[Female-to-male transgender chest reconstruction: A retrospective study of patient satisfaction]. / Chirurgie mammaire de réassignation vers le sexe masculin : étude rétrospective de la satisfaction des patients transsexuels après mastectomie.

BACKGROUND: Mammaplasty in gender reassignment surgery is often poorly understood, due to a lack of information about this condition and its therapy. The aim of this work was to evaluate patient satisfaction following bilateral mastectomy for female-to-male gender reassignment. METHODS: We contacted 22 patients who underwent mammaplasty for female-to-male gender reassignment between January 2012 and March 2013 in our university hospital. Patients were sent postal questionnaires. A modified Q-breast questionnaire adapted for gender reassignment surgery enabled us to objectively evaluate patient aesthetic and psychological satisfaction. An overall score superior to 320 was considered as very satisfied for the patient. RESULTS: A total of 73% of the patients answered the questionnaire. The mean score was 332/378. This score corresponded to "very satisfied" on our questionnaire. The psychological score was 54.5/60. CONCLUSION: This study showed that a real benefit was obtained in terms of patient quality of life and self-confidence. The high level of patient satisfaction confirmed that gender reassignment mastectomy is a useful and valid procedure, which enables these patients to reclaim their place in society. It can only be considered if it is within the framework of structures that ensure comprehensive and pluridisciplinary treatment for the patient.

Rats and mice share common ethologically relevant parameters of exploratory behavior.

Detailed studies of rat exploratory behavior reveal that it consists of typical behavior patterns having a distinct structure. Recently we have developed interactive software that uses as input the automatically digitized time-series of the animal's location for the visualization, analysis, capturing and quantification of these patterns. We use this software here for the study of BALB/cJtau mouse behavior. The results suggest that a considerable number of rat patterns are also present in the mouse. These ethologically-relevant patterns have a significant potential as a phenotyping tool.

Controlling the false discovery rate in behavior genetics research.

The screening of many endpoints when comparing groups from different strains, searching for some statistically significant difference, raises the multiple comparisons problem in its most severe form. Using the 0.05 level to decide which of the many endpoints' differences are statistically significant, the probability of finding a difference to be significant even though it is not real increases far beyond 0.05. The traditional approach to this problem has been to control the probability of making even one such error--the Bonferroni procedure being the most familiar procedure achieving such control. However, the incurred loss of power stemming from such control led many practitioners to neglect multiplicity control altogether. The False Discovery Rate (FDR), suggested by Benjamini and Hochberg [J Royal Stat Soc Ser B 57 (1995) 289], is a new, different, and compromising point of view regarding the error in multiple comparisons. The FDR is the expected proportion of false discoveries among the discoveries, and controlling the FDR goes a long way towards controlling the increased error from multiplicity while losing less in the ability to discover real differences. In this paper we demonstrate the problem in two studies: the study of exploratory behavior [Behav Brain Res (2001)], and the study of the interaction of strain differences with laboratory environment [Science 284 (1999) 1670]. We explain the FDR criterion, and present two simple procedures that control the FDR. We demonstrate their increased power when used in the above two studies.

SEE: a tool for the visualization and analysis of rodent exploratory behavior.

The complexity of exploratory behavior creates a need for a visualization and analysis tool that will highlight regularities and help generating new hypotheses about the structure of this behavior. The hypotheses can then be formulated as algorithms that capture the patterns and quantify them. SEE is a Mathematica based software developed by us for the exploration of exploratory behavior. The raw data for SEE are a time series of the animal 's coordinates in space sampled at a rate that allows a meaningful computation of speeds. SEE permits: (i) a visualization of the path of the animal and a computation of the dynamics of activity; (ii) a decomposition of the path into several modes of motion (1st gear, 2nd gear, etc.) and a computation of the typical maximal speeds, the spatial spread, and the proportion of each of these modes; and(iii) a visualization of the location in the environment of stopping episodes, along with their dwell time. These visualizations highlight the presence of preferred places, including the animal's so-called home base, and permits a computation of the spatio-temporal diversity in the location of stopping episodes. The software also: (i) decomposes the animal's path into round trips from the home base, called 'excursions', and computes the number of stops per excursion; (ii) generates a visualization of the phase space (path+speed, traced in a three-dimensional graph) of any progression segment or list of such segments; and (iii) produces a visualization of the way places in the animal's operational world are connected to each other. SEE also permits the definition and computation of behavioral endpoints across any section of any database of raw data. The range of applicability of SEE to various experimental set ups, tracking procedures, species, and preparations is addressed in the discussion.

