Digital Commons Network^™

The Rising Tide Of Revisional Surgery: Tracking Changes In Index Cases Among Bariatric-Accredited Fellowships, Holger K Eltzschig

Faculty, Staff and Student Publications

Pancreatic ductal adenocarcinoma (PDAC) is characterized by a dense desmoplastic stroma that impedes drug delivery, reduces parenchymal blood flow, and suppresses the anti-tumor immune response. The extracellular matrix and abundance of stromal cells result in severe hypoxia within the tumor microenvironment (TME), and emerging publications evaluating PDAC tumorigenesis have shown the adenosine signaling pathway promotes an immunosuppressive TME and contributes to the overall low survival rate. Hypoxia increases many elements of the adenosine signaling pathway, resulting in higher adenosine levels in the TME, further contributing to immune suppression. Extracellular adenosine signals through 4 adenosine receptors (Adora1, Adora2a, Adora2b, Adora3). Of …

Modelling Nhs England 111 Demand For Primary Care Services: A Discrete Event Simulation, R Pilbery, M Smith, J Green, D Chalk, Ca O'Keeffe

School of Health Professions

ObjectivesThis feasibility study aimed to model in silico the current healthcare system for patients triaged to a primary care disposition following a call to National Health Service (NHS) 111 and determine the effect of reconfiguring the healthcare system to ensure a timely primary care service contact.DesignDiscrete event simulation.SettingSingle English NHS 111 call centre in Yorkshire.ParticipantsCallers registered with a Bradford general practitioner who contacted the NHS 111 service in 2021 and were triaged to a primary care disposition.Primary and secondary outcome measuresFace validity of conceptual model. Comparison between real and simulated data for quarterly counts (and 95% CIs) for patient contact …

Cognitive Rehabilitation And Aerobic Exercise For Cognitive Impairment In People With Progressive Multiple Sclerosis (Cogex): A Randomised, Blinded, Sham-Controlled Trial, Anthony Feinstein, Maria Pia Amato, Giampaolo Brichetto, Jeremy Chataway, Nancy D. Chiaravalloti, Gary Cutter, Ulrik Dalgas, John Deluca, Rachel Farrell, Peter Feys, Massimo Filippi, Jennifer Freeman, Matilde Inglese, Cecilia Meza, Robert W. Motl, Maria A. Rocca, Brian M. Sandroff, Amber Salter, Alex Pietrusz, Andrea Tacchino, A Smith, Anne Sophie Michelsen, Ashlie Kristin, Blake Bichler, Brendon Truax, Carmen Vizzino, Catherine Danielle Jones, Catherine Holme, C Smith, Charly Keytsman, Chiara Pollio, Chris Cole, Claudia Niccolai, Claudio Cordani, Eleonora Colombo, Elisa Pelosin, Ellen Vanzeir, Fedrica Vannetti, Filippo Gerli, Francesco Maranta, Gianna Riccitelli, Guido Pasquini, Holly Wilkinson, Irene Mosca, James Braisher, Jessica Baird, Jessica Podda, Jimmy Morecraft, Joke Lenaerts, Juliana Puopolo, K Algie, L Kenton, L Toll, Lt Madsen, L Knevels, L Lee, L Pedullà, M Cellerino, James Braisher, M-Lk Jørgensen, M Pardini, M Sibilia, M Nabarro, Md Diedmann, M Dibenedetto, M Curran, M Koch, M D'Hooge, N Moore, Nd Weerdt, P Preziosa, P Pajak, P Silic, Rb Walters, R Finegan, R Veldkamp, R Hernandez, R Donnee, S Casagrande, S Lancia, Sd Bella, S Vandecasteele, V Vandael

School of Health Professions

Background Cognitive dysfunction in people with relapsing-remitting multiple sclerosis can improve with cognitive rehabilitation or exercise. Similar effects have not been clearly shown in people with progressive multiple sclerosis. We aimed to investigate the individual and synergistic effects of cognitive rehabilitation and exercise in patients with progressive multiple sclerosis. Methods CogEx was a randomised, sham-controlled trial completed in 11 hospital clinics, universities, and rehabilitation centres in Belgium, Canada, Denmark, Italy, UK, and USA. Patients with progressive multiple sclerosis were eligible for inclusion if they were aged 25–65 years and had an Expanded Disability Status Scale (EDSS) score of less than …

