Cells are known to perceive their microenvironment through extracellular and intracellular mechanical signals. Upon sensing mechanical stimuli, cells can initiate various downstream signaling pathways that are vital to regulating proliferation, growth, and homeostasis. One such physiologic activity modulated by mechanical stimuli is osteogenic differentiation. The process of osteogenic mechanotransduction is regulated by numerous calcium ion channels—including channels coupled to cilia, mechanosensitive and voltage‐sensitive channels, and channels associated with the endoplasmic reticulum. Evidence suggests these channels are implicated in osteogenic pathways such as the YAP/TAZ and canonical Wnt pathways. This review aims to describe the involvement of calcium channels in regulating osteogenic differentiation in response to mechanical loading and characterize the fashion in which those channels directly or indirectly mediate this process. The mechanotransduction pathway is a promising target for the development of regenerative materials for clinical applications due to its independence from exogenous growth factor supplementation. As such, also described are examples of osteogenic biomaterial strategies that involve the discussed calcium ion channels, calcium‐dependent cellular structures, or calcium ion‐regulating cellular features. Understanding the distinct ways calcium channels and signaling regulate these processes may uncover potential targets for advancing biomaterials with regenerative osteogenic capabilities.
Despite a substantial increase in health insurance coverage of gender-affirming care over the past decade in the United States, 1,2 statespecific health laws and policies on gender-affirming care are highly variable and constantly changing. Although most gender-affirming operations before 2010 were self-paid, a number of states have enacted policies requiring public and private insurers to provide coverage for gender-affirming care, including both medical and surgical services. The issuance of
in the liver but was not sensitive to the lower concentrations of nanoparticles in other tissues. The fluorescent polymer nanoparticles indicated that ADSCs were retained near the injection site, with limited migration due to and inherent fibrotic response to the cells, regardless of whether the ADSCs contained nanoparticles or not. The fluorescent nanoparticles facilitated visualization of the lack of ADSC migration following injection.
METHODS:Cases of MCR were selected from the pediatric and adult American College of Surgeons and National Surgical Quality Improvement Program (NSQIP). Adolescent (ages 18 and under) and young adult (ages 19-25) transgender patients were analyzed for differences in demographics, comorbidities, surgical characteristics, and postoperative complications. Multivariate regression analysis was performed to control for confounding variables. RESULTS:A total of 1,287 cases were identified, with an adolescent cohort of 189 patients. The earliest case occurred in 2010, and there was an overall decline in average age from 2010 to 2020. The proportion of white patients to other races was greater among adolescents than young adults (92% vs. 83.8%, p=0.007). In the entire study cohort, white patients had an earlier age of surgery than non-white patients (21.29 vs. 21.86 yrs; p=.007). Of adolescents and young adults 4.7% and 9.1% identified as Hispanic/Latino, respectively; this difference approached significance with p=0.059. Rates of complications were similar between age groups. Univariate analysis showed that white patients experienced fewer postoperative complications than non-white patients (3.6% vs. 7.4%, p=0.029). Multivariate binary logistic regression showed that Black or African American patients in particular experienced more all-cause postoperative complications than other races after controlling for ASA classification, age group (adolescents vs. young adults) and BMI (Odds Ratio 2.8; 95% CI: [1.3, 5.9]; p = 0.008). CONCLUSION:Our data show that MCR is increasing in prevalence and at progressively younger ages. Demographic data also indicates that white patients have earlier access to treatment and may experience fewer post-operative complications. Overall, our results indicate that MCR is comparably safe between adolescent and young adult patient cohorts, with no significant differences in surgical risk factors, comorbidities, or surgical complications. Objective outcome data and individual patient needs should inform clinical decisions over chronological age. An intersectional approach is needed to better understand the unique healthcare needs and barriers to care of minority transgender youth.
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