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Water is the foundation of life, and without it life as we know it would not exist. An organism consists to a large extent of water and, apart from a few larger reservoirs, almost all water in a living organism is closely associated with surfaces of biomolecules of different kinds. This so-called biological water is known to affect the dynamics of biomaterials such as proteins, which in turn is crucial for its functions. However, how and why the surrounding environment affects the dynamics of proteins and other biomolecules is still not fully understood. Recently, it was suggested [Fenimore et al. PNAS 2004, 101 14408] that local and more global protein motions are slaved (or driven) by the local β-relaxation and the more large-scale cooperative α-relaxation in the surrounding solvent, respectively. In this chapter we present results from dielectric measurements on myoglobin in water-glycerol mixtures that support this slaving idea. Moreover, we show how confined supercooled water changes its dynamical behaviour from a low temperature Arrhenius behaviour to a high temperature non-Arrhenius behaviour at a certain temperature (around 200 K), and then we discuss likely explanations for the crossover and its consequence for protein dynamics. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Puberty suppression (PS) is a cornerstone of treatment in youth experiencing abstract gender dysphoria. In this study, we aim to inform prescribing professionals on the long-term effects of PS treatment on the development of sex characteristics and surgical implications. METHODS: Participants received PS according to the Endocrine Society guideline at Tanner 2 or higher. Data were collected from adolescents who received PS between 2006 and 2013 and from untreated transgender controls. Data collection pre- and post-PS and before surgery included physical examination and surgical information. RESULTS: In total, 300 individuals (184 transgender men and 116 transgender women) were included. Of these, 43 individuals started PS treatment at Tanner 2/3, 157 at Tanner 4/5, and 100 used no PS (controls). Breast development was significantly less in transgender men who started PS at Tanner 2/3 compared with those who started at Tanner 4/5 and controls. Mastectomy was more frequently omitted or less invasive after PS. In transgender women, the mean penile length was significantly shorter in the PS groups compared with controls (by 4.8 cm [Tanner 2/3] and 2.1 cm [Tanner 4/5]). As a result, the likelihood of undergoing intestinal vaginoplasty was increased (odds ratio = 84 [Tanner 2/3]; odds ratio = 9.8 [Tanner 4/5]). CONCLUSIONS: PS reduces the development of sex characteristics in transgender adolescents. As a result, transgender men may not need to undergo mastectomy, whereas transgender women may require an alternative to penile inversion vaginoplasty. These surgical implications should inform decision-making when initiating PS. [ABSTRACT FROM AUTHOR]

Transgender and gender-nonconforming (TGNC) youth who suffer from gender dysphoria are at a substantially elevated risk of numerous adverse physical and psychosocial outcomes compared with their cisgender peers. Innovative treatment options used to support and affirm an individual's preferred gender identity can help resolve gender dysphoria and avoid many negative sequelae of nontreatment. Yet, despite advances in these relatively novel treatment options, which appear to be highly effective in addressing gender dysphoria and mitigating associated adverse outcomes, ethical challenges abound in ensuring that young patients receive appropriate, safe, affordable treatment and that access to this treatment is fair and equitable. Ethical considerations in gender-affirming care for TGNC youth span concerns about meeting the obligations to maximize treatment benefit to patients (beneficence), minimizing harm (nonmaleficence), supporting autonomy for pediatric patients during a time of rapid development, and addressing justice, including equitable access to care for TGNC youth. Moreover, although available data describing the use of gender-affirming treatment options are encouraging, and the risks of not treating TGNC youth with gender dysphoria are evident, little is known about the long-term effects of both hormonal and surgical interventions in this population. To support ethical decision-making about treatment options, we encourage the development of a comprehensive registry in the United States to track long-term patient outcomes. In the meantime, providers who work with TGNC youth and their families should endeavor to offer ethically sound, patient-centered, gender-affirming care based on the best currently available evidence. [ABSTRACT FROM AUTHOR]