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Background: Among communities with elevated HIV burden, increased uptake of PrEP, including long-acting injectable (LAI) PrEP, could lower HIV incidence. Lack of data on LAI PrEP interest among transgender women in the United States has limited scientific understanding of the potential impact of LAI PrEP on new infections within transgender communities. Our objective was to determine the percent of transgender women interested in LAI PrEP and identify correlates of interest. Methods: Transgender women enrolled in the LITE Cohort who completed 12-month surveys between March 2019 and September 2021 were asked about interest in using LAI PrEP. Prevalence ratios (PR) estimated with modified Poisson regression models were assessed for predictors of interest in LAI PrEP. Results: Among 867 participants, 15% were current users of oral PrEP and 11% were former oral PrEP users. In total, 47% reported interest in LAI PrEP. Interest in LAI PrEP was more common among participants who were Black (PR: 1.28; 95% CI: 1.05 to 1.55), college-educated (PR: 1.28; 95% CI: 1.04 to 1.57), food insecure (PR: 1.19; 95% CI: 1.00 to 1.41), and had PrEP indications (PR: 1.44; 95% CI: 1.21 to 1.71). LAI PrEP interest was also more common among adherent users of oral PrEP and those who had discontinued oral PrEP, compared with PrEP-naïve participants. Conclusions: Interest in LAI PrEP among transgender women varied by demographic and clinical characteristics. Increased interest in LAI PrEP among Black transgender women, those with PrEP indications, and those who had previously discontinued oral PrEP underscores the need to increase LAI PrEP access for transgender women who are interested. [ABSTRACT FROM AUTHOR]

Background: Transgender and gender diverse (TGD) adults in the U.S. experience health disparities, including in anogenital sexually transmitted infections (STI). Gender-affirming hormone therapy (GAHT) is known to be medically necessary and improve health. Few studies have assessed the effect of GAHT on STI diagnoses. Objective: To evaluate the effect of GAHT delivered in primary care as an intervention to improve STI outcomes for TGD adults. Design: LEGACY is a longitudinal, multisite cohort study of adult TGD primary care patients from two federally qualified community health centers in Boston, MA, and New York, NY. Participants: Electronic health record data for eligible adult TGD patients contributed to the LEGACY research data warehouse (RDW). A total of 6330 LEGACY RDW patients were followed from 2016 to 2019, with 2555 patients providing STI testing data. Main Measures: GAHT exposure was being prescribed hormones, and the clinical outcome was anogenital gonorrhea or chlamydia diagnoses. Log-Poisson generalized estimating equations assessed the effect of prescription GAHT on primary outcomes, adjusting for age, race, ethnicity, gender identity, poverty level, health insurance, clinical site, and cohort years. Key Results: The median age was 28 years (IQR = 13); the racial breakdown was 20.4% Black, 8.1% Multiracial, 6.9% Asian/Pacific Islander, 1.8% Other; 62.8% White; 21.3% Hispanic/Latinx; 47.0% were assigned female at birth, and 16.0% identified as nonbinary. 86.3% were prescribed hormones. Among those tested, the percentage of patients with a positive anogenital STI diagnosis ranged annually from 10.0 to 12.5% between 2016 and 2019. GAHT prescription was associated with a significant reduction in the risk of anogenital STI diagnosis (aRR = 0.75; 95% CI = 0.59–0.96) over follow-up. Conclusions: GAHT delivered in primary care was associated with less STI morbidity in this TGD cohort over follow-up. Patients may benefit from individualized and tailored clinical care alongside GAHT to optimize STI outcomes. [ABSTRACT FROM AUTHOR]

Employing the distinction between "ghosts" and "ancestors" as developed by Hans Loewald, my essay applies this transformation of destructive to constructive internal objects to Toni Morrison's novel, Song of Solomon (1977). The essay traces the movement from the spectral to the ancestral in Morrison's protagonist, Milkman Dead. Its main concern is to show that soaring through ancestry is just as germane to the experience of uncanny inner objects as is the more familiar haunting through spectrality. The Morrison-narrator shows this process through Milkman and Pilate Dead, a startling original woman without a navel who emerges as protagonist, counselor, and cultural symbol all at once. Morrison reworks African legend into a mid-twentieth-century American fable. Milkman, almost a black Hamlet, looks for a lost heritage in the woods of Pennsylvania and over a canyon in Virginia. As Milkman moves through the American continent, he experiences a geographical version of Winnicott's liberating "Potential Space." He finds the deeper meanings of both love and being through his counselor-as-good-object, Pilate. The forest community he meets near Shalimar, VA, provides a communal passage from ghosts to ancestors in his understanding of his own heritage. Community and counselor lead him to a mythical-but-true ancestor: legendary Solomon, the slave who really knew how to fly. [ABSTRACT FROM AUTHOR]

Background: Sexual orientation refers to a person's enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider desires for, or sexual behavior with, transgender people. We describe measures inclusive of transgender people and characterize sexual orientation identity, behavior, and attraction in a representative sample of the U.S. transgender population. Methods: Between April 2016-December 2018, a U.S. national probability sample of transgender (n = 274) and cisgender (n = 1,162) adults were invited to complete a self-administered web or mailed paper survey. We assessed sexual identity with updated response options inclusive of recent identity terms (e.g., queer), and revised sexual behavior and attraction measures that included transgender people. Multiple response options were allowed for sexual behavior and attraction. Weighted descriptive statistics and sexual orientation differences by gender identity groups were estimated using age-adjusted comparisons. Results: Compared to the cisgender population, the transgender population was more likely to identify as a sexual minority and have heterogeneity in sexual orientation, behavior, and attraction. In the transgender population, the most frequently endorsed sexual orientation identities were "bisexual" (18.9%), "queer" (18.1%), and "straight" (17.6%). Sexually active transgender respondents reported diverse partners in the prior 5 years: 52.6% cisgender women (CW), 42.7% cisgender men (CM), 16.9% transgender women (TW), and 19.5% transgender men (TM); 27.7% did not have sex in the past 5 years. Overall, 73.6% were "somewhat"/ "very" attracted to CW, 58.3% CM, 56.8% TW, 52.4% TM, 59.9% genderqueer/nonbinary-females-at-birth, 51.9% genderqueer/nonbinary-males-at-birth. Sexual orientation identity, behavior, and attraction significantly differed by gender identity for TW, TM, and nonbinary participants (all p < 0.05). Conclusions: Inclusive measures of sexual orientation captured diverse sexual identities, partner genders, and desires. Future research is needed to cognitively test and validate these measures, especially with cisgender respondents, and to assess the relation of sexual orientation and health for transgender people. [ABSTRACT FROM AUTHOR]