Recent Progress Of Molecular Diagnosis Via Crispr Cas-Based Biosensors And Bioassays, S. Nazir

School of Engineering, Computing and Mathematics

The immune systems of bacteria and archaea served as the inspiration for CRISPR/Cas technology, which won the 2020 Nobel Prize in Chemistry for its achievements in genetic manipulation. Because of its enormous value globally, molecular diagnostics emerged as a fresh wave of diagnostic technologies. A growing number of studies have demonstrated the compatibility of CRISPR/Cas technology with biosensors and bioassays for molecular diagnostics. As highly precise, sensitive, easily programmable, and device-independent sensors, CRISPR-based detection has received a lot of interest. One of the most precise and sensitive diagnostic techniques is nucleic acid-based detection. It has the potential for detecting other …

Cardiovascular Risk Factors In Secondary Progressive Multiple Sclerosis: A Cross‐Sectional Analysis From The Ms‐Stat2 Randomized Controlled Trial, Thomas Williams, Nevin John, Alberto Calvi, Alessia Bianchi, Floriana De Angelis, Anisha Doshi, Sarah Wright, Madiha Shatila, Marios C. Yiannakas, Fatima Chowdhury, Jon Stutters, Antonio Ricciardi, Ferran Prados, David Macmanus, Marie Braisher, James Blackstone, Olga Ciccarelli, Cam Gandini Wheeler‐Kingshott, Frederik Barkhof, Jeremy Chataway, Jeremy Hobart

Peninsula Medical School

Background and purpose.There is increasing evidence that cardiovascular risk (CVR) contributes to disability progression in multiple sclerosis (MS). CVR is particularly prevalent in secondary progressive MS (SPMS) and can be quantified through validated composite CVR scores. The aim was to examine the cross‐sectional relationships between excess modifiable CVR, whole and regional brain atrophy on magnetic resonance imaging, and disability in patients with SPMS. Methods. Participants had SPMS, and data were collected at enrolment into the MS‐STAT2 trial. Composite CVR scores were calculated using the QRISK3 software. Prematurely achieved CVR due to modifiable risk factors was expressed as QRISK3 premature CVR, …

An Isotopic Analysis Of Carbon Dynamics In Sphagnum Peat, Jasper Michael Newman

School of Geography, Earth and Environmental Sciences Theses

Methane and carbon dioxide produced in peatlands can be held temporarily in dissolved surface waters and accessible to aquatic plants. The primary peat building plant in northern peatlands, Sphagnum moss, grows in these dissolved carbon rich waters. Understanding Sphagnum carbon cycles is key for radiocarbon dating, peatland restoration, and modelling of methane release from warming peatlands globally. This combined surface and multi‐proxy palaeoenvironmental study challenges common assumptions about the dissolved gas cycling in this semi‐aquatic environment. The Sphagnum associated methanotrophic communities within the water filled hyaline cells have commonly been linked to unusual 13C‐depleted measurements of Sphagnum carbon isotope ratios. …

Motivational Support Intervention To Reduce Smoking And Increase Physical Activity In Smokers Not Ready To Quit: The Tars Rct, Adrian H. Taylor, Tom P. Thompson, Adam Streeter, Jade Chynoweth, Tristan Snowsill, Wendy Ingram, Michael Ussher, Paul Aveyard, Rachael L. Murray, Tess Harris, Colin Green, Jane Horrell, Lynne Callaghan, Colin J. Greaves, Lisa Price, Lucy Cartwright, Jonny Wilks, S Campbell, Dan Preece, Siobhan Creanor

Peninsula Medical School

No abstract provided.

Voices From The Field: Brexit, Citizenship And Agricultural Labour, Richard Yarwood, Gina Kallis, Leonie Boland

School of Geography, Earth and Environmental Sciences

Drawing on a case-study of Cornwall in the South-West of England, this paper has three main aims. First, it seeks to listen to the voices of migrant workers and, in doing so, learn more about their experiences of moving to, and working in, the British countryside. Second, it evaluates the impact of Brexit on their lives and, in particular, how it influences their decision to work in the UK or elsewhere. Finally, consideration is given to the significance of citizenship to their lives, both as a formal contract with the EU and as a lived experience.

