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Grock S, Weinreb J, Williams KC, Weimer A, Fadich S, Patel R, Geft A, Korenman S. Priorities for efficacy trials of gender-affirming hormone therapy with estrogen: collaborative design and results of a community survey. Hormones (Athens) 2024:10.1007/s42000-024-00532-3. [PMID: 38311658 DOI: 10.1007/s42000-024-00532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/17/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Treatment guidelines for gender-affirming hormone therapy with estrogen (GAHT-E) recommend specific dosing regimens based on limited data. Well-controlled efficacy trials are essential to tailoring treatment to patient goals as the guidelines recommend. The goal of this study was to take a foundational step toward designing community-centered effectiveness trials for gender-diverse individuals seeking GAHT-E. METHODS Our team developed a cross-sectional survey based on broad clinical experience and consultation with our community advisory board. The survey included 60 items covering demographics, transition history, goals and priorities for treatment, indicators of treatment success, sexual function goals, and future research priorities. The survey was distributed during the summer of 2021, primarily through social networks designed for gender-expansive individuals seeking treatment with estrogen. RESULTS A total of 1270 individuals completed the survey. Overall treatment goals most frequently rated "extremely important" or "very important" were the following: (1) improved satisfaction with life (81%), (2) appearing more feminine (80%), (3) appearing less masculine (77%), (4) improved mental health (76%), and (5) being seen as your true gender by others (75%). The three body characteristics most frequently rated "highest priority" or "high priority" among changes were the following: (1) facial hair (85%), (2) breast shape or size (84%), and (3) body shape (80%). The highest-rated research priority was comparing feminization with different routes of estrogen administration. CONCLUSION The goals and experiences of individuals seeking GAHT-E are diverse. Future clinical trials of GAHT-E should be grounded in the needs and priorities of community stakeholders.
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Affiliation(s)
- Shira Grock
- Division of Endocrinology, Diabetes and Metabolism, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA.
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA.
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA.
| | - Jane Weinreb
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- Division of Endocrinology, Diabetes and Metabolism, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA
| | - Kristen C Williams
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Amy Weimer
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Sarah Fadich
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Reema Patel
- Division of Endocrinology, Diabetes and Metabolism, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Atara Geft
- Division of Endocrinology, Diabetes and Metabolism, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA
- Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA
| | - Stanley Korenman
- Division of Endocrinology, Diabetes and Metabolism, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
- UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
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Hotez E, Yang B, Chua KJ, Smith AM, Lee C, Delgado D, Weimer A. Preliminary Pilot-Testing of Intimate Partner Violence Screening for Transgender and Gender Diverse (TGD) Individuals in Med-Peds and Family Medicine. Cureus 2023; 15:e43983. [PMID: 37746480 PMCID: PMC10516247 DOI: 10.7759/cureus.43983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/16/2023] [Indexed: 09/26/2023] Open
Abstract
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.
