1 K-1 (m = 4) and ~1.0 W m-1 K-1 (m = 2) at 300 K. The electrical conductivity (σ) decreases almost linearly with increasing temperature, indicating metal-like behavior. The ZT value increases as a function of temperature. A maximum ZT value of ~0.07 is achieved at room temperature for the Br-doped phase with m = 4.

Superordinate identities and self-transcendent emotions: Longitudinal study in Spain and Chile.

Recent studies suggest that identification with all humanity (IWAH), apart from being related to universalistic values, could also be related to self-transcendent emotions (STE). In this scenario, the general objective of this cross-cultural longitudinal study is to examine the relationship between identification with proximate categories (i.e., community and country) and superordinate one (all humanity), and their association with positive self-oriented and STEs during a traumatic global phenomenon such as COVID-19 pandemics. Additionally, we explore variations regarding the patterns of those associations in different cultural contexts (Chile and Spain) and examine whether they change among two different time points (T1-T2). The total sample was composed of 403 participants, of whom 224 were residents in Chile (M = 39.25, SD = 12.56; range 18-71 years; 49.6% women) and 179 were residents in Spain (M = 36.35, SD = 12.12; range 18-68 years; 59.8% women). Data collection was carried out in September (T1) and November (T2) 2020, through online surveys administered via Survey Monkey® platform. Overall, results show, as expected, greater identification with proximate categories rather than superordinate ones, and an association between STEs and IWAH, but also with national and community identification. IWAH, but not STEs decreased significantly (T1-T2) in both countries. Thereafter, these emotional and behavioral responses decline as a symptom of growing fatigue with the pandemic situation, and also reflect a shift from broader to more local concerns. Analysis regarding comparisons between countries indicated higher levels of identification with community and with all humanity in Spain and with country in Chile. The results are discussed in the context of new developments in studies on IWAH.

When is transanal endoscopic surgery appropriate?

Rectal cancer is a complex medical diagnosis which requires critical decision-making on the part of physician and patient. Organ preservation with local excision for early stage rectal cancer, if done under the correct circumstances, allows for oncologically sound surgery with good patient outcomes. However, locally advanced disease as well as tumor location and size can change potential long-term outcomes. This article will investigate the technical and clinical aspects of transanal surgery and the decision-making algorithms for clinicians and patients.

Design and Fabrication of a Customized Partial Hip Prosthesis Employing CT-Scan Data and Lattice Porous Structures.

As a larger elderly human population is expected worldwide in the next 30 years, the occurrence of aging-associated illnesses will also be increased. The use of prosthetic devices by this population is currently important and will be even more dramatic in the near future. Hence, the design of prosthetic devices able to reduce some of the problems associated with the use of current components, such as stress shielding, reduced mobility, infection, discomfort, etc., becomes relevant. The use of additive manufacturing (AM) and the design fabrication of self-supported cellular structures in the biomedical area have opened up important opportunities for controlling the physical and mechanical properties of hip implants, resulting in specific benefits for the patients. Different studies have reported the development of hip prosthetic designs employing AM, although there are still opportunities for improvement when it comes to customized design and tuning of the physical and mechanical properties of such implants. This work shows the design and manufacture by AM of a personalized stainless-steel partial hip implant using tomography data and self-supported triply periodic minimal surface (TPMS) cell structures; the design considers dimensional criteria established by international standards. By employing tomography data, the external dimensions of the implant were established and the bone density of a specific patient was calculated; the density and mechanical properties in compression of the implant were modulated by employing an internal gyroid-type cell structure. Using such a cell structure, the patient's bone density was emulated; also, the mechanical properties of the implant were fine-tuned in order to make them comparable to those reported for the bone tissue replaced by the prosthesis. The implant design and manufacturing methodology developed in this work considered the clinical condition of a specific patient and can be reproduced and adjusted for different types of bone tissue qualities for specific clinical requirements.