Evaluating The Risks Of Human Factors Associated With Social Media Cybersecurity Threats, Fai Ben Salamah, Marco A. Palomino, Maria Papadaki, Matthew J. Craven, Steven Furnell

School of Engineering, Computing and Mathematics

Human behaviors and attitudes play a significant role in cybersecurity. However, studies to quantify the impact of such behaviors and attitudes are scarce, and they are not always considered when developing mitigation strategies. To compensate for this, we have looked into a large sample of employees with different levels of expertise and backgrounds across a variety of industrial sectors and organizations. We have found that age and job role constitute the main human factors associated with social media cybersecurity risks. We can confirm that the youngest employees are the most risk prone within an organization, and the employees working in …

At What Scale Should We Assess The Health Of Pelagic Habitats? Trade-Offs Between Small-Scale Manageable Pressures And The Need For Regional Upscaling, C. A. Graves, M. Best, A. Atkinson, B. Bear, E. Bresnan, M. Holland, D. G. Johns, M. Machairopoulou, A. Mcquatters-Gollop, A. Mellor, C. Ostle, K. Paxman, S. Pitois, P. Tett, M. Devlin

School of Biological and Marine Sciences

Major planktonic lifeforms such as diatoms, dinoflagellates, meroplankton and holoplankton have recently shown significant and alarming changes in abundance - mainly downwards trends - around the northwest European shelf. This has major implications for food web connections and for ecosystem services including seafood provision and carbon storage. We have quantified these changes in abundance for 2006–2019/20 using a Plankton Index (PI) and show that the scale of spatial aggregation is critical to the ability of the PI to detect change, understand causal mechanisms, and provide advice to policymakers. We derived PI statistics in the Celtic and North Seas from data …

Mental Imagery Of Suicide And Non-Suicidal Self-Injury: A Meta-Analysis And Systematic Review, Hannah R. Lawrence, Emma G. Balkind, Julie L. Ji, Taylor A. Burke, Richard T. Liu

School of Psychology

Background The vast majority of research on, and clinical assessment of, cognitions related to suicide and non-suicidal self-injury (NSSI) has focused on verbal thoughts. And yet, mental imagery is more realistic and emotionally arousing than verbal thoughts. Methods We conducted a systematic review and meta-analysis documenting the prevalence of suicidal and NSSI mental imagery and describing the content and characteristics of suicidal and NSSI mental imagery, links between suicidal and NSSI mental imagery and suicidal and NSSI behavior, and how to intervene on suicidal and NSSI mental imagery. Studies published through December 17, 2022 were identified through a systematic search …

Recommendations From Diabetes Uk's 2022 Diabetes And Physical Activity Workshop, Anna Morris, Chris Bright, Matthew Cocks, Neil Gibson, Louise Goff, Colin Greaves, Simon Griffin, Ben Jane, Florence Kinnafick, Paul Robb, Michelle Roberts, David Salman, John Saxton, Adrian Taylor, Daniel West, Thomas Yates, Rob C. Andrews, Jason M.R. Gill

Peninsula Medical School

Abstract Aims To describe the process and outputs of a workshop convened to identify key priorities for future research in the area of diabetes and physical activity and provide recommendations to researchers and research funders on how best to address them. Methods A 1‐day research workshop was conducted, bringing together researchers, people living with diabetes, healthcare professionals, and members of staff from Diabetes UK to identify and prioritise recommendations for future research into physical activity and diabetes. Results Workshop attendees prioritised four key themes for further research: (i) better understanding of the physiology of exercise in all groups of people: …

Victrices Scientiarum Of 1904: Who Were The First Women Elected As Fellows Of The Linnean Society Of London?, R Boden

School of Biological and Marine Sciences

Published within The Linnean Special Issue No. 10 "‘The Door Was Opened’ Pioneering Women at the Linnean Society of London and Their Continuing Legacy" Compiled and edited by Gina Douglas Hon FLS and Leonie Berwick

Investigating A Motivation Model For Gamified E-Learning: A Self-Determination Approach, A Sen, J Lean, J Kelland, J Moizer

Plymouth Business School

There has been a recent increase in educational interest in gamification over the past 5 years [1, 2]. A central tenet of the increase in its popularity may stem from its motivational power in educational settings [3, 4]. However, prior research on gamification has not sufficiently investigated the mechanisms by which the phenomenon induces its motivational effects. A crucial question to consider is how the motivational theories that underpin gamification really work. Consequently, the current study looks at how game elements map into the notion of self-determination to explore the relationship between intrinsic motivation and gamification in the context of …