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Affiliation(s)
- Emily Hotez
- General Internal Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
| | - Bridgette Yang
- Community Health Sciences, University of California Los Angeles Fielding School of Public Health, Los Angeles, USA
| | - Kristine J Chua
- Anthropology, University of California Santa Barbara, Santa Barbara, USA
| | - Andrew M Smith
- General Internal Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
| | - Cameron Lee
- General Internal Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
| | - Daniela Delgado
- Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
| | - Amy Weimer
- General Internal Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
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Caprini RM, Oberoi MK, Dejam D, Chan CH, Potemra HMK, Morgan KBJ, Weimer A, Litwin MS, Mendelsohn AH, Lee JC. Effect of Gender-affirming Facial Feminization Surgery on Psychosocial Outcomes. Ann Surg 2023; 277:e1184-e1190. [PMID: 35786682 DOI: 10.1097/sla.0000000000005472] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study investigates the effect of gender-affirming facial feminization surgery (FFS) on psychosocial outcomes in patients with gender dysphoria. BACKGROUND Comprehensive analyses of psychosocial outcomes after gender-affirming FFS are absent in the literature resulting in a paucity of information on the impact of FFS on quality of life as well as ramifications in health insurance coverage of FFS. METHODS Scores from 11 validated, quantitative instruments from the Patient-Reported Outcomes Measurement Information System (PROMIS) assessing anxiety, anger, depression, global mental health, global physical health, satisfaction with sex life, positive affect, emotional support, social isolation, companionship, and meaning and purpose. Patients within the preoperative group (pre-FFS) were evaluated >30 days before surgery and patients within the postoperative group (post-FFS) were evaluated ≥10 weeks after surgery. RESULTS A total of 169 patients [mean (SD) age, 33.5 (10.8) years] were included. Compared with the pre-FFS group (n=107), the post-FFS group (n=62) reported improved scores anxiety (56.8±8.8 vs 60.1±7.9, P =0.01), anger (47.4±7.6 vs 51.2±9.6, P =0.01), depression (52.2±9.2 vs 57.0±8.9, P =0.001), positive affect (46.6±8.9 vs 42.9±8.7, P =0.01), meaning and purpose (49.9±10.7 vs 46.2±10.5, P =0.03), global mental health (46.7±7.6 vs 43.1±9.2, P =0.01), and social isolation (52.2±7.5 vs 55.4±7.4, P =0.01). Multivariable analysis to account for the effects of other gender-affirming surgeries, hormone therapy duration, preexisting mental health diagnoses, socioeconomic disparities, and patient-reported quality of social relationships on psychosocial functioning demonstrated that completion of FFS was independently predictive of improved scores. CONCLUSIONS Gender-affirming FFS improves the quality of life by multiple psychosocial domains in transfeminine patients.
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Affiliation(s)
- Rachel M Caprini
- Division of Plastic and Reconstructive Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Michelle K Oberoi
- Division of Plastic and Reconstructive Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Dillon Dejam
- Division of Plastic and Reconstructive Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Candace H Chan
- Division of Plastic and Reconstructive Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Hi'ilani M K Potemra
- Division of Plastic and Reconstructive Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Katarina B J Morgan
- School of Dentistry, University of California San Francisco, San Francisco, CA
| | - Amy Weimer
- Department of Medicine, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
- UCLA Gender Health Program, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Mark S Litwin
- Department of Urology, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
- Department of Health Policy & Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA
- School of Nursing, University of California Los Angeles, Los Angeles, CA
- UCLA Gender Health Program, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Abie H Mendelsohn
- Department of Head and Neck Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
- UCLA Gender Health Program, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Justine C Lee
- Division of Plastic and Reconstructive Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
- UCLA Gender Health Program, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA
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Ly D, Hoyt AC, Weimer A, Chang EH, Capiro N, Xie C, Chow L. Breast Cancer Among Transgender and Nonbinary Patients: Paradigms for Improving Data Collection and Inclusion in Breast Imaging Settings. J Breast Imaging 2023; 5:73-79. [PMID: 38416956 DOI: 10.1093/jbi/wbac067] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Indexed: 03/01/2024]
Abstract
Breast cancer incidence among transgender and nonbinary (TGNB) individuals is not well characterized owing to the absence of robust data collection among this patient population. Consequently, breast cancer risks are largely unknown, and screening guidelines are not based on robust evidence. Additionally, TGNB patients experience barriers to access health care. A first step in improving data collection, research, and ultimately care of TGNB individuals is the identification of group members and demonstration to patients that our breast imaging centers are champions of LGBTQ+ health. At our institution, patients who present for breast imaging complete an iPad-administered breast imaging history and breast cancer risk assessment survey. Using the modified Tyrer-Cuzick model, the lifetime risk of developing breast cancer is estimated, and additional key history that may impact breast care and future breast imaging is collected. Under the previous clinic workflow, patients are identified as either "male" or "female" and complete a corresponding gender-specific survey. To improve care, we revised the survey using gender-inclusive language and developed four versions to allow patients to separately self-report their sex assigned at birth and gender identity. Relevant queries relating to hormone use and gender-affirming chest/breast surgery that are concordant with six gender-identity groups were added. Long-term collection of these inclusive data by imaging centers has the potential to enhance the data set available to improve breast care and better understand breast cancer risk and outcomes among TGNB populations.
