BACKGROUND Literature focused on cancer screening and management is lacking in the transgender population.AIM To action to increase contributions to the scientific literature that drives the creation of cancer screeni...BACKGROUND Literature focused on cancer screening and management is lacking in the transgender population.AIM To action to increase contributions to the scientific literature that drives the creation of cancer screening and management protocols for transgender and gender nonconforming(TGNC)patients.METHODS We performed a systematic search of PubMed on January 5th,2022,with the following terms:“TGNC”,OR“transgender”,OR“gender non-conforming”,OR“gender nonbinary”AND“cancer screening”,AND“breast cancer”,AND“cervical cancer”,AND“uterine cancer”,AND“ovarian cancer”,AND“prostate cancer”,AND“testicular cancer”,AND“surveillance”,AND“follow-up”,AND“management”.70 unique publications were used.The findings are discussed under“Screening”and“Management”categories.RESULTS Screening:Current cancer screening recommendations default to cis-gender protocols.However,long-term genderaffirming hormone therapy and loss to follow-up from the gender-specific specialties contribute to a higher risk for cancer development and possible delayed detection.The only known screening guidelines made specifically for this population are from the American College of Radiology for breast cancer.Management:Prior to undergoing Gender Affirmation Surgery(GAS),discussion should address cancer screening and management in the organs remaining in situ.Cancer treatment in this population requires consideration for chemotherapy,radiation,surgery and/or reconstruction.Modification of hormone therapy is decided on a case-by-case basis.The use of prophylactic vs aesthetic techniques in surgery is still debated.CONCLUSION When assessing transgender individuals for GAS,a discussion on the future oncologic risk of the sex-specific organs remaining in situ is essential.Cancer management in this population requires a multidisciplinary approach while the care should be highly individualized with considerations to social,medical,surgical and gender affirming surgery related specifications.Special considerations have to be made during planning for GAS as surgery will alter the anatomy and may render the organ difficult to sample for screening purposes.A discussion with the patient regarding the oncologic risk of remaining organs is imperative prior to GAS.Other special considerations to screening such as the conscious or unconscious will to unassociated with their remaining organs is also a key point to address.We currently lack high quality studies pertinent to the cancer topic in the gender affirmation literature.Further research is required to ensure more comprehensive and individualized care for this population.展开更多
BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can produce a wide range of clinical manifestations from asymptomatic to life-threatening.Various researchers have worked to elucidate the pathogen...BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can produce a wide range of clinical manifestations from asymptomatic to life-threatening.Various researchers have worked to elucidate the pathogenic mechanisms underlying these variable presentations.Differences in individual responses to systemic inflammation and coagulopathy appear to be modulated by several factors,including sex steroid hormones.Transgender men or non-binary individuals who undergo gender-affirming hormone therapy(GAHT)are a unique population of interest for exploring the androgen-mediated coronavirus disease 2019(COVID-19)hypothesis.As the search for reliable and effective COVID-19 treatments continues,understanding the risks and benefits of GAHT may mitigate COVID-19 related morbidity and mortality in this patient population.AIM To investigate the potential role of GAHT in the development of COVID-19 infections and complications.METHODS This systematic review implemented an algorithmic approach using PRISMA guidelines.PubMed,Scopus,Google Scholar top 100 results,and archives of Plastic and Reconstructive Surgery was on January 12,2022 using the key words“gender”AND“hormone”AND“therapy”AND“COVID-19”as well as associated terms.Non-English articles,articles published prior to 2019(prior to COVID-19),and manuscripts in the form of reviews,commentaries,or letters were excluded.References of the selected publications were screened as well.RESULTS The database search resulted in the final inclusion of 14 studies related to GAHT COVID-19.Of the included studies,only two studies directly involved and reported on COVID-19 in transgender patients.Several clinical trials looked at the relationship between testosterone,estrogen,and progesterone in COVID-19 infected cis-gender men and women.It has been proposed that androgens may facilitate initial COVID-19 infection,however,once this occurs,testosterone may have a protective effect.Multiple clinical studies have shown that low baseline testosterone levels in men with COVID-19 are associated with worsening outcomes.The role of female sex hormones,including estrogen and progesterone have also been proposed as potential protective factors in COVID-19 infection.This was exemplified in multiple studies investigating different outcomes in pre-and post-menopausal women as well as those taking hormone replacement therapy.Two studies related specifically to transgender patients and GAHT found that estrogen and progesterone could help protect men against COVID-19,and that testosterone hormone therapy may increase the risk of contracting COVID-19.CONCLUSION Few studies were found related to the role of GAHT in COVID-19 infections.Additional research is necessary to enhance our understanding of this relationship and provide better care for transgender patients.展开更多