Paternal Supervisor Gatekeeping: How Supervising Fathers Hinder Other Fathers At Work In Their Uptake Of Flexible Work Arrangements, Sophie Hennekam, Jasmine Kelland, Jean Pierre Dumazert

Plymouth Business School

This study explores the role that supervisors play in the low uptake of Flexible Work Arrangements (FWA) among fathers in France. We draw on 28 interviews with fathers who had requested access to FWA and reported on the reaction of their supervisors. These supervisors were all fathers themselves and had previously benefitted from such arrangements themselves, but did not grant such policies to other fathers. To understand these unexpected findings, we conducted an additional 16 interviews with supervising fathers in organizations who had previously enjoyed similar FWA. The findings show that supervising fathers can act as barriers to other fathers …

Spatial Robustness: Double-Design And The Democratization Of Space, An Exploration Of Designing For Multiple Uses, Michael Cassidy

School of Art, Design and Architecture Theses

Spatial Robustness: Double-design And The Democratization Of Space, An Exploration Of Designing For Multiple Uses by Michael Warren Arkinstall Cassidy Differing attitudes to the expected life and value of architecture characterize the sustainability debate, yet space itself is rarely mentioned. The buildings for which architecture is responsible comprise both space and materials. While it is taken for granted that some existing buildings can be reused productively, this cultural phenomenon has not influenced the design of the new stock. While content to revere old buildings, the qualities that make them valued have not influenced design principles for new projects. Should new …

Shanshuihua: ‘Mountain-Water-Painting’ For An Ecological Age, Lei Liu

School of Art, Design and Architecture Theses

This practice-led research project appraises the tradition of shanshuihua, or ‘mountain-water painting’, within broader traditions of Chinese ink painting, or shuimohua, and, through links with ancient Chinese philosophies, considers its continuing relevance to contemporary painting, and modern ecological themes, both in China and beyond. The research initially assesses historical connections between ink painting and the fundamental philosophies of Chinese history and culture, namely Confucianism, Taoism and Buddhism, and maps certain connections to the development of shanshuihua. Through a series of interviews with contemporary Chinese artists, the project investigates whether the influence of these philosophic traditions have a continuing significance to …

Hippo Signaling: Advances In Potential Therapeutic Targets For Sinoatrial Node Disorders

Faculty, Staff and Student Publications

The cardiac conduction system (CCS) propagates electrical impulses, generates cardiac contractions, and ultimately ensures regular heartbeats. Disruptions within the CCS lead to cardiac arrhythmias, which are known to be the leading cause of cardiac-related mortalities in humans. The sinoatrial node (SAN) is a key component of the CCS and functions as the natural cardiac pacemaker to initiate normal cardiac impulse and conduction. The SAN is characterized by significant heterogeneity and contains various cell types, including pacemaker cells that spontaneously generate action potentials to maintain a constant beating rhythm. The fundamental Hippo signaling pathway plays a key role in heart development …

Exaptation And Evolutionary Adaptation In Nociceptor Mechanisms Driving Persistent Pain

Faculty, Staff and Student Publications

Background: Several evolutionary explanations have been proposed for why chronic pain is a major clinical problem. One is that some mechanisms important for driving chronic pain, while maladaptive for modern humans, were adaptive because they enhanced survival. Evidence is reviewed for persistent nociceptor hyperactivity (PNH), known to promote chronic pain in rodents and humans, being an evolutionarily adaptive response to significant bodily injury, and primitive molecular mechanisms related to cellular injury and stress being exapted (co-opted or repurposed) to drive PNH and consequent pain.

Summary: PNH in a snail (Aplysia californica), squid (Doryteuthis pealeii), fruit fly (Drosophila melanogaster), mice, rats, …

Unveiling The Prognostic Implications Of Rplp1 Upregulation In Osteosarcoma, Ruiying Zhao

Faculty, Staff and Student Publications

Osteosarcoma, a malignant bone tumor characterized by a high rate of metastasis and poor survival, presents a critical need for identifying novel biomarkers associated with metastasis. In this study, we conducted an extensive analysis utilizing transcriptional and clinical data sourced from databases such as GEO, TCGA, CCLE, R2, and Xena. And we discovered that Ribosomal protein LP1 (RPLP1) ranked among the top upregulated genes in relation to osteosarcoma metastasis. Notably, RPLP1 exhibited significant expression in both osteosarcoma cell lines and patient samples. Moreover, multiple osteosarcoma studies revealed a strong correlation between RPLP1 overexpression and worse metastasis-free survival as well as …

