Bountiful Applied Research Corporation (United States)

Relationships in which one partner is transgender are often more complex compared to other LGBQ+couples, due to the ways in which gender transition prompts changes for each partner and their relationship. Despite the impact of transition on both partners, the relationships of transgender people have been underresearched. This study was guided by symbolic interactionism to explore how transgender and cisgender women in romantic relationships experienced their relationship during their transition process. Constructivist grounded theory was used to analyze interviews with 20 transgender and cisgender participants using group-level analysis. Both groups described their journeys in terms of emotional tensions that ebbed and flowed across time. Participants reflected on how they experienced tensions internally and within their relationships as they worked through change and created meaning from their experiences. Recommendations for research and clinical work are provided, in light of these findings.

INTRODUCTION: Gastrointestinal bleeding (GIB) is a common symptom in patients with advanced cardiovascular disease. Among those at highest risk are patients with non-pulsatile left ventricular assist devices (LVADs).1 This has been attributed to multiple factors including therapeutic anticoagulation, degradation of von Willebrand factor,1 formation of angiodysplasias and advanced age.2,3 Such conditions predispose bleeding from arteriovenous malformations (AVMs) as well as other commonly occurring lesions. However, an overlooked cause of bleeding in these patients is direct injury from tunnelization of the LVAD driveline. Here we review a case of overt GIB, months after direct colonic injury from an LVAD driveline. CASE DESCRIPTION/METHODS: A 72 year old man with history of end stage heart failure underwent placement of an LVAD in January of 2019. His post-operative course was tumultuous and complicated by polymicrobial driveline infection. He recovered gradually and was discharged to medical rehabilitation in February with therapeutic warfarin and low dose aspirin. In April the patient presented to the Emergency Department after a syncopal episode and subsequent dizziness. He was found to have heme positive stool and hemoglobin of 7.8 g/dL (from 9.0 g/dL one month earlier). Other labs revealed iron deficiency with serum Iron level of 48 ug/dL and international normalized ratio (INR) elevation to 1.9 with warfarin therapy. Gastroenterology was consulted for evaluation of gastrointestinal blood loss with anemia. The patient underwent EGD and colonoscopy. EGD showed only retained gastric contents and no active bleeding. Colonoscopy revealed a linear, rigid foreign body penetrating the colonic wall and traversing the lumen (Figure 1). Review of prior CT scans confirmed the LVAD driveline had penetrated and passed through the transverse colon (Figures 2 and 3). The patient was subsequently taken to surgery for transverse colon resection with washout and exteriorization of the contaminated LVAD driveline. DISCUSSION: Gastrointestinal bleeding is common in cardiac patients following LVAD placement.1 Contributing factors include the use of anticoagulation and acquired von Willebrand disease, which most commonly causes bleeding from from AVMs.1,2 However, this case describes late bleeding after direct mucosal injury with LVAD driveline placement. Although a rare occurrence, this complication should be considered in LVAD patients, especially those with history of prior driveline infection.

Context: Wearing wristbands embedded with holograms at certain frequencies are believed to increase proprioception. There has been very little research to determine if holographic wristbands have any physiological effect on the body. Objective: To determine if the holograms embedded in the wristbands will improve proprioception during a single leg stance test on the dominant foot. Design and Setting: Controlled Athletic Training laboratory study. Participants: Twenty-four healthy college students of different activity levels (7 men, 17 women; age = 22.6 ± 1.2 years, height = 170.18 ± 12.10 cm, mass = 69.51 ± 15.63 kg) without any lower extremity injuries in the past three months participated. The subjects were also excluded if they have worn a holographic wristband in the past three months. Intervention(s): Each subject completed two trials under three protocols (holographic wristband, placebo wristband, no wristband) in a counter-balanced order for a total of six different tests with each test lasting 30 seconds. Subjects tested under each protocol using a single leg stance test on their dominant leg, hands on their hips, and looking forward at a fixed point on the wall. Main Outcome Measure(s): Balance analysis of the subjects was performed using an AMTI AccuSway Force Platform measuring Center of Pressure velocity and Center of Pressure Area 95. A statistical analysis of the data was done using repeated measures to test for differences between each condition. Results: The results showed no significant differences between protocols for Center of Pressure velocity (F = 1.130, P = .332). We also found no significant differences between protocols for Center of Pressure Area 95 (F = 1.271, P = .290). Conclusions: The results showed that the use of the holographic wristbands or a placebo wristband did not appear to have an impact on static balance. Overall, the results show that the use of the wristbands did not appear to have an impact on proprioception.

Background Propofol can be associated with delayed awakening after prolonged infusion. The aim of this study was to characterize the preclinical pharmacology of AZD-3043, a positive allosteric modulator of the γ-aminobutyric acid type A (GABA(A)) receptor containing a metabolically labile ester moiety. The authors postulated that its metabolic pathway would result in a short-acting clinical profile. Methods The effects of AZD-3043, propofol, and propanidid were studied on GABA(A) receptor-mediated chloride currents in embryonic rat cortical neurons. Radioligand binding studies were also performed. The in vitro stability of AZD-3043 in whole blood and liver microsomes was evaluated. The duration of the loss of righting reflex and effects on the electroencephalograph evoked by bolus or infusion intravenous administration were assessed in rats. A mixed-effects kinetic-dynamic model using minipigs permitted exploration of the clinical pharmacology of AZD-3043. Results AZD-3043 potentiated GABA(A) receptor-mediated chloride currents and inhibited [(35)S]tert-butylbicyclophosphorothionate binding to GABA(A) receptors. AZD-3043 was rapidly hydrolyzed in liver microsomes from humans and animals. AZD-3043 produced hypnosis and electroencephalograph depression in rats. Compared with propofol, AZD-3043 was shorter acting in rats and pigs. Computer simulation using the porcine kinetic-dynamic model demonstrated that AZD-3043 has very short 50 and 80% decrement times independent of infusion duration. Conclusions AZD-3043 is a positive allosteric modulator of the GABA(A) receptor in vitro and a sedative-hypnotic agent in vivo. The esterase dependent metabolic pathway results in rapid clearance and short duration of action even for long infusions. AZD-3043 may have clinical potential as a sedative-hypnotic agent with rapid and predictable recovery.

The AutoModTM simulation system differs significantly from other systems because of its ability to deal with the physical elements of a system in physical (graphical) terms and the logical elements of a system in logical terms. AutoMod also offers advanced features to allow users to simulate complex movement (kinematics and velocity) of equipment such as robots, machine tools, transfer lines, and special machinery. All graphics are represented in 3-D space with unlimited viewing control, including: translation, rotation, scale, light-sourced solids, perspective, and continuous motion viewing.