We use molecular dynamics simulation to probe the non-equilibrium physics of two nanochannel-confined semiflexible polymers in a homogeneous flow field. We find that for sufficiently stiff chains the internal organization of the two chains takes the form of interwoven folds and circular coils. This organization can lead to mixing or demixing depending on chain stiffness and flow speed. At low and intermediate flow, the two chains adopt a folded configuration, which favours mixing. At high flow, the two chains adopt a predominantly coiled configuration. The coiled configuration results in demixing when the chains are compressed from an initially demixed condition and mixing when the chains are compressed from an initially mixed condition. We find that the mixing/demixing behaviour is governed by the ratio of the number of folded segments of one chain relative to the other at low flow and by the degree of coiling in both chains at high flow. For decreasing stiffness, the chains start to aggregate locally instead of mixing smoothly at low and intermediate flow. In the limit of completely flexible chains, the two chains either completely segregate at low flow, or adopt a locally demixed configuration consisting of large aggregates of one chain relative to the other that undergo complex stochastic dynamics, diffusing, disintegrating, and reforming at intermediate flow. The transition from complete segregation to the aggregate-dominated configuration occurs when the linear intra-chain ordering breaks down. [ABSTRACT FROM AUTHOR]

Solar reforming (SR) is a promising green‐energy technology that can use sunlight to mitigate biomass and plastic waste while producing hydrogen gas at ambient pressure and temperature. However, practical challenges, including photocatalyst lifetime, recyclability, and low production rates in turbid waste suspensions, limit SR's industrial potential. By immobilizing SR catalyst materials (carbon nitride/platinum; CNx|Pt and carbon nitride/nickel phosphide; CNx|Ni2P) on hollow glass microspheres (HGM), which act as floating supports enabling practical composite recycling, such limitations can be overcome. Substrates derived from plastic and biomass, including poly(ethylene terephthalate) (PET) and cellulose, are reformed by floating SR composites, which are reused for up to ten consecutive cycles under realistic, vertical simulated solar irradiation (AM1.5G), reaching activities of 1333 ± 240 µmolH2 m−2 h−1 on pre‐treated PET. Floating SR composites are also advantageous in realistic waste where turbidity prevents light absorption by non‐floating catalyst powders, achieving 338.1 ± 1.1 µmolH2 m−2 h−1 using floating CNx versus non‐detectable H2 production with non‐floating CNx and a pre‐treated PET bottle as substrate. Low Pt loadings (0.033 ± 0.0013% m/m) demonstrate consistent performance and recyclability, allowing efficient use of precious metals for SR hydrogen production from waste substrates at large areal scale (217 cm2), taking an important step toward practical SR implementation. [ABSTRACT FROM AUTHOR]

As the climate system warms, megafires have become more frequent with devastating effects. A byproduct of these events is the creation of smoke plumes that can rise into the stratosphere and spread across the globe where they reside for many months. To gain a deeper understanding of the plume dynamics, global climate simulations of a megafire were performed at a wide range of grid spacings from 2.0° down to 7 km, including a 7 km nonhydrostatic experiment. The analysis focuses on how the resolved dynamics affects the specification of the plume characteristics such as injection height and black carbon (BC) mass. Prior studies initialize the smoke plume at one or a few grid points and this is shown here to produce severely dissipative dynamics. In order to validate such simulations with observations, enhancements of the plume characteristics to offset the dissipation is necessary. Using a numerically converged simulation, sensitivity tests show that to approximate the observed stratospheric lifetime, a reduction in BC fraction by 50% is necessary for external mixtures. The vorticity dynamics of the plume is also analyzed with a Lagrangian budget to understand the mechanisms responsible for the evolution of a collocated anticyclonic vortex. The results can be distilled down into a simple conceptual model. As the plume rises, the air diverges at the top of the updraft where the largest concentrations of smoke are found. This divergence induces a dilution of the background cyclonic absolute vorticity producing an anticyclonic vortex. Vortex decay occurs from opposite arguments. Plain Language Summary: Recently, there has been an increase in large and intense wildfires ("megafires") across the Earth in response to global warming. These megafire events produce large amounts of smoke that can rise high up in the atmosphere to a level well above clouds and weather. The smoke can stay at these high levels for long periods of time and spread across much of the Earth, which blocks sunlight from reaching the surface. It is important to understand the properties of these smoke plumes and how to correctly predict their consequences on human life. However, uncertainties in both observations and models make it difficult to achieve these goals. In particular, models contain various sources of uncertainty that can interact in complex ways. In this paper, we show that previous research has used a model grid spacing that does not sample the plume accurately, which leads to errors that affect the interpretation of the smoke properties, evolution of the plume and potential climatic effects. By choosing a model grid spacing that accurately samples the plume structure, the errors in the dynamics component of the model can be minimized, providing a baseline for reducing uncertainty in other parts of the system. Key Points: Simulations of megafire smoke plumes require fully resolved dynamics (∼8 Δx) in order to accurately characterize plume properties (e.g., black carbon [BC] fraction)For the 2017 British Columbia event, smoke injected at ∼12 km height requires a reduction in BC fraction by 50% to match observations for external mixturesAnalysis of the vorticity dynamics shows that smoke plume anti‐cyclonic vortices form (decay) due to the dilution (concentration) of cyclonic absolute vorticity [ABSTRACT FROM AUTHOR]