Natural segmentation of the locomotor behavior of drug-induced rats in a photobeam cage.

Recently, Drai et al. (J Neurosci Methods 96 (2000) 119) have introduced an algorithm that segments rodent locomotor behavior into natural units of 'staying in place' (lingering) behavior versus going between places (progression segments). This categorization, based on the maximum speed attained within the segment, was shown to be intrinsic to the data, using the statistical method of Gaussian Mixture Model. These results were obtained in normal rats and mice using very large (650 or 320 cm) circular arenas and a video tracking system. In the present study, we reproduce these results with amphetamine, phencyclidine and saline injected rats, using data measured by a standard photobeam tracking system in square 45 cm cages. An intrinsic distinction between two or three 'gears' could be shown in all animals. The spatial distribution of these gears indicates that, as in the large arena behavior, they correspond to the difference between 'staying in place' behavior and 'going between places'. The robustness of this segmentation over arena size, different measurement system and dose of two psychostimulant drugs indicates that this is an intrinsic, natural segmentation of rodent locomotor behavior. Analysis of photobeam data that is based on this segmentation has thus a potential use in psychopharmacology research.

Statistical discrimination of natural modes of motion in rat exploratory behavior.

We analyze the locomotor behavior of the rat during exploration, and show that digitally collected data (time series of positions) provide a sufficient basis for establishing that the rat uses several distinct modes of motion (first, second, third, and sometimes fourth gear). The distinction between these modes is obtained by first segmenting the time series into sequences of data points occurring between arrests (as ascertained within the resolution of the data acquisition system). The statistical distribution of the maximal amount of motion occurring within each of these episodes is then analyzed and shown to be multi modal. This enables us to decompose motion into distinct modes. In one application of this decomposition we show that the ethological ad hoc notion of stopping behavior corresponds to progression without leaving first gear. We do so by showing that the spatial spread of such progressions is confined to a small 20-50 cm range in a 6.5 m diameter arena. This provides a justification for a construct of 'staying in place'. This construct is not defined in terms of position in objective space, but purely in terms of the rat's own behavior. We test the generality of our method by applying it to mouse exploratory behavior.

Comprehension regularity in Broca's aphasia? There's more of it than you ever imagined.

We analyze the comprehension data in Broca's aphasia, pooled together by Berndt, Mitchum, and Haendinges (1996). We show that once analyzed properly, these data have statistical structure that is very similar to that revealed by the analysis in Grodzinsky, Pinango, Zurif, and Drai (1999). The suggestion that the latter authors doctored the data to obtain a desired outcome is as false as the claim that the data in Berndt et al. show no regularity. Comprehension scores in Broca's aphasia do have statistical structure, which correlates with syntactic structure. Thus, the role of Broca's area and its vicinity in language processing can be made more precise.

The critical role of group studies in neuropsychology: comprehension regularities in Broca's aphasia.

We reexamine the empirical record of the comprehension abilities of Broca's aphasic patients. We establish clear, commonly accepted, selection criteria and obtain a pool of results. We then subject these results to a detailed statistical analysis and show that these patients comprehend certain canonical sentences (actives, subject relatives, and clefts with agentive predicates) at above-chance levels, whereas comprehension of sentences that contain deviations from canonicity (passives, object-gap relatives, and clefts) is distinct and is at chance. That the latter is the case, and patients indeed guess at such structures, we show by comparing the distribution of individual results in passive comprehension to that of a model for such guessing-an analogous series of tosses of an unbiased coin. The two distributions are virtually identical. We conclude that the group's performance is stable, and well-delineated, despite intersubject variation whose source is now identified. This means that certain comprehension tests may not always be used for the diagnosis of individual patients, but they do characterize the group. It also means that group studies are not just a valid option in neuropsychology; they are a must, since demonstrations like ours indiciate very clearly that single-case studies may be misleading. As we show, the findings from any one patient, without the context of a group, may give a distorted picture of the pathological reality. Our conclusions thus promote studies of groups of brain-damaged patients as a central tool for the investigation of brain/behavior relations.