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Affiliation(s)
- David Ly
- David Geffen School of Medicine at University of California Los Angeles, Department of Radiological Sciences, Los Angeles, CA, USA
| | - Anne C Hoyt
- David Geffen School of Medicine at University of California Los Angeles, Department of Radiological Sciences, Los Angeles, CA, USA
| | - Amy Weimer
- David Geffen School of Medicine at University of California Los Angeles, Department of Medicine, Los Angeles, CA, USA
| | - Emery H Chang
- David Geffen School of Medicine at University of California Los Angeles, Department of Medicine-Pediatrics, Los Angeles, CA, USA
| | - Nina Capiro
- David Geffen School of Medicine at University of California Los Angeles, Department of Radiological Sciences, Los Angeles, CA, USA
| | | | - Lucy Chow
- David Geffen School of Medicine at University of California Los Angeles, Department of Radiological Sciences, Los Angeles, CA, USA
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Gaither TW, Williams K, Mann C, Weimer A, Ng G, Litwin MS. Initial Clinical Needs Among Transgender and Non-binary Individuals in a Large, Urban Gender Health Program. J Gen Intern Med 2022; 37:110-116. [PMID: 33904031 PMCID: PMC8739414 DOI: 10.1007/s11606-021-06791-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 04/01/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Transgender and gender-diverse individuals are particularly vulnerable to healthcare discrimination and related health sequelae. OBJECTIVE To demonstrate diversity in demographics and explore variance in needs at the time of intake among patients seeking care at a large, urban gender health program. DESIGN We present summary statistics of patient demographics, medical histories, and gender-affirming care needs stratified by gender identity and sexual orientation. PARTICIPANTS We reviewed all intake interviews with individuals seeking care in our gender health program from 2017 to 2020. MAIN MEASURES Clients reported all the types of care in which they were interested at the time of intake as their "reason for call" (i.e., establish primary care, hormone management, surgical services, fertility services, behavioral health, or other health concerns). KEY RESULTS Of 836 patients analyzed, 350 identified as trans women, 263 as trans men, and 223 as non-binary. The most prevalent sexual identity was straight among trans women (34%) and trans men (38%), whereas most (69%) non-binary individuals identified as pansexual or queer; only 3% of non-binary individuals identified as straight. Over half of patients reported primary care, hormone management, or surgical services as the primary reason for contacting our program. Straight, transgender women were more likely to report surgical services as their primary reason for contacting our program, whereas gay transgender men were more likely to report primary care as their reason. CONCLUSIONS Individuals contacting our gender health program to establish care were diverse in sexual orientation and gender-affirming care needs. Care needs varied with both gender identity and sexual orientation, but primary care, hormone management, and surgical services were high priorities across groups. Providers of gender-affirming care should inquire about sexual orientation and detailed treatment priorities, as trans and gender-diverse populations are not uniform in their treatment needs or goals.
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Affiliation(s)
- Thomas W Gaither
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Kristen Williams
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Christopher Mann
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Amy Weimer
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Gladys Ng
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Mark S Litwin
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.,School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
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Pätzold M, Weimer A, Liese A, Holtmann D. Optimization of solvent-free enzymatic esterification in eutectic substrate reaction mixture. ACTA ACUST UNITED AC 2019; 22:e00333. [PMID: 31008067 PMCID: PMC6453777 DOI: 10.1016/j.btre.2019.e00333] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/04/2019] [Accepted: 03/28/2019] [Indexed: 11/27/2022]
Abstract
The Candida rugosa lipase catalyzed esterification of (-)-menthol and lauric acid (LA) was studied in a eutectic mixture formed by both substrates((-)-menthol:LA 3:1, mol/mol). No additional reaction solvent was necessary, since the (-)-menthol:LA deep eutectic solvent (DES) acts as combined reaction medium and substrate pool. Therefore, the esterification is conducted under solvent-free conditions. The thermodynamic water activity (aw) was identified as a key parameter affecting the esterification performance in the (-)-menthol:LA DES. A response surface methodology was applied to optimize the esterification conditions in terms aw, amount of C. rugosa lipase (mCRL) and reaction temperature. Under the optimized reaction conditions (aw = 0.55; mCRL =60 mg; T =45 °C), a conversion of 95 ± 1% LA was achieved (one day), the final (-)-menthyl lauric acid ester concentration reached 1.36 ± 0.04 M (2.25 days). The experimental product formation rate agreed very well with the model prediction.