Introduction: People with serious mental illness (SMI) are three times more likely to smoke and be heavy smokers than smokers without SMI. Counseling combined with smoking cessation medication (SCM) is the recommended treatment. However, until 2017, SCM prescription for SMI smokers was discouraged (FDA black box warning). This study compared use of smoking cessation programs (SCP) and SCM between smokers with and without SMI.Aims and Methods: Data regarding SCP and SCM use were extracted from the database of a large HMO that offers free Group and telephone SCP. SCP registration, participation, completion, and abstinence rates between July 2013 and December 2019 were compared between smokers with and without SMI, controlling for demographic and health variables.Results: 48 000 smokers registered for a SCP during the study period. Smokers with SMI were 1.8 times more likely to register for a SCP than smokers without SMI. Smokers without SMI were, however, 1.2 times more likely to start the SCP, 1.5 times more likely to complete the SCP, and 1.6 times more likely to have quit by the end of the program. The strongest factors predicting abstinence were SCP completion and SCM use. Smokers with SMI were less likely to purchase SCM, although their purchase rate increased after the black box warning was lifted.Conclusions: Smoking cessation programs and SCM use should be encouraged in the SMI population. Providing support during the quit attempt and adapting SCP to the needs of smokers with SMI, combined with SCM prescription promotion, should improve abstinence.Implications: Smokers with serious mental illness (SMI) were more likely to seek professional help to quit smoking than non-SMI smokers, with over 30% achieving abstinence, discrediting healthcare professional beliefs that SMI smokers don't want to and cannot quit. Smoking cessation program (SCP) completion and smoking cessation medication (SCM) utilization were the strongest predictors of abstinence. SMI smokers were more likely to drop out of SCPs and less likely to use SCMs. Providing support during the quit attempt and adapting SCPs to the needs of smokers with SMI, combined with SCM prescription promotion, should improve abstinence. [ABSTRACT FROM AUTHOR]

The author discusses the relationship between the Reformation and modernity. He mentions the religious aspects of the Reformation as opposed to the secular and intellectual state of modern society, the expansion of interdisciplinary approaches to study of the Reformation, and the Reformation's impact on early modern society.

Suicide risk among transgender populations is an important public health issue. In a project evaluating association between gender affirmation and suicide attempts in the US Transgender Survey, we evaluated the relationship between gender affirmation and risk for suicide attempts. One of the challenges is that the age at suicide attempts was only collected for the first and last attempt. The initial zero-inflated negative binomial model enabled us to evaluate the association between gender affirmation and number of suicide attempts per 5 years adjusting for other covariates. However, ignoring missing failure times of recurrent events may have caused bias and loss of efficiency. In this paper, we use a recurrent-event survival analysis incorporating time-varying covariates with three approaches to impute the age at suicide attempt, estimates from three imputation approaches are similar. We were able to confirm the findings from the initial model and identify additional associations that were not detected in the initial analysis. Findings suggest the need to consider additional analytical approaches in settings with high data missingness by design. Research to validate and compare measures that ask first and last attempt to those which enumerate all attempts in this population will be important for future surveys. [ABSTRACT FROM AUTHOR]

Focusing on Manchester, the largest city in the north of England, this paper explores why and how Black rap practitioners have been excluded from performing and promoting rap music in its city centre during the last 20 years. Discussing the intersecting factors of policing of venues and racial bias and class stigma among Manchester's venue owners and promoters, while also scrutinising the city's neoliberal urban expansion and gentrification, the paper analyses the ways in which Black rappers and practitioners have been marginalised but also how they have attempted to resist and overcome these conditions. Drawing on cultural studies, critical race theory and urban geography, while employing qualitative research methods of in-depth interviews, this paper builds on existing research on the marginalisation of Black rap musicians and promoters. It builds on and moves beyond the scholarly emphasis on the policing of rap genres in London to argue that discrimination faced by Black rap practitioners extends far outside the capital and is part of a wider problem of racial capitalism of which policing is but one agent. [ABSTRACT FROM AUTHOR]

Smoking rates are three times higher among people with serious mental illness (PWSMI), yet, earlier studies showed that physician compliance with smoking cessation guidelines (5As) for PWSMI is low. 1) Compare the 5A (Ask-Advise-Assess-Assist-Arrange) practice rates between psychiatrists and primary care physicians (PCPs) regarding smoking cessation for PWSMI. 2) Compare the 5A practice rates reported by physicians with rates reported by PWSMI. 3) Identify which specialty is perceived as primarily responsible for smoking cessation promotion for PWSMI. Telephone surveys were carried out in a large health maintenance organization (HMO) among all psychiatrists, a random sample of PCPs, and HMO members with serious mental illness who had registered/participated in a smoking cessation program. Physicians were asked how frequently they carried out each 5A practice, along with questions regarding role responsibility and interaction between the two clinical specialties. PWSMI were asked to report about each 5A practice by both PCP and treating psychiatrist. Ask-Advise-Assess rates were higher than Assist-Arrange rates for both specialties. 83% of PCPs had satisfactory 5A practice scores compared to 46% of psychiatrists (X2=23.9, p < 0.001). With the exception of Ask rates, physician rates for each 5A component were higher than those reported by PWSMI. PCPs were more likely to see smoking cessation promotion as their responsibility and did not always confer with the psychiatrist regarding referral and SCM prescription. Interventions focusing on promoting Assist-Arrange practices and better integration between the specialties are required. [ABSTRACT FROM AUTHOR]

