Development of the BODY-Q Chest Module Evaluating Outcomes following Chest Contouring Surgery.

BACKGROUND: Plastic surgery to improve chest appearance is becoming increasingly popular. The BODY-Q is a patient-reported outcome instrument designed for weight loss and/or body contouring. In this article, the authors describe the development of a new module for masculinizing chest contouring surgery. METHODS: Qualitative methods were used to develop the BODY-Q Chest Module, which was subsequently field-tested in Canada, the United States, The Netherlands, and Denmark between June of 2016 and June of 2017. Participants were aged 16 years or older and seen for gynecomastia, weight loss, or transman chest surgery. Data were collected using either a Web-based application or paper questionnaire. Rasch measurement theory analysis was performed. RESULTS: The sample included 739 participants (i.e., 174 gynecomastia, 224 weight loss, and 341 gender-affirming). Rasch measurement theory analysis refined a 10-item chest scale and a five-item nipple scale. All items had ordered thresholds and good item fit, and scales evidenced reliability [i.e., person separation index and Cronbach alpha values were 0.95 and 0.98 (chest scale) and 0.87 and 0.94 (nipple scale), respectively]. Scores for both scales correlated more strongly with similar (satisfaction with the body) versus dissimilar (psychological and social function) BODY-Q scales. The mean scores for the chest and nipple scales were significantly higher (p < 0.001 on independent samples t tests) in participants who were postoperative compared with preoperative. CONCLUSION: This new BODY-Q Chest Module is a clinically meaningful and scientifically sound patient-reported outcome instrument that can be used to measure outcomes for masculinizing chest contouring surgery.

Female-to-Male Gender Affirming Top Surgery: A Single Surgeon's 15-Year Retrospective Review and Treatment Algorithm.

BACKGROUND: Mastectomy, referred to here as "Top Surgery," is an important surgical step for female-to-male (FTM) transgender patients. The goal is to excise breast tissue and create a masculine chest contour. Despite the rising demand for Top Surgery, debate still exists regarding how to select the most appropriate surgical technique to optimize aesthetic outcomes safely. OBJECTIVES: To determine the safety profile and aesthetic outcome of one surgeon's 15-year FTM Top Surgery experience. To provide an algorithm for FTM surgery technique selection based on this experience. METHODS: A retrospective chart review was performed on 679 FTM patients (1358 mastectomies) undergoing Top Surgery from October 2001 to July 2016. The author's Top Surgery algorithm utilizes two techniques, "Keyhole" and "Double Incision Free Nipple Graft (DIFNG)," based on breast ptosis, inferior vertical skin pinch, and skin elasticity. Demographic data, operative details, complications, and reoperations along with their reasons were collected and analyzed. RESULTS: Of the 679 patients, 15.3% underwent Keyhole and the remaining 84.7% underwent DIFNG procedure. The total complication rate was 18.1% and the total reoperation rate was 11.2% and these rates were shown to decrease over time. The two techniques differed significantly (P < 0.001) in operating time (136 vs 102 min), breast weight excised (215 vs 638 g), and complication rate (33 vs 16%). The aesthetic rating of results was 4.6/5 for Keyhole and 3.7/5 for DIFNG. CONCLUSIONS: Safe and aesthetically pleasing results were achieved using this simplified algorithm. Experience with FTM techniques can decrease complication and reoperation rates over time. LEVEL OF EVIDENCE: 3.

Solid-stemmed wheat does not affect overwintering mortality of the wheat stem sawfly, Cephus cinctus.

The wheat stem sawfly, Cephus cinctus Norton (Hymenoptera: Cephidae), is a key pest of wheat in the northern Great Plains of North America. Host plant resistance in the form of solid-stemmed wheat cultivars is the main control strategy for C. cinctus. This study investigated the effect of novel and traditional solid wheat hosts on the overwintering mortality and cold-hardiness of C. cinctus. Field conditions from 2003-2005 showed that overwintering mortality in various wheat cultivars averaged 8% and was not related to the type of wheat cultivar. Similarly, supercooling points (-22° C) were not influenced by wheat host type. C. cintus are cold-hardy; up to 80% survive 10 days at -20° C and 10% survive 40 days. Its overwintering microhabitat near the crown area of the plant is well insulated for temperatures above -10° C and remains ~ 20° C above ambient minima. These data suggest that winter mortality is a minor factor in the population dynamics of wheat stem sawfly, and despite clear detrimental effects on larval weight and adult fitness, solid-stemmed cultivars do not reduce the ability of larvae to survive winters.

High-performance liquid chromatography coupled with tandem mass spectrometry for the detection of amyloid Beta peptide related with Alzheimer's disease.

Recent studies show that quantitative and qualitative differences in amyloid beta (Abeta ) peptides may be implicated in the development of Alzheimer's disease. New evidence seems to support the existence of a dynamic equilibrium between Abeta peptide in the brain and peripheral blood circulation. The quantitation of Abeta in the blood may allow the development of the potential value of Abeta peptides as a biomarker in the development of Alzheimer's disease. In this communication, quantitation of Abeta peptides using high-performance liquid chromatography coupled with tandem mass spectrometry in a linear ion trap mode is presented. RP-HPLC was performed using a Waters Xterra MS C8 column (3.0 mm x 150 mm). Abeta(1-40) peptide was eluted using a gradient elution program. Eluate from the RP-HPLC column was split to both the UV detector and electrospray ionization MS source. The product ion scan was performed in a linear ion trap mode utilizing the transition of a multiply charged molecular ion of Abeta(1-40) to a singly charged product ion. The detection limit of 31.25 ng in column load using a 3.0-mm-diameter conventional C8 column was achieved. The Abeta(1-40) standard calibration curves show excellent linearity from 34 ng to 2500 ng Abeta(1-40) of column sample load. The product ion scan enhances sensitivity 10 times compared with the best previously achieved by a single-quadrupole instrument in the selective ion monitoring mode. Moreover, the product ion scan of Abeta(1-40) provides superior selectivity and specificity, which is very important in the quantitation of Abeta(1-40) in a complex biological matrix.