Birth Order and Sibling Sex Ratio in Androphilic Males and Gynephilic Females Diagnosed With Gender Dysphoria From Iran

BackgroundThis study investigated the effect of older brothers on sexual orientation in male adults diagnosed with gender dysphoria and the effect of older sisters on sexual orientation in female adults diagnosed with gender dysphoria from Iran.AimTo assess for the presence of a fraternal birth order effect in transgender androphilic males and a sororal birth order effect in transgender gynephilic females.MethodsThe subjects were 92 transgender males and 107 transgender females (all of whom met the DSM-5 criteria for gender dysphoria), together with 72 male and 78 female clinical controls. All the transgender males were androphilic, all the transgender females were gynephilic (preferentially attracted to members of their own biological sex), and all of the clinical controls were heterosexual (none were transgender or had a diagnosis of gender dysphoria).OutcomesIn relation to the probands, we analyzed the sibship composition of our groups with regard to birth order and sibling sex ratio (brothers to sisters).ResultsThe results for the transgender males confirmed the findings of 2 recent meta-analyses that older brothers increase the odds of androphilia in later-born males. The results for the transgender females did not clearly confirm one previous finding that older sisters increase the odds of gynephilia in later-born females—a finding obtained in a relatively large study that included gynephilic cisgender girls as well as girls diagnosed with gender dysphoria who will probably be predominantly gynephilic.Clinical ImplicationsThe fraternal (later-born) birth order effect that we found for the transgender androphilic males, similar to that found in gay men, suggests a common underlying causal mechanism.Strengths and LimitationsOur study on Iranian patients diagnosed with gender dysphoria provides further generalizability for the study of birth order and sibling sex ratio that has, more often than not, been restricted to Western samples of adults diagnosed with gender dysphoria. It would be important to study these variables in Iranian gay men and lesbian women (without gender dysphoria) to further examine evidence for cross-cultural similarities when compared to Western samples.ConclusionsIn contrast to the well-established fraternal birth order effect for males, the possible sororal birth order effect for females needs to be examined with additional samples.Khorashad BS, Zucker KJ, Talaei A. Birth Order and Sibling Sex Ratio in Androphilic Males and Gynephilic Females Diagnosed With Gender Dysphoria from Iran. J Sex Med 2020;17:1195–1202.     

Diffusion MRI abnormalities detection with orientation distribution functions: A multiple sclerosis longitudinal study

We propose a new algorithm for the voxelwise analysis of orientation distribution functions between one image and a group of reference images. It relies on a generic framework for the comparison of diffusion probabilities on the sphere, sampled from the underlying models. We demonstrate that this method, combined to dimensionality reduction through a principal component analysis, allows for more robust detection of lesions on simulated data when compared to classical tensor-based analysis. We then demonstrate the efficiency of this pipeline on the longitudinal comparison of multiple sclerosis patients at an early stage of the disease: right after their first clinically isolated syndrome (CIS) and three months later. We demonstrate the predictive value of ODF-based scores for the early detection of lesions that will appear or heal.     

Artificial neural network for modeling the elastic modulus of electrospun polycaprolactone/gelatin scaffolds

Scaffolds for tissue engineering (TE) require the consideration of multiple aspects, including polymeric composition and the structure and mechanical properties of the scaffolds, in order to mimic the native extracellular matrix of the tissue. Electrospun fibers are frequently utilized in TE due to their tunable physical, chemical, and mechanical properties and porosity. The mechanical properties of electrospun scaffolds made from specific polymers are highly dependent on the processing parameters, which can therefore be tuned for particular applications. Fiber diameter and orientation along with polymeric composition are the major factors that determine the elastic modulus of electrospun nano- and microfibers. Here we have developed a neural network model to investigate the simultaneous effects of composition, fiber diameter and fiber orientation of electrospun polycaprolactone/gelatin mats on the elastic modulus of the scaffolds under ambient and simulated physiological conditions. The model generated might assist bioengineers to fabricate electrospun scaffolds with defined fiber diameters, orientations and constituents, thereby replicating the mechanical properties of the native target tissue.     

Static and dynamic validation of inertial measurement units

Optical motion capture systems are used to assess human motion. While these systems provide a reliable analysis, they limit collection to a laboratory based setting. Devices such as Inertial Measurement Units (IMUs) have been developed as alternative tools. Commercially available IMUs are utilized for a variety of applications; however limited work has been done to determine the reliability of these devices. The objective of this study was to assess the accuracy and precision of a commercially available IMU, containing tri-axial accelerometers, gyroscopes, and magnetometers, under controlled static and dynamic conditions. The sensor output was validated against the gold standard measures of custom made mechanical testing apparatuses. The IMUs provide an accurate (within 0.6°) and precise (within 0.1°) measurement of static sensor orientation and an accurate (within 4.4° per second) and precise (within 0.2° per second) representation of angular velocity. The sensors are more accurate at lower velocities, but the percent error remains relatively constant across all angular velocities. Inclusion of IMUs as an appropriate measurement tool should be based on the application, specific demands and necessary reliability.     

