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This article explores the experiences of lesbians who have become mothers using donated semen. During the 1980s lesbian access to clinic-based donor insemination was limited because it was seen to threaten both the traditional family and the medical definition of 'infertility'. However, the spread of self-insemination networks has enabled more lesbians to become mothers. This article analyses how lesbians negotiate and manage the role that donated semen, and donors, play in their, and their children's, lives. In the discussion, it is suggested that lesbian donor insemination has now gained some acceptance, but only within a medicalised framework. Self-insemination is still seen as a threat to medicine since it is a de-professionalised, de-medicalised practice that privileges the lay knowledge and concerns of the women themselves. [ABSTRACT FROM AUTHOR]

Heteroepitaxial InxGa1-xAs/GaAs structures have been formed for the first time by pulsed laser induced mixing of molecular beam epitaxy deposited In films (∼200 Å) on GaAs (100) substrates. The process occurs by a melt-induced, rapid-mixing and solidification process driven by a XeCl pulsed excimer laser. The laser has a 27 ns full width at half maximum pulse width at 308 nm with its energy density of 0.28–0.61 J cm-2 homogenized into a 4×4 mm square area which is stepped across the wafer. InxGa1-xAs layers with x values, as determined by both x-ray diffraction and Rutherford backscattering spectrometry simulation ranging from x=0.21–0.26 and thicknesses of 77–94 nm, have been formed. The formation of single-crystal layers has been verified by 4He ion channeling and cross-section transmission electron microscopy. [ABSTRACT FROM AUTHOR]

A pulsed XeCl excimer laser (λ=308 nm) is used to melt n- and p-type GaAs samples. Melt-induced defects shift the surface Fermi level to a new pinning position at 0.58±0.04 eV below the conduction-band minimum for both n- and p-type samples. The Schottky barrier height of Au, deposited on the GaAs after laser irradiation, is increased by 0.38 eV (from 0.43 to 0.81 eV) for p-type, and decreased by 0.30 eV (from 0.84 to 0.54 eV) for n-type samples. In the post-melted GaAs near-surface region, four deep levels are found using deep level transient spectroscopy. The observation of minority-carrier traps in the Schottky diode structures suggests the existence of minority-carrier source. We speculate a compensated region forms near the GaAs surface. A bulk Fermi level stabilization model is used to explain the changes observed in the Schottky barrier heights. [ABSTRACT FROM AUTHOR]

This article analyses a set of videos which featured public figures encouraging racially minoritised people in the UK to take the COVID-19 vaccine or get involved in related research. As racially targeted health communication has both potentially beneficial and problematic consequences, it is important to examine this uniquely high-profile case. Using a purposive sample of 10 videos, our thematic content analysis aimed to reveal how racially minoritised people were represented and the types of concerns about the vaccine that were expressed. We found representations of racialised difference that centred on 'community' and invoked shared social experiences. The expressed concerns centred on whether ethnic difference was accounted for in the vaccine's design and development, plus the overarching issue of trust. Our analysis adopts and develops the concept of 'racialisation'; we explore how 'mutuality' underpinned normative calls to action ('ethico-racial imperatives') and how the videos 'responsibilised' racially minoritised people. We discuss two points of tension in this case: the limitations for addressing the causes of mistrust and the risks of reductivism that accompanied the ambiguous notion of community. Our analysis develops scholarship on racialisation in health contexts and provides public health practitioners with insights into the socio-political considerations of racially targeted communications., (© 2024 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for the Sociology of Health & Illness.)

Objective: To utilize whole exome or genome sequencing and the scientific literature for identifying candidate genes for cyclic vomiting syndrome (CVS), an idiopathic migraine variant with paroxysmal nausea and vomiting., Methods: A retrospective chart review of 80 unrelated participants, ascertained by a quaternary care CVS specialist, was conducted. Genes associated with paroxysmal symptoms were identified querying the literature for genes associated with dominant cases of intermittent vomiting or both discomfort and disability; among which the raw genetic sequence was reviewed. "Qualifying" variants were defined as coding, rare, and conserved. Additionally, "Key Qualifying" variants were Pathogenic/Likely Pathogenic, or "Clinical" based upon the presence of a corresponding diagnosis. Candidate association to CVS was based on a point system., Results: Thirty-five paroxysmal genes were identified per the literature review. Among these, 12 genes were scored as "Highly likely" ( SCN4A , CACNA1A , CACNA1S , RYR2 , TRAP1 , MEFV ) or "Likely" ( SCN9A , TNFRSF1A , POLG , SCN10A , POGZ, TRPA1 ) CVS related. Nine additional genes ( OTC, ATP1A3, ATP1A2, GFAP, SLC2A1, TUBB3 , PPM1D , CHAMP1 , HMBS ) had sufficient evidence in the literature but not from our study participants. Candidate status for mitochondrial DNA was confirmed by the literature and our study data. Among the above-listed 22 CVS candidate genes, a Key Qualifying variant was identified in 31/80 (34%), and any Qualifying variant was present in 61/80 (76%) of participants. These findings were highly statistically significant ( p  < 0.0001, p  = 0.004, respectively) compared to an alternative hypothesis/control group regarding brain neurotransmitter receptor genes. Additional, post-analyses, less-intensive review of all genes (exome) outside our paroxysmal genes identified 13 additional genes as "Possibly" CVS related., Conclusion: All 22 CVS candidate genes are associated with either cation transport or energy metabolism (14 directly, 8 indirectly). Our findings suggest a cellular model in which aberrant ion gradients lead to mitochondrial dysfunction, or vice versa, in a pathogenic vicious cycle of cellular hyperexcitability. Among the non-paroxysmal genes identified, 5 are known causes of peripheral neuropathy. Our model is consistent with multiple current hypotheses of CVS., Competing Interests: RB is an officer and receives equity from NeuroNeeds, a company that produces dietary supplements for neurological conditions. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bar, Ebenau, Weiner, Mintz and Boles.)