This article focusses on Fatma Shanan, one of the groundbreaking Druze women artists in Israel. The article presents an analysis of four of the artist's self-portraits, made between the years 2010–2017, relating to Shanan's work as an emotional process. The authors examine how the artist relates to the complexity of her experience as a woman and as an artist active within the patriarchal Druze community and as a woman artist from an ethnic minority acting in the Israeli Western-oriented artworld. The article looks at her struggle through her intersectional experience and studies the strategies of action she has used in this struggle, focusing on the artist undergoing process of transformation from being a young student and artist (functioning under this multiple oppression) to her identification of herself as an individual artist and a pioneering feminist. [ABSTRACT FROM AUTHOR]

Purpose: Adherence to pre-exposure prophylaxis (PrEP) during periods of PrEP-indication (i.e., prevention-effective adherence) is critical for preventing HIV. We sought to describe factors associated with prevention-effective adherence trajectories among transgender women (TW) to inform PrEP implementation strategies.Methods: Using data from The LITE American Cohort (n = 728), we performed group-based multi-trajectory modeling (GBMTM) to identify clusters of TW with similar trajectories of PrEP adherence and indication, and sociodemographic, biobehavioral, and structural correlates of each trajectory.Results: We identified five trajectories: (1) consistent indication/no PrEP (15.3%), (2) initial indication/no PrEP (47.1%), (3) declining indication/discontinued PrEP (9.5%), (4) consistent indication/PrEP adherent (18.5%), and (5) increasing indication/initiated PrEP (9.6%). TW diagnosed with an STI were more likely to follow a consistent indication/no PrEP trajectory compared to consistent indication/PrEP adherent trajectory (adjusted Relative Risk Ratio [aRRR], 2.54; 95% confidence interval [CI], 1.16-5.57). TW who experienced homelessness were more likely to follow PrEP discontinuation and initiation trajectories relative to PrEP adherence (aRRR, 2.71; 95% CI, 1.10-6.70 and 2.83; 95% CI, 1.13-7.05, respectively).Conclusions: Over a quarter of TW followed trajectories suggestive of prevention-effective adherence, while 15% did not initiate PrEP despite consistent indication. Findings highlight missed opportunities for PrEP engagement at STI diagnosis and suggest structural interventions addressing housing instability may improve prevention-effective adherence among TW. [ABSTRACT FROM AUTHOR]

Background: Generalized pustular psoriasis (GPP) is a rare disease characterized by episodic worsening (flares). Knowledge of the burden of GPP and the experience of affected individuals is limited. Aims: To conduct a survey of people living with GPP to understand how they experience GPP flares, which therapies they have received and are receiving, and how GPP impacts their activities of daily living. Methods: The online survey consisted of 43 questions answered by individuals recruited from an opt-in market research database. The research team performed a targeted outreach to identify individuals with GPP. The survey included screening questions to determine if potential participants qualified for inclusion. Eligible individuals were US residents aged ≥ 18 years who self-reported that they had been diagnosed with GPP. Respondents provided consent to participate and received compensation (fair market value) for their time. Results: Between August 4 and 14, 2020, 66 people living with GPP in the USA were surveyed. Most participants were female, aged 40–59 years, had been diagnosed ≥ 1 year previously, and had experienced ≥ 2 flares in the past year. A substantial proportion of respondents had symptoms for years, had consulted multiple healthcare professionals, and experienced misdiagnoses before receiving a diagnosis of GPP. Emotional stress was the most common cause of flares and many respondents reported a fear of flares. Respondents defined flares by the presence of itching, an increase in the size of the affected area, more crusts or pustules, and fatigue. A change in mood was the most burdensome symptom. Most respondents were receiving topical corticosteroids and only approximately one-third felt their condition was well controlled. GPP had an impact on activities of daily living even in the absence of flares and many respondents felt that their physician did not understand the level of emotional, psychological, or physical pain caused by GPP. Conclusions: GPP imposes a substantial emotional burden on patients, with wide-ranging impacts on activities of daily living beyond the physical discomfort of skin lesions. [ABSTRACT FROM AUTHOR]

Today, Stalin still haunts the Georgian public. Recent studies have focused solely on "collected" quantitative surveys, rather than "collective" memory on Stalin in Georgia. This paper approaches the Stalin puzzle differently by introducing specific social frameworks and by going beyond a generational analysis. This study illustrates a case of contested memory around Stalin monuments. Drawing on fieldwork (ethnography and interviews) conducted in the Kakheti region and the city of Gori, we analyse how the Stalin cult developed into a memory site. This transformation happened by applying a specific narrative template, which was adapted to different political environments, from the Stalin era until today. We conclude that two opposing interpretations of the narrative template for Stalin as a memory site rely on the same forms, while containing totally different content that we label as an affirmative "golden" variant and an unfavourable "pink" one. [ABSTRACT FROM AUTHOR]

Immobilization of a phosphonated cobalt bis(terpyridine) catalyst on TiO2 nanoparticles generates a photocatalyst that allows coupling aqueous CO2‐to‐syngas (CO and H2) reduction to selective oxidation of biomass‐derived oxygenates or cellulose to formate. An enzymatic saccharification pre‐treatment process is employed that enables the use of insoluble cellulose as an electron‐donating substrate under benign aqueous conditions suitable for photocatalytic CO2 conversion. The hybrid photocatalyst consists of solely earth‐abundant components, and its heterogeneous nature allows for reuse and operation in aqueous solution for several days at 25 °C, reaching a cellulose‐to‐formate conversion yield of 17 %. Thus, the proof‐of‐concept for valorizing two waste streams (CO2 and biomass) simultaneously into value‐added chemicals through solar‐driven catalysis is demonstrated. [ABSTRACT FROM AUTHOR]