Frequentist Model Averaging For Analysis Of Dose-Response In Epidemiologic Studies With Complex Exposure Uncertainty

Faculty, Staff and Student Publications

In epidemiologic studies, association estimates of an exposure with disease outcomes are often biased when the uncertainties of exposure are ignored. Consequently, corresponding confidence intervals (CIs) will not have correct coverage. This issue is particularly problematic when exposures must be reconstructed from physical measurements, for example, for environmental or occupational radiation doses that were received by a study population for which radiation doses cannot be measured directly. To incorporate complex uncertainties in reconstructed exposures, the two-dimensional Monte Carlo (2DMC) dose estimation method has been proposed and used in various dose reconstruction efforts. The 2DMC method generates multiple exposure realizations from …

Antithrombin Activity Is Associated With Persistent Thromboinflammation And Mortality In Patients With Severe Covid-19 Illness, Bela Patel, Jessica C Cardenas

Faculty, Staff and Student Publications

Introduction: Severe COVID-19 illness can lead to thrombotic complications, organ failure, and death. Antithrombin (AT) regulates thromboinflammation and is a key component of chemical thromboprophylaxis. Our goal was to examine the link between AT activity and responsiveness to thromboprophylaxis, markers of hypercoagulability, and inflammation among severe COVID-19 patients.

Methods: This was a single-center, prospective observational study enrolling SARS-CoV-2-positive patients admitted to the intensive care unit on prophylactic enoxaparin. Blood was collected daily for 7 days to assess AT activity and anti-factor Xa levels. Patient demographics, outcomes, and hospital laboratory results were collected. Continuous variables were compared using Mann-Whitney tests, and …

Lung Cancer In The Emergency Department

Faculty, Staff and Student Publications

Background: Though decreasing in incidence and mortality in the USA, lung cancer remains the deadliest of all cancers. For a significant number of patients, the emergency department (ED) provides the first pivotal step in lung cancer prevention, diagnosis, and management. As screening recommendations and treatments advance, ED providers must stay up-to-date with the latest lung cancer recommendations. The purpose of this review is to identify the many ways that emergency providers may intersect with the disease spectrum of lung cancer and provide an updated array of knowledge regarding detection, management, complications, and interdisciplinary care.

Findings: Lung cancer, encompassing 10-12% of …

Peripheral Vascular Access As Exclusive Access Mode In Pediatric Intensive Care Unit, Sonya Hayes Armstrong, Shantaveer Gangu, Alina Nico West, Thomas Spentzas

Faculty, Staff and Student Publications

INTRODUCTION: The type of vascular access (central or peripheral) in pediatric critical care depends on several factors, including the duration of treatment, the properties of the medication (osmolarity or vesicant), and the need for central pressure monitoring. The utilization of peripheral intravascular catheters (PIVCs) has shown a notable increase in the number of patients being treated. Extended dwell or midline catheters are another peripheral access option in addition to PIVCs. However, there are currently no established guidelines on their placement.

OBJECTIVES: The aim of this study is to estimate the duration of dwell time for PIVCs, analyze the specific parameters …

Determinants Of Human Papillomavirus Vaccine Hesitancy Among Lebanese Parents, Ramia Zakhour, Hani Tamim, Farah Faytrouni, Maha Makki, Rayan Hojeij, Lama Charafeddine

Faculty, Staff and Student Publications

Introduction: Human papillomavirus (HPV) is the most common sexually transmitted infection. HPV is responsible for cancer of cervix uteri. Despite its safety and immunogenicity, HPV vaccine hesitancy is one of the most challenging topics that pediatricians face.

