There are over 1 million transgender people living in the United States, and 33% report negative experiences with a healthcare provider, many of which are connected to data representation in electronic health records (EHRs). We present recommendations and common pitfalls involving sex- and gender-related data collection in EHRs. Our recommendations leverage the needs of patients, medical providers, and researchers to optimize both individual patient experiences and the efficacy and reproducibility of EHR population-based studies. We also briefly discuss adequate additions to the EHR considering name and pronoun usage. We add the disclaimer that these questions are more complex than commonly assumed. We conclude that collaborations between local transgender and gender-diverse persons and medical providers as well as open inclusion of transgender and gender-diverse individuals on terminology and standards boards is crucial to shifting the paradigm in transgender and gender-diverse health.
Highlights d Chronic spike blockade with tetrodotoxin causes homeostatic spike broadening d Alternative splicing of BK channels by exclusion of a specific exon is responsible d Synaptic homeostasis starts CaM kinase signaling to drive nuclear exit of Nova-2 d Chronic inactivity and hyperactivity can initiate similar LTPlike events
Azure Data Lake Store (ADLS) is a fully-managed, elastic, scalable, and secure file system that supports Hadoop distributed file system (HDFS) and Cosmos semantics. It is specifically designed and optimized for a broad spectrum of Big Data analytics that depend on a very high degree of parallel reads and writes, as well as collocation of compute and data for high bandwidth and low-latency access. It brings together key components and features of Microsoft's Cosmos file system-long used internally at Microsoft as the warehouse for data and analytics-and HDFS, and is a unified file storage solution for analytics on Azure. Internal and external workloads run on this unified platform. Distinguishing aspects of ADLS include its support for multiple storage tiers, exabyte scale, and comprehensive security and data sharing. We discuss ADLS architecture, design points, and performance.
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