Immobilization of a phosphonated cobalt bis(terpyridine) catalyst on TiO2 nanoparticles generates a photocatalyst that allows coupling aqueous CO2‐to‐syngas (CO and H2) reduction to selective oxidation of biomass‐derived oxygenates or cellulose to formate. An enzymatic saccharification pre‐treatment process is employed that enables the use of insoluble cellulose as an electron‐donating substrate under benign aqueous conditions suitable for photocatalytic CO2 conversion. The hybrid photocatalyst consists of solely earth‐abundant components, and its heterogeneous nature allows for reuse and operation in aqueous solution for several days at 25 °C, reaching a cellulose‐to‐formate conversion yield of 17 %. Thus, the proof‐of‐concept for valorizing two waste streams (CO2 and biomass) simultaneously into value‐added chemicals through solar‐driven catalysis is demonstrated. [ABSTRACT FROM AUTHOR]

The minimization of the remanent magnetization of ferromagnetic materials is a prerequisite for a reproducible low magnetic field inside shields. To realistically describe this so-called magnetic equilibration procedure, this paper proposes two approaches for the calculation of time- and space-dependent fields in the presence of ferromagnetic materials like permalloy. The first method is based on the Jiles-Atherton model and also takes into account frequency dependent effects. The second method is the newly developed empirical phase shift model, tailored specially for the simulation of the equilibration procedure. Both approaches are compared to experimental tests and show good quantitative agreement. [ABSTRACT FROM AUTHOR]

Information is provided on the American Society of Church History's (ASCH's) roundtable sessions titled "Does the Reformation Still Matter? American, Global, and Early Modern Perspectives" and "Whither Reformation History" at the meeting of the American Historical Society (AHA) held in Denver, Colorado in January 2017. The conference's focus on the Protestant Reformation, including Protestant missions, Reformation research, historiography and modernity, is discussed.

Background: Despite the high prevalence of smoking amongst people with serious mental illness (SMI), referral rates to smoking cessation programs (SCPs) are low. Mental health workers reticence to refer to SCPs has been attributed, in part, to their belief that quitting will have a deleterious effect on their patients' mental health status. Objectives: This study's objective was to determine if participating in a smoking cessation program had an adverse effect on mental health status among people with SMI, measured here by a change in hospitalization occurrence or psychiatric medication utilization. People with SMI who had participated in at least one SCP session in a large health maintenance organization (n = 403) were compared to an age-gender-diagnosis matched sample of SMI smokers (1,209) who had never participated. Results: No change in psychiatric hospitalization occurrence pre- versus post-SCP participation was found among participants (Pre:7.2% vs. Post:5.2, p = 0.2) or nonparticipants (Pre:7.0% vs. Post:6.0%, p = 0.2). Mean defined daily dose (DDD) for anti-psychotic, mood stabilizer, anti-depressant and anxiolytic medications also did not change over time for participants and nonparticipants. However, participants who did not complete the SCP and didn't quit had a 0.35 higher mean DDD for anti-psychotic medications compared with participants who had completed the SCP or quit, and with nonparticipants (p = 0.006), and were the only group to exhibit an increase in mean antipsychotic DDD over time (Pre:1.42, Post:1.63). SCP participation was not associated with hospitalization occurrence or psychiatric medication utilization. Conclusions/Importance: Smoking cessation should be encouraged, with close monitoring during the quit process. [ABSTRACT FROM AUTHOR]

Introduction: Preexposure prophylaxis (PrEP) is effective in preventing HIV among adherent users. However, PrEP uptake among transgender women is low, and current prescribing guidelines from the Centers for Disease Control and Prevention (CDC) are not specific to transgender women. Self-perceived risk of HIV among those who are PrEP-indicated is not well understood. Methods: This cross-sectional analysis included 1293 transgender women screened at baseline from March 2018 to May 2020 for a multisite, prospective cohort study. We compared the prevalence of PrEP indication using current CDC prescribing criteria versus transgender women-specific criteria developed by study investigators with community input. We identified factors associated with study-specific PrEP indication and factors associated with self-perceived low to no HIV risk among those who were PrEP-indicated. We also calculated descriptive statistics to depict the PrEP care continuum. Results: PrEP indication prevalence using transgender women-specific criteria was 47% (611), 155 more than who were identified using the CDC criteria. Eighty-three percent were aware of PrEP, among whom 38% had ever used PrEP. Among PrEP ever users, 63% were using PrEP at the time of the study. There were 66% of current PrEP users who reported 100% adherence within the previous 7 days. Among those who were PrEP-indicated, 13% were using and adherent to PrEP at the time of the study. More than half (55%) of PrEPindicated participants had low or no self-perceived HIV risk. Conclusions: These findings suggest that further guidance is needed for health care providers in prescribing PrEP to transgender women. Greater uptake and adherence are also needed for optimal effectiveness. [ABSTRACT FROM AUTHOR]

Background: The health of transgender men (trans men)–individuals who identify as men and were assigned a female sex assigned at birth–is overlooked globally. This mixed-methods exploratory study sought to understand the lived experiences, health, and social needs of trans men in Lima, Peru to bring visibility to specific health needs and inform responsive and holistic public health efforts. Methods: Between July 2016-January 2017, 46 trans men in Lima, Peru participated in a mixed-methods study. Four focus group discussions were conducted, complemented with 10 one-on-one interviews to explore in-depth issues that arose in groups. Two individuals participated in both a focus group and an interview. All participants completed a brief survey assessing sociodemographic characteristics and experiences with healthcare, mental health, and stigma. Audio files were transcribed verbatim and analyzed using an immersion crystallization approach to identify themes. Results: Participants had a mean age of 24 years (range 18–48). Trans men reported a lack of awareness and information among medical providers, avoidance of healthcare due to discrimination and maltreatment, an absence of public services for medical gender affirmation (hormones, surgeries), and unmet mental health needs. Trans men described health as multidimensional and influenced by social, economic, and legal contexts including family, school, employment and work, legal identity recognition, discrimination in public spaces, and peer support. Violence, stigma, and intersecting forms of oppression were described as limiting social and legal recognition of trans identity a central dimension of health. Peer support, often in an online environment, was described as important to resistance and well-being. Conclusions: Findings demonstrate that the physical and mental health of trans men, as well as unmet needs for healthcare services, are influenced by a complex set of social, economic, and legal challenges due to the social exclusion of trans people in Peruvian society. Results are a call to action for stakeholders in Peru to guarantee the rights, health, and wellbeing of this community. [ABSTRACT FROM AUTHOR]