Objective: We aimed to determine the rate of complications associated with autologous costal cartilage graft harvest for pediatric laryngotracheal reconstruction (LTR). Secondarily, we sought to identify risk factors associated with the harvest of autologous costal cartilage, as well as evaluate management strategies., Data Sources: An electronic database search of Ovid MEDLINE, Ovid EMBASE, and PubMed was completed for articles pertaining to complications in autologous costal cartilage harvest for pediatric LTR., Review Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The study characteristics, operative information, and patient demographics were collected. The data concerning postoperative complications, risk factors, and management strategies were collected and analyzed for patterns., Results: A total of 31 manuscripts representing 745 patients were included for analysis. The reported donor site complications included pneumothorax ( n  = 13, 1.74%), pleural tear ( n  = 5, 0.67%), infection ( n  = 8, 1.07%), and scar-related problems ( n  = 2, 0.26%). There were no reported cases of seroma, persistent pain, or chest wall deformity. Only five studies discussed the management of donor site complications, with intervention in 11 (39.28%) patients including chest tube drainage and steroid injection., Conclusion: There is significant variability in the literature regarding complication rates in autologous costal cartilage harvest for pediatric LTR. The incidence of major postoperative complications is low and supports the use of autologous costal cartilage as graft material for pediatric LTR., Level of Evidence: NA., Competing Interests: The authors have no conflict of interest to declare., (© 2023 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Background: Use of existing data in electronic health records (EHRs) could be used more extensively to better leverage real world data for clinical studies, but only if standard, reliable processes are developed. Numerous computable phenotypes have been validated against manual chart review, and common data models (CDMs) exist to aid implementation of such phenotypes across platforms and sites. Our objective was to measure consistency between data that had previously been manually collected for an implantable cardiac device registry and CDM-based phenotypes for the condition of heart failure (HF)., Methods: Patients enrolled in an implantable cardiac device registry at two hospitals from 2013 to 2018 contributed to this analysis wherein registry data were compared to PCORnet CDM-formatted EHR data. Seven different phenotype algorithms were used to search for the presence of HF and compare the results with the registry. Sensitivity, specificity, predictive value and congruence were calculated for each phenotype., Results: In the registry, 176 of 319 (55%) patients had history of HF, compared with different phenotypes estimating between 96 (30%) and 188 (59%). The least-restrictive phenotypes (any diagnosis) had high sensitivity and specificity (90%/80%), but more restrictive phenotypes had higher specificity (e.g., code present in problem list, 94%). Differences were observed using time-based criteria (e.g., days between visit diagnoses) and between participating hospitals., Conclusions: Consistency between manually-collected registry data and CDM-based phenotypes for history of HF was high overall, but use of different phenotypes impacted sensitivity and specificity, and results may differ depending on the medical condition of interest., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Several authors (AI, JM, KW, KS, KS, ES) are employed by and own shares in Medtronic plc.]., (© 2022 The Authors.)

Background: Home self-monitoring of blood pressure is widely used in primary care to assist in the diagnosis of hypertension, as well as to improve clinical outcomes and support adherence to medication. The National Institute for Health and Care Excellence (NICE) care pathways for hypertension recommend specific guidelines, although they lack detail on supporting patients to self-monitor., Aim: To elicit primary care practitioners' experiences of managing patients' home blood pressure self-monitoring, across surgeries located in different socioeconomic areas., Design & Setting: A qualitative focus group study was conducted with a total of 21 primary care professionals., Method: Participants were GPs and practice nurses (PNs), purposively recruited from surgeries in areas of low and high deprivation, according to the English indices of multiple deprivation. Six vignettes were developed featuring data from interviews with people who self-monitor and these were used in five focus groups. Results were thematically analysed., Results: Themes derived in the thematic analysis largely reflected topics covered by the vignettes. These included: advice on purchase of a device; supporting home monitoring; mitigating patient anxiety experienced as a result of home monitoring; valuing patients' data; and effect of socioeconomic factors., Conclusion: The work provides an account of methods used by primary care practitioners in the management of home blood pressure self-monitoring, where guidance may be lacking and primary care practitioners act on their own judgement. Findings complement recent policy documentation, which recognises the need to adopt new ways of working to empower patients (for example, additional support from healthcare assistants), but lacks detail on how this should be done., (Copyright © 2020, The Authors.)