Pulmonary vein orientation is independently associated with outcomes following cryoballoon-based atrial fibrillation ablation

AimsSeveral studies have investigated the influence of pulmonary vein (PV) anatomy on outcomes of atrial fibrillation (AF) ablation. We aimed to evaluate the relationship between PV orientation and AF-free survival following cryoablation.Methods160 patients scheduled for cryoablation between September 2012–March 2014 were included. Patients underwent a pre-procedural cardiac CT scan with retrospective ECG gating. PV orientation was assessed according to the position of the PV orifice relative to the sagittal plane with reference to coronal and horizontal planes.Results160 patients (57 ± 9 years, 54% male, 33% persistent AF) were included and followed for a median of 17 (12–36) months. Excluding a blanking period of 3 months, freedom from AF after a single ablation procedure was 76%. Ventral-caudal left upper PV (p = 0.044) and ventral-caudal left lower PV orientation (p = 0.001) were more common in patients with AF recurrence. In multivariate Cox regression analysis, only left lower PV orientation [particularly dorsal-caudal (HR: 3.447, 95% CI: 1.180–10.070, p = 0.024) and ventral-caudal (HR: 3.391, 95% CI: 1.088–10.571, p = 0.035) orientations compared to dorsal-cranial orientation] as well as LA diameter (HR: 3.420, 95% CI: 1.809–6.465, p < 0.001) were significantly associated with AF recurrence.ConclusionThis is the first study to demonstrate the impact of PV orientation on prediction of AF recurrence following cryoablation. Preprocedural assessment of PV orientation may modify operator preferences on treatment strategies in AF.     

护士“三定”管理在手术室的实施

目的 探讨“三定”（即定员管理、定向培养、定能分级）管理为核心的新型护理能级管理模式在手术室的实施,以加快专科护士培养进程,提升护士职业发展空间,深化护理内涵质量,推进优质护理服务。方法 根据手术室专科建设规范,按照定员管理原则合理配置护理人员。对规范化培训护士、准专科护士、专科护士三个阶段进行手术室专科护理人才的定向培养,并根据定能分级实现对护士能力的分层次使用及绩效分配。结果 手术室实施“三定”管理后,护士的工作能力得以提升,医生的工作满意度明显提高。结论 “三定”管理方案在手术室切实可行,提高了护理质量,促进了护理队伍的内涵建设和护理专科化发展,激发了护理人员的工作热情和创新能力,可为患者提供高质量的围手术期优质护理服务。     

Image and geometry processing with Oriented and Scalable Map

We turn the Self-organizing Map (SOM) into an Oriented and Scalable Map (OS-Map) by generalizing the neighborhood function and the winner selection. The homogeneous Gaussian neighborhood function is replaced with the matrix exponential. Thus we can specify the orientation either in the map space or in the data space. Moreover, we associate the map’s global scale with the locality of winner selection. Our model is suited for a number of graphical applications such as texture/image synthesis, surface parameterization, and solid texture synthesis. OS-Map is more generic and versatile than the task-specific algorithms for these applications. Our work reveals the overlooked strength of SOMs in processing images and geometries.     

Axon growth-promoting properties of human bone marrow mesenchymal stromal cells

Mesenchymal stromal cells are promising candidate donor cells for promoting functional tissue repair following traumatic spinal cord injury (SCI), however, the mechanism(s) of action remain poorly defined. Here, we describe an in vitro study of the axon growth-promoting properties of highly enriched populations of adult human mesenchymal stromal cells (hMSC). A random, non-oriented pattern of neuritic outgrowth was observed from dissociated adult rat DRG neurons seeded onto confluent A431 cells and PLL/laminin positive control substrata. Confluent hMSC formed arrays of similarly orientated cell bodies and processes which supported the regeneration of significantly more primary neurites but a slightly lower overall neuritic length than was observed over the PLL/laminin control substrate. The hMSC exerted a strong influence on the direction of neuritic outgrowth, with many regenerating processes following the orientation of underlying hMSC. The production of extracellular matrix appeared to be responsible for neuritic directionality, but the release of growth factors was a significant promoter for DRG neuritic outgrowth. This suggests that further investigations into the properties of hMSC may be of particular interest in the development of transplant-mediated strategies intending to promote functional axonal regeneration after SCI.     

中老年人胃癌前哨淋巴结术中定位的临床研究

目的　探讨胃癌前哨淋巴结 (SLN)术中定位和检测应用的可行性及其预测胃癌淋巴转移的准确性。方法　应用 1 %亚甲蓝染色剂 ,对 2 8例 (T1、T2期 )胃癌病人进行术中SLN定位 ,切除蓝染淋巴结〔平均每例病人 (2 6± 1 7)个〕 ,随后对患者均行胃癌扩大根治术。SLNs和非前哨淋巴结 (nSLNs)均行苏木精 伊红 (HE)染色。结果　 2 8例中有 2 7例 (96 4% )成功检出SLN ,1 0例患者有淋巴结转移 ,其中 6例存在SLN及n SLN转移 ,3例存在SLN转移 ,1例只有n SLN转移。由SLN状态预测胃周淋巴结转移情况的敏感性为 90 % (9/ 1 0 ) ,特异性为 1 0 0 % (1 7/ 1 7) ,准确率为 96 3 % (2 6/ 2 7)。T1组 (1 2例 )与T2组 (1 6例 )敏感性分别为 1 0 0 %和 88%。结论　应用亚甲蓝染色剂对胃癌SLN定位检测成功率高 ,SLN状态 ,尤其是T1期胃癌 ,能够准确预测胃癌患者的淋巴结转移状况。