Methods: We aimed to describe the impact of knowledge, attitude, and practice towards vaccines in general, on practice related to HPV vaccination in Lebanon. A questionnaire addressed to parents of students (3-18 years of age) was distributed in 2 public and 2 private schools randomly selected from the greater Beirut area during the school year 2017-2018. Questionnaires covered knowledge, attitude, and practices of …

Imaging Neuroscience Opening Editorial, Stephen Smith, Til Ole Bergmann, Birte Forstmann, Alain Dagher, Shella Keilholz, Kristen Kennedy, Sonja A Kotz, Cindy Lustig, Bruce Pike, Marc Tittgemeyer, Mark Woolrich, B T Thomas Yeo, Andrew Alexander, Janine Bijsterbosch, Tjeerd Boonstra, Mallar Chakravarty, Chris Chambers, Catie Chang, Bradley Christian, Sarang S Dalal, Nai Ding, Audrey Duarte, Audrey P Fan, Alexandre Gramfort, Gesa Hartwigsen, Mbemba Jabbi, Peter Kochunov, Ulrike Krämer, Martin Lindquist, Jean-Francois Mangin, Kevin Murphy, Jonathan Polimeni, Emma Robinson, Monica Rosenberg, Sepideh Sadaghiani, Mohamed Seghier, Yen-Yu Ian Shih, Axel Thielscher, Lucina Q Uddin, Dimitri Van De Ville, Wim Vanduffel, Chao-Gan Yan, Anastasia Yendiki

Faculty, Staff and Student Publications

In this editorial we introduce a new non-profit open access journal, Imaging Neuroscience. In April 2023, editors of the journals NeuroImage and NeuroImage:Reports resigned, and a month later launched Imaging Neuroscience. NeuroImage had long been the leading journal in the field of neuroimaging. While the move to fully open access in 2020 represented a positive step toward modern academic practices, the publication fee was set to a level that the editors found unethical and unsustainable. The publisher of NeuroImage, Elsevier, was unwilling to reduce the fee after much discussion. This led us to launch Imaging Neuroscience with …

Title Vi Compliance Report And Implementation Plan Fy 2021-2022, Tennessee. Department Of Commerce And Insurance.

Title VI Implementation Report

No abstract provided.

High-Definition Transcranial Direct Current Stimulation For Upper Extremity Rehabilitation In Moderate-To-Severe Ischemic Stroke: A Pilot Study, Evgeny V Sidorov

Faculty, Staff and Student Publications

Introduction: Previous studies found that post-stroke motor impairments are associated with damage to the lesioned corticospinal tract (CST) and hyperexcitability of the contralesional cortico-reticulospinal tract (CRST). This proof-of-concept study aims to develop a non-invasive brain stimulation protocol that facilitates the lesioned CST and inhibits the contralesional CRST to improve upper extremity rehabilitation in individuals with moderate-to-severe motor impairments post-stroke.

Methods: Fourteen individuals (minimum 3 months post ischemic stroke) consented. Physician decision of the participants baseline assessment qualified eight to continue in a randomized, double-blind cross-over pilot trial (ClinicalTrials.gov Identifier: NCT05174949) with: (1) anodal high-definition transcranial direct stimulation (HD-tDCS) over …

Fascial Defect Closure During Ventral Hernia Repair: A Systematic Review Of Randomized Controlled Trials, Naila H Dhanani

Faculty, Staff and Student Publications

Background: During minimally invasive ventral hernia repair (VHR) it is unknown if a fascial defect closure, as opposed to a bridged repair (current care), is beneficial for patients. We sought to systematically review the published literature on the role of fascial defect closure during minimally invasive VHR.

Methods: PubMed, Embase, Scopus, Cochrane, and Clinicaltrials.gov were reviewed for randomized controlled trials (RCTs) that compared fascial defect closure with bridged repair. The primary outcome was major complications defined as deep/organ-space surgical site infections (SSIs), reoperations, hernia recurrences, or deaths. Secondary outcomes included SSI, seroma, eventration, hernia recurrence, post-operative pain, and quality of …

Dermatological Concerns For Women And Girls With Turner Syndrome, Melissa Aldrich

Faculty, Staff and Student Publications

Introduction: Turner syndrome (TS) is associated with distinct manifestations in women and girls including short stature, cardiac abnormalities, premature ovarian failure as well as dermatological features, including lymphedema, keloids, onychodystrophy, and acne. Although many dermatological concerns present during the first few decades of life, the overwhelming majority of respondents are not provided with dermatology referrals at diagnosis.

Methods: This cross-sectional study utilized an author designed survey to assess self-reported dermatological manifestations, dermatology referral experience, common therapies for select dermatological conditions, as well as a validated 10-question Dermatology Life Quality Index (DLQI) to assess quality-of-life impact in women and girls with …