Ants are undisputed masters at transforming the local environments they inhabit, with subsequent vast effects on soil chemical and hydrological processes. Yet, it remains unclear how deep into the subsoil these effects range, as most ant-soil studies focus on the topsoil. Furthermore, studies quantifying these effects on podzolized, and nutrient-poor heathland soils remain scarce. We excavated 15 Formica exsecta ant mounds on a long-term, unmanaged heathland in Denmark. We sampled soil moisture, soil penetration resistance (SPR), pH, total phosphorous content, and the thickness of each soil horizon at three positions at each mound: directly below the mound, at the edge of the mound, and an adjacent undisturbed reference soil. Results revealed that ant activity reduced soil moisture, loosened the soil, and increased the flow of total phosphorus to the deeper layers. Importantly, the cemented spodic horizons (hardpans) with waterlogging properties were penetrated by ant digging, resulting in potentially higher water infiltration into the subsoil. The ant activity within the otherwise undisturbed sandy subsoil below the hard pan caused a slight alteration in the thickness of each soil horizon and chemistry. These patchy, small-scale disturbances (mounds covered 0.06 % of the site) increase heathland soil heterogeneity and affect subsoil properties in time. We conclude that ant mounds may play a previously overlooked role in heathland soil dynamics by penetrating the heathland hardpans and manipulating soil chemistry and soil moisture. We argue that a viable mound-forming ant community is valuable for the soil heterogeneity of dry heathland ecosystems. • Ants are important pedogenic factors in heathlands. • Conserving ant mounds is important for heathland soil heterogeneity. [ABSTRACT FROM AUTHOR]

Pure VO2, GexV1−xO2 (x < 0.2), and AlxV1−xO2 (x ≤ 0.02) exhibit above room temperature the well-known insulator-metal-transition (IMT) (at TIMT ≅ 340 K). In addition, AlxV1−xO2 exhibits an insulator-insulator-transition (IIT) at TIIT < TIMT. Both transitions can be induced either by external or by Joule heating. Both leave prominent marks on the I–V characteristics of the investigated samples, IIT at low currents and IMT at high currents. Reported herein is a comparative study of the I–V characteristics of needle-like pure and doped VO2 single crystals obtained with pulsed currents of various durations and with DC, in an attempt to separate thermal from non-thermal electric field effects. Identification of the Poole–Frenkel effect (a non-thermal electric field effect) in the I–V characteristics of the doped crystals may play an important role in a long-standing debate on the mechanism of IMT. Such an identification was obtained in this investigation for several Ge- and Al-doped VO2 crystals, so far only in narrow ranges of electric fields (<2000 V/cm) and pulse durations (≤1 ms) above which the non-linear conductivity of the crystals is dominated by Joule heating. [ABSTRACT FROM AUTHOR]

From the understanding of biological processes and metalloenzymes to the development of inorganic catalysts, electro‐ and photocatalytic systems for fuel generation have evolved considerably during the last decades. Recently, organic and hybrid organic systems have emerged to challenge the classical inorganic structures through their enormous chemical diversity and modularity that led earlier to their success in organic (opto)electronics. This Minireview describes recent advances in the design of synthetic organic architectures and promising strategies toward (solar) fuel synthesis, highlighting progress on materials from organic ligands and chromophores to conjugated polymers and covalent organic frameworks. [ABSTRACT FROM AUTHOR]

From the understanding of biological processes and metalloenzymes to the development of inorganic catalysts, electro‐ and photocatalytic systems for fuel generation have evolved considerably during the last decades. Recently, organic and hybrid organic systems have emerged to challenge the classical inorganic structures through their enormous chemical diversity and modularity that led earlier to their success in organic (opto)electronics. This Minireview describes recent advances in the design of synthetic organic architectures and promising strategies toward (solar) fuel synthesis, highlighting progress on materials from organic ligands and chromophores to conjugated polymers and covalent organic frameworks. [ABSTRACT FROM AUTHOR]

Policy PointsProtective transgender‐specific policies (including those related to experiences of discrimination, health insurance coverage, and changing legal documents) are associated with increased access to medical gender affirmation services (hormone treatment, therapy/counseling) for transgender and other gender‐diverse people. Restrictive transgender‐specific policies are associated with less access to these services.The relationship between race/ethnicity and use of medical gender affirmation services varies across states and is context specific, indicating that race/ethnicity also plays a role in access to these types of care across states.Advocacy is needed to prevent or overturn restrictive policies and promote protective policies for transgender and other gender‐diverse people, especially for people of color. Context: In the 2010s, the number of federal, state, and local transgender‐specific policies increased. Some of these policies advanced protections for transgender and other gender‐diverse (TGGD) people, and others were restrictive. Little is known about the relationships between these policies and use of medical gender affirmation services (eg, hormone treatment, therapy/counseling), or about how these associations may vary among different racial and ethnic groups. Methods: Multilevel modeling was used to examine the associations between state‐level transgender‐specific policies and the use of medical gender affirmation services among TGGD people in the United States. Data are from the 2015 U.S. Trans Survey of nearly 28,000 TGGD people. The medical gender affirmation services examined in this study were hormone treatment and therapy/counseling. The state policies we analyzed addressed discrimination, health insurance coverage, and changing legal documents; these policies were measured individually and as a composite index. Race/ethnicity was included in the multilevel regression models as a random slope to determine whether the relationship between race/ethnicity and the use of medical gender affirmation services varied by state. Findings: Individual policies and the policy index were associated with both outcomes (use of therapy/counseling and hormone treatment services), indicating that protective policies were associated with increased care. Broad religious exemption laws and Medicaid policies that excluded transgender‐specific care were both associated with less use of therapy/counseling, whereas transgender‐care‐inclusive Medicaid policies were associated with more use of therapy/counseling. Nondiscrimination protections that include gender identity were associated with increased use of hormone treatment services. The relationship between race/ethnicity and medical gender affirmation services varied across states. Conclusions: State‐level transgender‐specific policies influence medical gender affirmation service use and seem to affect use by non‐Hispanic white TGGD people and TGGD people of color differently. Advocacy is needed to repeal restrictive policies and promote protective policies in order to reduce health inequities among TGGD people, especially people of color. [ABSTRACT FROM AUTHOR]