This paper analyzes the role of six tropes （metonymy, synecdoche, metaphor, analogy, allegory, and irony） in Nietzsche＇s and Novalis＇ writings on language and cognition, using the comparison to show how a negative...This paper analyzes the role of six tropes （metonymy, synecdoche, metaphor, analogy, allegory, and irony） in Nietzsche＇s and Novalis＇ writings on language and cognition, using the comparison to show how a negative element in Nietzsche＇s attitude towards the tropic nature of cognition underlies well-known problems in his response to nihilism. These problems include ambiguities in Nietzsche＇s attitude to truth, and the question of how well he can carry through his project of affirming the individual on the basis of a creative reinterpretation of experience. I maintain that Novalis understands language and cognition to be tropic in a similar way as Nietzsche does, and that these writers provide similar critiques of discursive reason on the basis of what they view as its stultifying rigidity and misleading claims to a ＂literal＂ form of objectivity. However, I argue that Novalis avoids Nietzsche＇s difficulties by maintaining that a creative element in cognition does not rule out a variant of a correspondence notion of truth. Although Novalis＇ account thus falls foul of Nietzsche＇s goal of providing an immanent affirmation of human experience, the comparison shows that a Nietzschean attempt to provide a convincing model of individual self-affirmation should integrate a more positive role for trope, which can support a satisfying conception of the value of human creativity.展开更多
What are the real intentions of young women to play online games? Can they benefit more than just entertainment? Based on a 2-year followup survey of a young female online gamer, this paper explores the inner experien...What are the real intentions of young women to play online games? Can they benefit more than just entertainment? Based on a 2-year followup survey of a young female online gamer, this paper explores the inner experiences of a young female gamers. Findings indicate that young female Chinese gamers attach importance to the choice of characters in the world of online games and that they establish a sense of identity in virtual space through character affirmation and interactions with other gamers. For young female gamers, who are eager to temporarily escape from reality, playing online games is a positive psychological compensation and a process for building self-confidence.展开更多
Establishing and protecting the right to development of disabled persons is not only the important part of Xi Jinping’s thought on human rights, but also a reflection of Marxism’s idea of human rights and a requirem...Establishing and protecting the right to development of disabled persons is not only the important part of Xi Jinping’s thought on human rights, but also a reflection of Marxism’s idea of human rights and a requirement of the rule of law in China. It is necessary to promote the protection of the right to development of disabled persons in terms of affirmative action. The Chinese government’s affirmative action requires structural characteristics, including providing the institutional basis for the affirmative action by constructing legal and non-legal institutions, providing an environment conducive for the affirmative action by shaping a more aware social ecology and providing valid guarantees for affirmative action by increasing the responsibility of local governments.展开更多
Sexual minority(SM)is gradually becoming more visible as a more open and diversity society.SM mainly includes lesbian,gay,bisexual,transgender,asexual and so on.According to SM stress theory,SM people,populations at r...Sexual minority(SM)is gradually becoming more visible as a more open and diversity society.SM mainly includes lesbian,gay,bisexual,transgender,asexual and so on.According to SM stress theory,SM people,populations at risk,have poor mental and physical health under a long-term acute or chronic stress and pressure due to prejudice and discrimination[1].In America,among young SM,minority stress,negative psychology,substance use,and human immunodeficiency virus(HIV)risk influence each other to damage psychosomatic health[2].With an increase in SM stress,participation in health-promoting activities decreased and problems with physical health increased[3].展开更多
Objective: The objective of the current study was to determine the clinical factors that were associated with abandonment of a rate-control or a rhythm-control strategy in patients with atrial fibrillation(AF). Backgr...Objective: The objective of the current study was to determine the clinical factors that were associated with abandonment of a rate-control or a rhythm-control strategy in patients with atrial fibrillation(AF). Background: Although the AFFIRM Study demonstrated that outcomes are similar with a primary strategy of rate-control or rhythm-control for AF, there may be clinical or demographic factors associated with abandonment of the initial treatment strategy. Knowledge of these risk factors would be useful so that patients may be given appropriate initial therapy and, as appropriate, switched to alternative treatments earlier. Methods: Patients in the AFFIRM Study were subdivided into those who were maintained on their initial treatment strategy versus those who abandoned initial treatment strategy for alternative therapies. We determined the clinical and demographic factors associated with change in initial treatment strategy. Results: At 5 years the original treatment strategy was maintained in 85%of the patients in the rate-control arm versus 62%of those in the rhythm-control arm(P< .0001). Length of the qualifying episode of AF was associated with abandonment of both rhythm-control and rate-control strategies. Antiarrhythmic drug failure before randomization and a history of thyroid disease also were associated with abandonment of rhythm-control. Patients were more likely to maintain rate-control if they already had an implanted pacemaker or if they were older than 75 years, while an ejection fraction < 30%was associated with abandonment of the rate-control strategy. Conclusions: In patients with AF, rhythm-control strategies are abandoned significantly more often than rate-control strategies. Patients with long durations of AF on presentation or previous antiarrhythmic drug failure might be considered for rate-control as initial treatment.展开更多