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Affiliation(s)
- M Pätzold
- DECHEMA Research Institute, Industrial Biotechnology, Theodor-Heuss-Allee 25, 60486, Frankfurt a.M., Germany.,Hamburg University of Technology (TUHH), Institute of Technical Biocatalysis, Denickestr. 15, 21073, Hamburg, Germany
| | - A Weimer
- DECHEMA Research Institute, Industrial Biotechnology, Theodor-Heuss-Allee 25, 60486, Frankfurt a.M., Germany
| | - A Liese
- Hamburg University of Technology (TUHH), Institute of Technical Biocatalysis, Denickestr. 15, 21073, Hamburg, Germany
| | - D Holtmann
- DECHEMA Research Institute, Industrial Biotechnology, Theodor-Heuss-Allee 25, 60486, Frankfurt a.M., Germany
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Weimer A, Tagny CT, Tapko JB, Gouws C, Tobian AAR, Ness PM, Bloch EM. Blood transfusion safety in sub-Saharan Africa: A literature review of changes and challenges in the 21st century. Transfusion 2018; 59:412-427. [PMID: 30615810 DOI: 10.1111/trf.14949] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Access to a safe, adequate blood supply has proven challenging in sub-Saharan Africa, where systemic deficiencies spanning policy, collections, testing, and posttransfusion surveillance have long been recognized. Progress in transfusion safety in the early 2000s was in large part due to intervention by the World Health Organization and other foreign governmental bodies, coupled with an influx of external funding. STUDY DESIGN AND METHODS A review of the literature was conducted to identify articles pertaining to blood safety in sub-Saharan Africa from January 2009 to March 2018. The search was directed toward addressing the major elements of the blood safety chain, in the countries comprising the World Health Organization African region. Of 1380 articles, 531 met inclusion criteria and 136 articles were reviewed. RESULTS External support has been associated with increased recruitment of voluntary donors and expanded testing for the major transfusion-transmitted infections (TTIs). However, the rates of TTIs among donors remain high. Regional education and training initiatives have been implemented, and a tiered accreditation process has been adopted. However, a general decline in funding for transfusion safety (2009 onwards) has strained the ability to maintain or improve transfusion-related services. Critical areas of need include data collection and dissemination, epidemiological surveillance for TTIs, donor recruitment, quality assurance and oversight (notably laboratory testing), and hemovigilance. CONCLUSION Diminishing external support has been challenging for regional transfusion services. Critical areas of deficiency in regional blood transfusion safety remain. Nonetheless, substantive gains in education, training, and accreditation suggest durable gains in regional capacity.