Non-inductive advanced tokamak scenarios are a possible way for future nuclear fusion power plants to run in non-pulsed operation. In these scenarios, the ohmic current is replaced on the one hand with a current driven by external sources such as NBI and ECRH and on the other hand with a substantial bootstrap-current. The bootstrap current is produced in the presence of pressure gradients. This means, to increase the bootstrap-current-fraction, it is advantageous to have regions where ITG turbulence is reduced. To be able to extrapolate from non-inductive scenarios done in smaller present day devices, it is important to have transport models that allow the user to reproduce these experiments and accurately capture the physics behind the reduction of turbulent transport. One commonly used model is the quasi-linear gyrofluid transport model TGLF, which is well tested in standard scenarios. However, in the past, TGLF has failed to reproduce the peaked ion temperature profiles of certain advanced scenario shots. In this article, progress in overcoming this issue of TGLF will be discussed. Results of a recent publication are reproduced in which TGLF was able to match the experimentally measured peaked ion temperature profiles. In these simulations, we find the E × B-shear to play an important role in the reduction of ITG turbulence. In contrast to that, experimentally we find the E × B-shear to have no effect on the formation of such regions of decreased turbulent transport. This finding is in line with simulations using the gyrokinetic code GENE. A new approach of modelling these advanced scenarios in TGLF is introduced, allowing us to match the peaked ion temperature profiles without depending on the E × B-shear. [ABSTRACT FROM AUTHOR]

Introduction: The introduction and passing of restrictive and protective transgender-specific state policies have increased during the past decade. These policies are critical for the health of transgender and other gender diverse people; however, little is known about the relationship between these policies and healthcare use, and the role that race/ethnicity plays in this relationship.Methods: Analysis was conducted in 2018-2019 using multilevel modeling and data from the 2015 U.S. Trans Survey (conducted by the National Center for Transgender Equality among nearly 28,000 transgender and other gender diverse people across the U.S.) to explore associations between transgender-specific state policies and healthcare avoidance because of fear of mistreatment. State policies included those related to experiences of discrimination, health insurance coverage, and changing legal documents. Restrictive and protective policies were measured individually and as a composite index. The relationship between race/ethnicity and healthcare use was also examined to determine whether there were differences in the association between race/ethnicity and healthcare avoidance by state.Results: None of the individual policies were associated with healthcare use, but the composite index was significant, such that living in states with more protective policies was associated with reduced odds of avoiding health care because of fear of mistreatment. The relationship between race/ethnicity and health care also varied across states.Conclusions: Findings suggest the importance of advocating for more protective transgender-specific policies to improve healthcare access for transgender and other gender diverse people in the U.S., particularly for transgender and other gender diverse people of color. [ABSTRACT FROM AUTHOR]

And even in those courses where lectures assume a central role, classroom instruction does not necessarily consist in a single teacher lecturing to the students in a classroom setting. For example, students may take over the instructor's role in class by learning through teaching, and the instructor may choose to combine classroom discussion with instructional and practical elements within a teacher-centered classroom. In addition, flexible classroom settings allow the teacher to shift seamlessly between teacher-centered and student-centered learning arrangements, depending on the actual needs of the learners. Instructors withdraw from directly participating in classroom instruction and implement instead a constructive didactics that guides classroom activities at a distance. Conclusion It is often overlooked that seminar-based instruction-at least for the humanities-offers exactly what flipped classrooms tout as an innovation: students read assigned texts at home and present and discuss their findings together with their peers and the instructor in class. [Extracted from the article]

Background: Obtaining representative data from the transgender population is fundamental to improving their health and well-being and advancing transgender health research. The addition of the Behavioral Risk Factor Surveillance System (BRFSS) gender identity-measure is a promising step toward better understanding transgender health. However, methodological concerns have emerged regarding the validity of data collected from transgender participants and its effect on the accuracy of population parameters derived from those data. Objectives: The aim of the study was to provide rationale substantiating concerns with the formulation and application of the 2015 BRFSS sampling weights and address the methodological challenges that arise when using this surveillance data to study transgender population health. Methods: We examined the 2015 BRFSS methodology and used the BRFSS data to present a comparison of poor health status using two methodological approaches (a matched-subject design and the full BRFSS sample with sampling weights applied) to compare their effects on parameter estimates. Results: Measurement error engendered by BRFSS data collection procedures introduced sex/gender identity discordance and contributed to problematic sampling weights. The sex-specific "raking" algorithm used by BRFSS to calculate the sampling weights was contingent on the classification accuracy of transgender by participants. Because of the sex/gender identity discordance of 74% of the transgender women and 66% of transgender men, sampling weights may not be able to adequately remove bias. The application of sampling weights has the potential to result in inaccurate parameter estimates when evaluating factors that may influence transgender health. Discussion: Generalizationsmade from the weighted analysismay obscure the need for healthcare policy and clinical interventions aimed to promote health and prevent illness for transgender adults. Methods of public health surveillance and population surveys should be reviewed to help reduce systematic bias and increase the validity of data collected from transgender people. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) youth face disparities in bullying victimization are associated with higher rates of physical injury, psychological distress, and even suicide. Innovative strategies to address bullying victimization are needed to prevent adverse physical and mental health outcomes, including those engaging school health professionals (SHPs; school nurses, psychologists). This mixed-methods study sought to identify factors that facilitate or impede SHPs' reporting and responding to LGBTQ bullying in Massachusetts from the perspectives of LGBTQ students and SHPs. Between August 2017 and July 2018, asynchronous online focus group discussions and a brief survey were conducted separately for 28 LGBTQ students and 19 SHPs in Massachusetts (9-12 participants per group; n = 47 enrolled). Focus groups probed on bullying experiences. Rapid qualitative inquiry was used for thematic coding of facilitators and barriers to address LGBTQ student bullying described by youth and SHPs. Facilitators and barriers largely coalesced around the social ecological model. Youth and SHPs identified factors at multiple levels of the social ecological model: (1) individual (knowledge, skills, attitudes); (2) interpersonal (trust and follow-through, confidentiality and fear of being "outed," close relationships, champion SHPs); and (3) structural (school buy-in, time, reporting and protocols, staff roles, resources, and school culture of inclusivity). LGBTQ students expressed a need for an intersectional lens for SHPs when addressing LGBTQ student bullying. Interventions that help SHPs overcome multilevel barriers and leverage facilitators are needed. Consideration of intersectionality will better equip SHPs to support LGBTQ students and address disparities in LGBTQ student bullying that confer health risks. [ABSTRACT FROM AUTHOR]

