Search

Objective To test the feasibility of undertaking a simultaneous Study Within A Trial (SWAT) to train staff who recruit participants into surgical randomised controlled trials (RCTs), by assessing key uncertainties around recruitment, randomisation, intervention delivery and data collection. Study design and setting Twelve surgical RCTs were eligible. Interested sites (clusters) were randomised 1:1, with recruiting staff (surgeons and nurses) offered training or no training. The primary outcome was the feasibility of recruiting sites across multiple surgical trials simultaneously. Secondary outcomes included numbers/types of staff enrolled, attendance at training, training acceptability, confidence in recruiting and participant recruitment rates six months later. Results Four RCTs (33%) comprising 91 sites participated. Of these, 29 sites agreed to participate (32%) and were randomised to intervention (15 sites, 29 staff) or control (14 sites, 29 staff). Research nurses attended and found the training to be acceptable; no surgeons attended. In the intervention group, there was evidence of increased confidence when pre- and post- training scores were compared (mean difference in change 1.42; 95% CI 0.56, 2.27; p = 0.002). There was no effect on recruitment rate. Conclusion It was feasible to randomise sites across four surgical RCTs in a simultaneous SWAT design. However, as small numbers of trials and sites participated, and no surgeons attended training, strategies to improve these aspects are needed for future evaluations.

We obtain microstates accounting for the Gibbons-Hawking entropy in $dS_3$, along with a subleading logarithmic correction, from the solvable $T\bar T+\Lambda_2$ deformation of a seed CFT with sparse light spectrum. The microstates arise as the dressed CFT states near dimension $\Delta=c/6$, associated with the Hawking-Page transition; they dominate the real spectrum of the deformed theory. We exhibit an analogue of the Hawking-Page transition in de Sitter. Appropriate generalizations of the $T\bar T+\Lambda_2$ deformation are required to treat model-dependent local bulk physics (subleading at large central charge) and higher dimensions. These results add considerably to the already strong motivation for the continued pursuit of such generalizations along with a more complete characterization of $T\bar T$ type theories, building from existing results in these directions.

Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person. ispartof: INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH vol:23 issue:Suppl 1 pages:S1-S258 ispartof: location:United States status: published

In order to calibrate a vocabulary base which might be utilized in preparing materials for reading instruction at the elementary level, the 1000 most frequently used words in the preschooler's vocabulary provided the experimental data for several studies: (1) a series of free-recall experiments which yielded a scaling of common words according to availability, (2) a rating of the image-evoking capacity of the words by 34 undergraduates, and (3) a rating for associative strength by 55 undergraduates. Finally, 39 preschool S's were employed while establishing hierarchies of associations for 160 of the 1000 words. (Appendixes contain (a) 1000 words scaled as to recall, imagery, and association, and (b) hierarchies of associations to 146 common, regularly spelled words.) (Author/RD)

A model for educational research and development is presented which, like an agricultural experiment station, would exist to interpret research findings, translating them into usable form. Allocations of funds would be made so that the bulk of the funds would go to the actual utilization levels. A plan for using such educational stations is proposed using television as a means of raising learning capacity by teaching printed language skills to young children. Researchers would focus on systematically deciding what words to present and what sequence to use. Animated cartoons would be broadcast in which children would see picture stories with words incorporated. Such a program would allow translation of research findings to a user level and would capitalize on the advantages of television as a learning mechanism. Very young children would be exposed to the printed word and might well be expected to assimilate reading as easily as they do speaking. Examples of cartoons, a flow chart for developing a reading technology, and references are included. (MS)

A model for transforming data from verbal learning experiments into tables useful to an educational technician was developed, based on a similar one for scientific agriculture. The necessary data were obtained through two experiments replicated upon relevant populations. In the first study, a series of free-recall experiments were performed using the 1,000 most frequently used words as stimuli and 87 five-year-old children as subjects. These experiments provided a scaling of common words according to response availability which could be used in conjunction with measures of stimulus discriminability to select an optimum list of words to teach look-and-say learning. The second study was comprised of two experiments of a series to determine the optimum list for teaching phonic blendings. In the first experiment, 287 two-phoneme syllables were blended by 17 preschool children. In the second experiment, six groups of 20 preschool children received training with vowel-consonant and consonant-vowel blends presented in various orders. Tables, a rank ordering of words according to ease of recall, and references are included. (Author/DH)

Recent advances in the treatment of metastatic melanoma have emerged only from advances in our understanding of melanoma development and progression at the cellular and molecular levels. Despite the impact that such advances have made on the clinical management of this cancer over the last decade, additional insights into factors that promote melanoma progression and therapeutic resistance are needed to combat this disease. CRISPR-Cas9 gene editing technology is a powerful tool for studying gene function in a timely and cost-effective manner, enabling the manipulation of specific DNA sequences via a targeted approach. Herein, we describe a protocol for generating functional gene knockouts in melanoma cell lines by CRISPR-Cas9 gene editing, and we present an example application of this protocol for the successful knockout of the Foxc2 transcription factor-encoding gene in the B16-F1 murine melanoma cell line.

Lymph node invasion by tumor cells is an important process in the progression of melanoma and is a poor prognostic factor for patients with this cancer. Before they are able to spread to regional lymph nodes, though, melanoma cells must first adhere to lymphatic endothelium and transmigrate into the lymphatic vasculature. In order to study melanoma cell adhesion to lymphatic endothelial cells and the factors that regulate this process, we have developed an in vitro flow cytometry-based assay to measure melanoma cell attachment to lymphatic endothelial cells. This assay will be a useful tool for investigating the interactions that take place between melanoma cells and lymphatic endothelial cells during the adhesion process.