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Affiliation(s)
- A Weimer
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - C T Tagny
- Hematology and Blood Transfusion service, University Teaching Hospital, Yaoundé, Cameroon
| | - J B Tapko
- African Society of Blood Transfusion, Yaoundé, Cameroon
| | - C Gouws
- Blood Transfusion Service of Namibia, Windhoek, Namibia
| | - A A R Tobian
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - P M Ness
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
| | - E M Bloch
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, Baltimore, MD
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Sutin AR, Rogers DL, Mercado A, Weimer A, Rodriguez CC, Gonzalez M, Robins RW, Schwartz SJ, Terracciano A. The association between personality traits and body mass index varies with nativity among individuals of Mexican origin. Appetite 2015; 90:74-9. [PMID: 25747285 DOI: 10.1016/j.appet.2015.02.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 01/28/2015] [Accepted: 02/26/2015] [Indexed: 11/17/2022]
Abstract
Personality traits have been associated consistently with health-related outcomes, but less is known about how aspects of the sociocultural environment modify these associations. This study uses a sample of participants of Mexican origin (N = 1013) to test whether exposure to the United States, indexed by nativity (Mexicans living in Mexico, foreign-born Mexican Americans, and U.S.-born Mexican Americans), moderates the association between personality traits and body mass index (BMI). Higher Conscientiousness was associated with lower BMI, regardless of nativity. In contrast, the association between Neuroticism and BMI was moderated by exposure to the U.S.: Neuroticism was associated with higher BMI among U.S.-born Mexican Americans (partial r = .15) but not among Mexican participants (partial r = .00), an effect strongest and most robust for the impulsivity facet of Neuroticism. This finding suggests that with more exposure to the United States, those who are more emotionally impulsive are at greater risk for obesity. More broadly, these findings suggest that social and psychological vulnerabilities interact to contribute to health outcomes.
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Affiliation(s)
- Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 1115 W. Call Street, Tallahassee, FL 32308.
| | - Darrin L Rogers
- Psychology Department, W357 Thompson Hall, State University of New York at Fredonia, Fredonia, NY 14063
| | - Alfonso Mercado
- Department of Psychology, The University of Texas-Pan American, 1201 W. University, Edinburg, TX 78539
| | - Amy Weimer
- Department of Psychology, The University of Texas-Pan American, 1201 W. University, Edinburg, TX 78539
| | | | - Monica Gonzalez
- Pedro de Alba S/N, Ciudad Universitaria, 66450 San Nicolás de Los Garza, N.L., Mexico
| | - Richard W Robins
- Department of Psychology, University of California, Davis One Shields Avenue, Davis, CA 95616
| | - Seth J Schwartz
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, 1120 N.W. 14th Street, 10th Floor, Miami, FL 33136
| | - Antonio Terracciano
- Department of Geriatrics, Florida State University College of Medicine, 1115 W. Call Street, Tallahassee, FL 32308
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Horai T, Ku N, Genovese E, Bermudez C, Bahma J, Teuteberg J, Winowich S, Weimer A, O'Shea G, Toyoda Y. 534: Major Neurological Events after Ventricular Assist Device (VAD) Implantation Are Device Specific but Are Also Related to Pre-Implant Factors. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Abstract
Cartilage tissue engineering is the creation of functional substitutes of native articular cartilage in bioreactors by attaching chondrogenic cells to polymer scaffolds. One limitation of tissue engineering is the delivery of regulatory signals to cells according to specific temporal and spatial patterns. Using gene transfer techniques, polypeptide growth factor genes such as the human insulin-like growth factor I (IGF-I) gene can be transferred into chondrocytes. When these modified cells are used for cartilage tissue engineering, the resulting cartilaginous constructs have improved structural and functional characteristics compared to constructs based on nonmodified cells. The combination of cartilage tissue engineering with overexpression of potential therapeutic genes using gene transfer technologies provides a basis for the development of novel molecular therapies for the repair of cartilage defects.
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Affiliation(s)
- H Madry
- Labor für Experimentelle Orthopädie,Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, 66421, Homburg.