文摘BACKGROUND Literature focused on cancer screening and management is lacking in the transgender population.AIM To action to increase contributions to the scientific literature that drives the creation of cancer screening and management protocols for transgender and gender nonconforming(TGNC)patients.METHODS We performed a systematic search of PubMed on January 5th,2022,with the following terms:“TGNC”,OR“transgender”,OR“gender non-conforming”,OR“gender nonbinary”AND“cancer screening”,AND“breast cancer”,AND“cervical cancer”,AND“uterine cancer”,AND“ovarian cancer”,AND“prostate cancer”,AND“testicular cancer”,AND“surveillance”,AND“follow-up”,AND“management”.70 unique publications were used.The findings are discussed under“Screening”and“Management”categories.RESULTS Screening:Current cancer screening recommendations default to cis-gender protocols.However,long-term genderaffirming hormone therapy and loss to follow-up from the gender-specific specialties contribute to a higher risk for cancer development and possible delayed detection.The only known screening guidelines made specifically for this population are from the American College of Radiology for breast cancer.Management:Prior to undergoing Gender Affirmation Surgery(GAS),discussion should address cancer screening and management in the organs remaining in situ.Cancer treatment in this population requires consideration for chemotherapy,radiation,surgery and/or reconstruction.Modification of hormone therapy is decided on a case-by-case basis.The use of prophylactic vs aesthetic techniques in surgery is still debated.CONCLUSION When assessing transgender individuals for GAS,a discussion on the future oncologic risk of the sex-specific organs remaining in situ is essential.Cancer management in this population requires a multidisciplinary approach while the care should be highly individualized with considerations to social,medical,surgical and gender affirming surgery related specifications.Special considerations have to be made during planning for GAS as surgery will alter the anatomy and may render the organ difficult to sample for screening purposes.A discussion with the patient regarding the oncologic risk of remaining organs is imperative prior to GAS.Other special considerations to screening such as the conscious or unconscious will to unassociated with their remaining organs is also a key point to address.We currently lack high quality studies pertinent to the cancer topic in the gender affirmation literature.Further research is required to ensure more comprehensive and individualized care for this population.
文摘BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can produce a wide range of clinical manifestations from asymptomatic to life-threatening.Various researchers have worked to elucidate the pathogenic mechanisms underlying these variable presentations.Differences in individual responses to systemic inflammation and coagulopathy appear to be modulated by several factors,including sex steroid hormones.Transgender men or non-binary individuals who undergo gender-affirming hormone therapy(GAHT)are a unique population of interest for exploring the androgen-mediated coronavirus disease 2019(COVID-19)hypothesis.As the search for reliable and effective COVID-19 treatments continues,understanding the risks and benefits of GAHT may mitigate COVID-19 related morbidity and mortality in this patient population.AIM To investigate the potential role of GAHT in the development of COVID-19 infections and complications.METHODS This systematic review implemented an algorithmic approach using PRISMA guidelines.PubMed,Scopus,Google Scholar top 100 results,and archives of Plastic and Reconstructive Surgery was on January 12,2022 using the key words“gender”AND“hormone”AND“therapy”AND“COVID-19”as well as associated terms.Non-English articles,articles published prior to 2019(prior to COVID-19),and manuscripts in the form of reviews,commentaries,or letters were excluded.References of the selected publications were screened as well.RESULTS The database search resulted in the final inclusion of 14 studies related to GAHT COVID-19.Of the included studies,only two studies directly involved and reported on COVID-19 in transgender patients.Several clinical trials looked at the relationship between testosterone,estrogen,and progesterone in COVID-19 infected cis-gender men and women.It has been proposed that androgens may facilitate initial COVID-19 infection,however,once this occurs,testosterone may have a protective effect.Multiple clinical studies have shown that low baseline testosterone levels in men with COVID-19 are associated with worsening outcomes.The role of female sex hormones,including estrogen and progesterone have also been proposed as potential protective factors in COVID-19 infection.This was exemplified in multiple studies investigating different outcomes in pre-and post-menopausal women as well as those taking hormone replacement therapy.Two studies related specifically to transgender patients and GAHT found that estrogen and progesterone could help protect men against COVID-19,and that testosterone hormone therapy may increase the risk of contracting COVID-19.CONCLUSION Few studies were found related to the role of GAHT in COVID-19 infections.Additional research is necessary to enhance our understanding of this relationship and provide better care for transgender patients.