Relación entre las teorías X y Y de McGregor, las formas de retribuir y la satisfacción de las personas en su trabajo / Relationships between McGregor's X and Y theory, compensation form, and job satisfaction

RESUMEN Cuando Douglas McGregor inició sus trabajos relacionados con el lado humano de las empresas, la forma de pensar y de administrar era muy diferente a la que se tiene actualmente. El objetivo de este trabajo fue determinar en el contexto mexicano, la validez y con-fiabilidad del instrumento de medida utilizado en la investigación de grupos de personas anglosajonas, y conocer la relación que existe entre: a) las características de las teorías X y Y de McGregor; b) las formas de retribuir a las personas en una empresa; y c) la satisfacción en el trabajo. Se usó un instrumento de medida con 51 preguntas, que se aplicó a una muestra aleatoria de 233 trabajadores, en el noreste de México. Mediante un modelo de ecuaciones estructurales, se llevó a cabo un análisis factorial exploratorio. Se encontraron resultados que mostraron validez y confiabili-dad en los constructos utilizados. Además, se detectó la existencia de una relación positiva entre la teoría Y con la satisfacción en el trabajo (r = 0.46), mientras que en la teoría X no hubo relación con ninguna variable. Con los diversos hallazgos, se comprueba la relevancia que tienen, en el ambiente laboral mexicano, los aspectos monetarios de la compensación y su influencia positiva en la satisfacción, y en la motivación y actitudes de las personas hacia las actividades que realizan, así como la relevancia de las estrategias de recursos humanos para mantener la satisfacción de los colaboradores.

ABSTRACT When Douglas McGregor started working on the human side of businesses, the way of thinking and managing was very different from the present time. The goal of this research is to determine the validity and reliability of a survey commonly used for conducting research in Anglo-Saxon populations within the Mexican context. We intend to identify the relationship among: a) the components of McGregor's X and Y theory, b) the different forms of compensation to people, and c) job satisfaction. For this research, we administered a 51-item survey to a random sample of 233 workers in the northeastern region of Mexico. An exploratory factor analysis (EFA) was carried out through structural equation modeling. The obtained results showed the validity and reliability of the constructs. In addition, the existence of a positive relationship between theory Y and job satisfaction was found (r = 0.46). On the other hand, theory X showed no relation with any variable. Findings confirm the relevance of the strategies used by human resources departments to maintain employees' motivation and satisfaction. Monetary retribution issues were highly valued within the Mexican work-place environment since they positively influence job satisfaction and workers' motivation to fulfill assigned activities.

Biodepuration of domestic sewage, textile effluents and acid mine drainage using starch-based xerogel from recycled potato peels.

Water is a finite resource. Its safety and cleanliness are highly important to meet current and future human needs. Compared to other resources, water represents a main factor to achieve development in several areas and leads to economic progress of a nation. However, in recent years, the excessive demographic and industrial growth has exacerbated water contamination. In this study, the biodepuration process of domestic sewage (DS), textile effluents (TE) and acid mine drainage (AMD) is conducted using starch-based xerogel from potato (Solanum tuberosum) peels. Results showed that the treatment is effective to achieve the reduction of 5-day biochemical oxygen demand. The most important result was the achievement of heavy metals removal for the three components. Firstly, there was a reduction of barium, zinc, and cadmium (91, 60 and 46%, respectively) for raw AMD. Secondly, there was a reduction in the levels of zinc, aluminum, and barium (89, 86 and 64%, respectively) for TE biodepuration. Finally, results showed a reduction in zinc, iron and cadmium levels (81, 78 and 57%, respectively) for DS biodepuration.

Vivir Con Un Corazón Saludable: a Community-Based Educational Program Aimed at Increasing Cardiovascular Health Knowledge in High-Risk Hispanic Women.

BACKGROUND: Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes. METHODS: Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms. RESULTS: Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains. CONCLUSION: A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.