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12
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Schatz A, Weimer A, Trauner D. Attentional differences in Asperger syndrome. Arch Clin Neuropsychol 1999. [DOI: 10.1093/arclin/14.8.681a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Török T, Kardos A, Rudas L, Paprika D, McLuckie A, Beale RJ, Bihari D, Keller H, Seltzer N, Weimer A, Menning H, Ulrich P, Staedt U, Kirschstein W, Kasai T, Endo S, Arakawa N, Sato N, Suzuki T, Taniguchi S, Inada K, Hiramori K, Schmidt W, Meineke I, Nottrott M, Frerichs I, Müller S, Hellige G, De Blasio E, De Sio A, Sibilio G, Papa A, Golia D, Grassia V, Bove G, Zehelgruber M, Mundigler G, Christ G, Merhaut C, Klaar U, Kratochwill C, Hofmann S, Siostrzonek P, Suarez F, Corrales M, Rábago R, Gonzalez-Arenas P, Morales R, Sanchez J, Fraile J, Rey M, Martinell J, Niederst PN, Mellwig KP, Schmidt HK, Gleichmann U, Körfer R, Di Bartolomeo S, Bertolissi M, Nardi G, De Monte A, Janssens U, Ochs JG, Klues HG, Hanrath P, Sajjanhar T, Tibby SM, Hatherill M, Anderson D, Murdoch IA, Krivec B, Voga G, Žuran I, Skale R, Parežnik R, Podbregar M, Bonnefoy E, Chevalier P, Kirkorian G, Guidolet J, Marchand A, Bouchayer D, Marcaz PB, Touboul P, Welte T, Molling J, Jepsen MS, Claus G, Klein H, Cinnella G, Dambrosio M, Brienza N, Conte M, Maggiore SM, Leone AM, Brienza A, DiVenere N, Vandewoude K, Poelaert J, Vogelaers D, Garcia RB, Buylaert W, Roosens C, Colardyn F, Annane D, Béllissant E, Pussard E, Asmar R, Lacombe F, Lanata E, Madonna O, Safar M, Giudicelli JF, Raphael JC, Gajdos P, Mattys M, Dumont L, Annaert JF, Mardirosoff C, Goldstein J, Verbeet T, Massaut J, Haas NA, Uhlemann F, Daehnert I, Berger F, Stiller B, Dittrich S, Schulze-Neick I, Eweit P, Lange PE, Langenherp CJM, Pietersen H, Geskes G, Wagenmakers A, Soeters P, Maggiorini M, Brimioulle S, Lejeune P, Delcroix M, Vermeulen F, Stephanazzi J, Naeije R, Kunert M, Stolzenburg H, Scheuble L, Emmerich K, Ulbricht LJ, Krakau I, Gülker H, Broch MJ, Valentín V, Murcia B, Bartual E, Málaga A, Miralles LL, Valls F, Wallin CJ, Sidenö B, Vaage J, Leksell LG, Stuchlinger HG, Seidler D, Hollenstein U, Janata K, Muellner M, Loeffler W, Gamper G, Bur A, Malzer R, Laggner AN, Hirschl MM, Binder M, Herkner H, Bur A, Laggner AN, Turani F, Ceraso C, Lironcurti A, Senesi P, Leonardis C, Sabato AF, Pietersen HG, Langenberg CJM, Geskes G, Wagenmakers AJM, de Lange S, Soeters PB, Royira A, Oussedik L, Cambray C, Glmeno C, Cerda M, Sanchez MA, Lesmes A, Guerrero M, Vigil E, Ortega F, Lucena F, Righini ER, Alvisi R, Marangoni E, Gritti G, Ordóñez A, Hernández A, Pérez-Bernal J, Hinojosa R, Borrego JM, Franco A, López-Barneo J, Pérez-Bernal J, Gutiérrez E, Hinojosa R, Hernández A, Borrego JM, Cerro J, Rincón D, Ordóñez A, Martin R, Saussine M, Sany CL, Calvet B, Raison D, Frapier JM, Wallin CJ, Olsson Å, Nordländer R, Leksell LG, Vasilkov V, Safronov A, Marinchev V, Rodrigues AC, Moraes A, Galas F, Angelim V, Medeiros C, Auler JO, Bellotti G, Pilleggi F, Carmona MJ, Messias ERR, Joseph D, Baigorri F, Artigas A, Blanch L, Wagner F, Dandel M, Günther G, Schulze-Neick I, Weng Y, Loebe M, Hetzer R, Colreavy F, Balea M, Cahalan M, Carpintero JL, de la Fuente MC, Estecha MA, Molina JM, del Fresno LR, Daga D, Toro R, Poullet A, de la Torre MV, Garcia AJ, Michalopoulos A, Rellos K, Skambas D, Liakopoulos O, Geroulanos S. Posters. Intensive Care Med 1996. [DOI: 10.1007/bf03216414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bartram HP, Gostner A, Kelber E, Dusel G, Weimer A, Scheppach W, Kasper H. Effects of fish oil on fecal bacterial enzymes and steroid excretion in healthy volunteers: implications for colon cancer prevention. Nutr Cancer 1996; 25:71-8. [PMID: 8837863 DOI: 10.1080/01635589609514429] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Diet-induced