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Background Objective Materials and methods Results Discussion and conclusions There are limited data on pelvic pain among transgender men and gender diverse people, and the impact of testosterone on pelvic pain is poorly understood.Characterize the prevalence and correlates of chronic pelvic pain (CPP) among transgender men and gender diverse people and examine the association between testosterone use and CPP.We used 2020–2022 data from The Population Research in Identity and Disparities for Equality (PRIDE) Study, an online prospective cohort study of sexual and gender minority adults in the United States, to conduct complementary cross‐sectional and longitudinal analyses. Our primary outcome was self‐reported CPP lasting 3 months or longer measured using the Michigan Body Map.Among 2579 transgender men and gender diverse people assigned female at birth included in our sample, 457 (18%) reported CPP. CPP correlates included: inflammatory bowel disease, irritable bowel syndrome (IBS), kidney stones, pelvic inflammatory disease, polycystic ovary syndrome (PCOS), uterine fibroids, current hormonal intrauterine device use, prior pregnancy, vaginal delivery, hysterectomy, and oophorectomy. Individuals with CPP reported a high prevalence of IBS (37%), PCOS (20%), uterine fibroids (9%), post‐traumatic stress disorder (51%), and severe depression and anxiety symptoms (42% and 25%, respectively). Current testosterone use was associated with a 21% lower prevalence of CPP (adjusted prevalence ratio (aPR) 0.79, 95% confidence interval [CI]: 0.65–0.96). In longitudinal analyses (N = 79), 15 (19%) participants reported any CPP after initiating testosterone: eight (56%) of whom reported CPP prior to testosterone initiation, and seven (47%) who reported new‐onset CPP.The relationship between CPP and testosterone is complex. Although testosterone use was associated with a lower prevalence of CPP, some transgender and gender diverse individuals experienced new‐onset pelvic pain after testosterone initiation. Given the significant impact that CPP can have on mental health and quality of life, future research must examine the role of testosterone in specific underlying etiologies of CPP and identify potential therapies. [ABSTRACT FROM AUTHOR]

The article examines chronic pain prevalence among sexual and gender minority (SGM) individuals based on data from The PRIDE Study, highlighting disparities compared to cisgender and heterosexual populations. It analyzes pain distribution across various body regions, identifies factors influencing chronic pain presence, and underscores the need for tailored healthcare approaches for SGM communities.

Objectives. To examine inequities in conversion practice exposure across intersections of ethnoracial groups and gender identity in the United States. Methods. Data were obtained from The Population Research in Identity and Disparities for Equality Study of sexual and gender minority people from 2019 to 2021 (n = 9274). We considered 3 outcomes: lifetime exposure, age of first exposure, and period between first and last exposure among those exposed to conversion practices. We used log-binomial, Cox proportional hazards, and negative binomial models to examine inequities by ethnoracial groups and gender identity adjusting for confounders. We considered additive interaction. Results. Conversion practice prevalence was highest among minoritized ethnoracial transgender and nonbinary participants (TNB; 8.6%). Compared with White cisgender participants, minoritized ethnoracial TNB participants had twice the prevalence (prevalence ratio = 2.16; 95% confidence interval [CI] = 1.62, 2.86) and risk (hazard ratio = 2.04; 95% CI = 1.51, 2.69) of conversion practice exposure. Furthermore, there was evidence of a positive additive interaction for age of first exposure. Conclusions. Minoritized ethnoracial TNB participants were most likely to recall experiencing conversion practices. Public Health Implications. Policies banning conversion practices may reduce the disproportionate burden experienced by minoritized ethnoracial TNB participants. (Am J Public Health. 2024;114(4):424–434. https://doi.org/10.2105/AJPH.2024.307580) [ABSTRACT FROM AUTHOR]