文摘This paper analyzes the role of six tropes （metonymy, synecdoche, metaphor, analogy, allegory, and irony） in Nietzsche＇s and Novalis＇ writings on language and cognition, using the comparison to show how a negative element in Nietzsche＇s attitude towards the tropic nature of cognition underlies well-known problems in his response to nihilism. These problems include ambiguities in Nietzsche＇s attitude to truth, and the question of how well he can carry through his project of affirming the individual on the basis of a creative reinterpretation of experience. I maintain that Novalis understands language and cognition to be tropic in a similar way as Nietzsche does, and that these writers provide similar critiques of discursive reason on the basis of what they view as its stultifying rigidity and misleading claims to a ＂literal＂ form of objectivity. However, I argue that Novalis avoids Nietzsche＇s difficulties by maintaining that a creative element in cognition does not rule out a variant of a correspondence notion of truth. Although Novalis＇ account thus falls foul of Nietzsche＇s goal of providing an immanent affirmation of human experience, the comparison shows that a Nietzschean attempt to provide a convincing model of individual self-affirmation should integrate a more positive role for trope, which can support a satisfying conception of the value of human creativity.
基金part of the research findings of"Studies in the Interaction between Chinese Cultural Elements and Chinese Animation Content Production Sector"(No.06JA860007)a humanity and social sciences project funded by the Ministry of Education of the PRC
文摘What are the real intentions of young women to play online games? Can they benefit more than just entertainment? Based on a 2-year followup survey of a young female online gamer, this paper explores the inner experiences of a young female gamers. Findings indicate that young female Chinese gamers attach importance to the choice of characters in the world of online games and that they establish a sense of identity in virtual space through character affirmation and interactions with other gamers. For young female gamers, who are eager to temporarily escape from reality, playing online games is a positive psychological compensation and a process for building self-confidence.
文摘Establishing and protecting the right to development of disabled persons is not only the important part of Xi Jinping’s thought on human rights, but also a reflection of Marxism’s idea of human rights and a requirement of the rule of law in China. It is necessary to promote the protection of the right to development of disabled persons in terms of affirmative action. The Chinese government’s affirmative action requires structural characteristics, including providing the institutional basis for the affirmative action by constructing legal and non-legal institutions, providing an environment conducive for the affirmative action by shaping a more aware social ecology and providing valid guarantees for affirmative action by increasing the responsibility of local governments.
文摘Sexual minority(SM)is gradually becoming more visible as a more open and diversity society.SM mainly includes lesbian,gay,bisexual,transgender,asexual and so on.According to SM stress theory,SM people,populations at risk,have poor mental and physical health under a long-term acute or chronic stress and pressure due to prejudice and discrimination[1].In America,among young SM,minority stress,negative psychology,substance use,and human immunodeficiency virus(HIV)risk influence each other to damage psychosomatic health[2].With an increase in SM stress,participation in health-promoting activities decreased and problems with physical health increased[3].
文摘Objective: The objective of the current study was to determine the clinical factors that were associated with abandonment of a rate-control or a rhythm-control strategy in patients with atrial fibrillation(AF). Background: Although the AFFIRM Study demonstrated that outcomes are similar with a primary strategy of rate-control or rhythm-control for AF, there may be clinical or demographic factors associated with abandonment of the initial treatment strategy. Knowledge of these risk factors would be useful so that patients may be given appropriate initial therapy and, as appropriate, switched to alternative treatments earlier. Methods: Patients in the AFFIRM Study were subdivided into those who were maintained on their initial treatment strategy versus those who abandoned initial treatment strategy for alternative therapies. We determined the clinical and demographic factors associated with change in initial treatment strategy. Results: At 5 years the original treatment strategy was maintained in 85%of the patients in the rate-control arm versus 62%of those in the rhythm-control arm(P< .0001). Length of the qualifying episode of AF was associated with abandonment of both rhythm-control and rate-control strategies. Antiarrhythmic drug failure before randomization and a history of thyroid disease also were associated with abandonment of rhythm-control. Patients were more likely to maintain rate-control if they already had an implanted pacemaker or if they were older than 75 years, while an ejection fraction < 30%was associated with abandonment of the rate-control strategy. Conclusions: In patients with AF, rhythm-control strategies are abandoned significantly more often than rate-control strategies. Patients with long durations of AF on presentation or previous antiarrhythmic drug failure might be considered for rate-control as initial treatment.