changes in fecal excretion of secondary bile acids, certain neutral sterols, and bacterial enzyme activities are known to play a role in colon cancer development. Dietary fish oil (FO) has been implicated as a protective agent in colon carcinogenesis. In the present study, the effects of FO and corn oil (CO) on these fecal parameters were investigated in 24 healthy volunteers consuming a low- or a high-fat diet (30% or 50% of energy derived from fat). After four weeks of FO or CO supplementation (4.4 g of n-3 fatty acids/day), no significant differences were noted for fecal activities of beta-glucuronidase, beta-glucosidase, and sulfatase, nor was fecal bile acid excretion significantly affected by FO or CO consumption. However, daily excretion of the putative colon carcinogen 4-cholesten-3-one was significantly lower in the FO than in the CO period during low- and high-fat experiments. This may be another biochemical mechanism by which FO exerts its protective effect on colon cancer development.
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Affiliation(s)
- H P Bartram
- Department of Medicine, University of Wuerzburg, Germany
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Clausing P, Bocker T, Diekgerdes J, Gärtner K, Güttner J, Haemisch A, Veckenstedt A, Weimer A. Social isolation modifies the response of mice to experimental Mengo virus infection. J Exp Anim Sci 1994; 36:37-54. [PMID: 8193172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
To investigate the effects of social isolation on host resistance male mice were housed either individually (IH) or in groups of four or five (GH). All animals were infected with MengoM,L virus. Incubation time (INCUB), duration of illness (ILL), death rate (DR), histopathological changes, and serum corticosterone levels (CORT) were recorded. First, the effect of IH starting 4 days prior to infection was studied in 5 different inbred strains. Next, the effect of different IH length was examined, and the role of T-cells was investigated by comparing euthymic (+/+) and athymic (nu/nu) NMRI mice. Finally, the effects of the infection on CORT in IH and GH mice were compared in C57BL/6 mice. The major findings were: 1. IH significantly increased ILL in all but the DBA/2 strain, whereas DR was not affected except in C57BL/6. 2. Longer IH (starting 35 [DBA/2] or 10 [NMRI] days prior to virus inoculation) significantly shortened INCUB and prolonged ILL, but IH starting on the day of virus inoculation [DBA/2] significantly prolonged INCUB and shortened ILL. 3. NMRI nude mice exhibited an unaltered DR accompanied by a tremendously prolonged INCUB. 4. Investigations in C57BL/6 mice revealed a significant rise of CORT after infection. This increase was higher in IH compared to GH mice. It is suggested that IH attenuates T-cell mediated inflammatory processes and/or increases macrophage activation, which in turn results in a prolonged course of the disease.
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Affiliation(s)
- P Clausing
- Institute of Microbiology and Experimental Therapy, Jena, Germany
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Weimer A. Starting Point: an approach to support for families of cardiac patients. Care Giver 1984; 1:26-8. [PMID: 10275332 DOI: 10.1080/10778586.1984.10767481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Weimer A. Pastoral care in a level one trauma center emergency room. Bull Am Protestant Hosp Assoc 1982; 47:99-103. [PMID: 10269998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Barlas P, Röhner H, Weimer A, Teller P, Schindler AE. [Effect of drugs on steroid metabolism in the normal placenta]. Arch Gynakol 1975; 219:280-1. [PMID: 1243334 DOI: 10.1007/bf00669088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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