The goal of this exploratory study was to delineate health differences among transgender subpopulations (transgender women/TW, transgender men/TM, gender nonbinary/GNB adults). 2015 Behavioral Risk Factor Surveillance System data were analyzed to compare the health of three groups (TW:N = 369; TM:N = 239; GNB:N = 156). Logistic regression and adjusted odds ratios were used to determine whether health outcomes (fair/poor health, frequent physical and mental unhealthy days, chronic health conditions, and health problems/impairments) are related to group and its interaction with personal characteristics and socioeconomic position. Group was a significant predictor of fair/poor health and frequent mental unhealthy days, revealing significant health differences between the transgender groups. The odds of poor/fair health were approximately 2.5 times higher in TM and GNB adults relative to TW. The odds of frequent mental unhealthy days for TM were approximately 1.5–2 times greater than TW and GNB adults. Among those with health insurance, the odds of fair/poor health for GNB adults was more than 1.5–2 times higher that of TM and TW. Among those without health insurance, TM had over 7 times greater odds of fair/poor health than TW. This study underscores the importance of classifying and examining the health of the transgender population as unique subpopulations, as notable health differences were discovered. TM and GNB adults have significant health concerns, requiring the attention of clinical interventions aimed at promoting health and preventing illness. [ABSTRACT FROM AUTHOR]

The electron cyclotron resonance heating (ECRH) system of the ASDEX Upgrade tokomak has been upgraded over the last 15 years from a 2MW, 2 s, 140 GHz system to an 8MW, 10 s, dual frequency system (105/140 GHz). The power exceeds the L/H power threshold by at least a factor of two, even for high densities, and roughly equals the installed ion cyclotron range of frequencies power. The power of both wave heating systems together (>10MW in the plasma) is about half of the available neutral beam injection (NBI) power, allowing significant variations of torque input, of the shape of the heating profile and of Qe/Qi, even at high heating power. For applications at a low magnetic field an X3-heating scheme is routinely in use. Such a scenario is now also forseen for ITER to study the first H-modes at one third of the full field. This versatile system allows one to address important issues fundamental to a fusion reactor: H-mode operation with dominant electron heating, accessing low collisionalities in full metal devices (also related to suppression of edge localized modes with resonant magnetic perturbations), influence of Te/Ti and rotational shear on transport, and dependence of impurity accumulation on heating profiles. Experiments on all these subjects have been carried out over the last few years and will be presented in this contribution. The adjustable localized current drive capability of ECRH allows dedicated variations of the shape of the q-profile and the study of their influence on non-inductive tokamak operation (so far at q95 > 5.3). The ultimate goal of these experiments is to use the experimental findings to refine theoretical models such that they allow a reliable design of operational schemes for reactor size devices. In this respect, recent studies comparing a quasi-linear approach (TGLF) with fully non-linear modeling (GENE) of non-inductive high-beta plasmas will be reported. [ABSTRACT FROM AUTHOR]

Background: Transgender men (TM) have a male, masculine, or nonfemale gender identity, yet were assigned female sex at birth on the basis of their external genitalia. The majority of TM are at risk of infection with one of several high-risk strains of the human papillomavirus (hr-HPV), acquired primarily through sexual contact, that cause 99.7% of cervical cancers. This study aimed to explore the association between sexual behaviors and current cervical hr-HPV infection in TM with a cervix.Methods: The primary aim of this analysis was to test for an association between participant self-report of sexual contact with a penis in the past 1 year and current infection with cervical hr-HPV as measured by provider-collected cervical HPV DNA assay. This is a secondary analysis of a bio-behavioral sexual health study conducted at a health center in Boston, MA from 2015 to 2016. Analysis was conducted using logistic regression with significance level set at P less than 0.05; the primary analysis was adjusted for self-reported age, current tobacco use, years of testosterone use, and HPV vaccination status.Results: Overall prevalence of hr-HPV was 15.9%. In adjusted analyses, participants reporting receptive penile vaginal sex with any of their most recent 3 sexual partners in the past 12 months had more than 5 times greater odds of current hr-HPV infection than those reporting no penile sex of any kind during this timeframe (odds ratio, 5.23; 95% confidence interval, 1.61-17.02).Conclusions: Vaginal-receptive penile sex in the last 12 months was associated with a 5-fold increased odds of cervical high-risk HPV infection among TM. Findings can inform future population level study of associations between sexual behaviors and hr-HPV risk, which could lead to more individualized approaches to screening. [ABSTRACT FROM AUTHOR]