Background: Although the Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used self-report assessments of eating disorder symptoms, evidence indicates potential limitations with its original factor structure and associated psychometric properties in a variety of populations, including sexual minority populations. The aims of the current investigation were to explore several previously published EDE-Q factor structures and to examine internal consistency and measurement invariance of the best-fitting EDE-Q model in a large community sample of cisgender gay men and cisgender lesbian women. Methods: Data were drawn from 1624 adults (1060 cisgender gay men, 564 cisgender lesbian women) who participated in The PRIDE Study, a large-scale longitudinal cohort study of sexual and gender minorities from the United States. A series of confirmatory factor analyses (CFAs) were conducted to explore the fit of eight proposed EDE-Q models; internal consistency (Cronbach's alphas, Omega coefficients) and measurement invariance (multi-group CFA) were subsequently evaluated. Results: A brief seven-item, three-factor (dietary restraint, shape/weight overvaluation, body dissatisfaction) model of the EDE-Q from Grilo et al. (Obes Surg. 23:657–662, 2013), consistently evidenced the best fit across cisgender gay men and lesbian women. The internal consistencies of the three subscales were adequate in both groups, and measurement invariance across the groups was supported. Conclusions: Taken together, these findings support the use of the seven-item, three-factor version of the EDE-Q for assessing eating disorder symptomatology in cisgender gay men and lesbian women. Future studies can confirm the current findings in focused examinations of the seven-item, three-factor EDE-Q in diverse sexual minority samples across race, ethnicity, socioeconomic status, and age ranges. Plain English summary: We asked cisgender gay men and lesbian women in The PRIDE Study to fill out a widely used survey about eating disorders, the Eating Disorder Examination-Questionnaire. We found that a version of this questionnaire based on seven questions including three parts—(1) dietary restraint, (2) shape and weight overvaluation, and (3) body dissatisfaction—had the best fit. These findings can assist doctors and scientists in understanding eating disorders in cisgender gay men and lesbian women. [ABSTRACT FROM AUTHOR]

Objectives. To examine the associations of self-reported disability status with health care access barriers for sexual and gender minority (SGM) people. Methods. The Population Research in Identity and Disparities for Equality (PRIDE) Study participants lived in the United States or its territories, completed the 2019 annual questionnaire (n = 4961), and self-reported their disability and health care access experiences, including whether they had a primary care provider, were uninsured, delayed care, and were unable to obtain care. We classified disabilities as physical, mental, intellectual, and other; compared participants to those without disabilities; and performed logistic regression to determine the associations of disability status and health care access barriers. Results. SGM people with disabilities were less likely to have a usual place to seek health care (69.0% vs 75.3%; P ≤.001) and more often reported being mistreated or disrespected as reasons to delay care (29.0% vs 10.2%; P ≤.001). SGM people with disabilities were more likely to delay care (adjusted odds ratio [AOR] = 3.28; 95% confidence interval [CI] = 2.83, 3.81) and be unable to obtain care (AOR = 3.10; 95% CI = 2.59, 3.71). Conclusions. Future work should address culturally competent health care to ameliorate disparities for the SGM disability community. (Am J Public Health. 2023;113(9):1009–1018. https://doi.org/10.2105/AJPH.2023.307333) [ABSTRACT FROM AUTHOR]

Objective: The Eating Disorder Examination‐Questionnaire (EDE‐Q) is one of the most widely used self‐report assessments of eating disorder symptoms. However, evidence indicates potential problems with its original factor structure and associated psychometric properties in a variety of populations, including gender minority populations. The aim of the current investigation was to explore several previously published EDE‐Q factor structures and to examine internal consistency and measurement invariance of the best‐fitting EDE‐Q model in a large community sample of gender minority adults. Methods: Data were drawn from 1567 adults (337 transgender men, 180 transgender women, and 1050 gender‐expansive individuals) who participated in The PRIDE Study, a large‐scale longitudinal cohort study of sexual and gender minorities from the United States. A series of confirmatory factor analyses (CFAs) were conducted to explore the fit of eight proposed EDE‐Q models; internal consistency (Cronbach's alphas, Omega coefficients) and measurement invariance (multi‐group CFA) were subsequently evaluated. Results: A brief seven‐item, three‐factor (dietary restraint, shape/weight overvaluation, body dissatisfaction) model of the EDE‐Q consistently evidenced the best fit across gender minority groups (transgender men, transgender women, gender‐expansive individuals). The internal consistencies of the three subscales were adequate in all groups, and measurement invariance across the groups was supported. Discussion: Taken together, these findings support the use of the seven‐item, three‐factor version of the EDE‐Q for assessing eating disorder symptomatology in gender minority populations. Future studies can confirm the current findings in focused examinations of the seven‐item, three‐factor EDE‐Q in diverse gender minority samples across race, ethnicity, socioeconomic status, and age ranges. Public Significance Statement: Although transgender individuals have greater risk of developing an eating disorder, the factor structure of the Eating Disorder Examination‐Questionnaire, one of the most widely used eating disorder assessment measures, has not been explored in transgender adults. We found that a seven‐item model including three factors of dietary restraint, shape and weight overvaluation, and body dissatisfaction had the best fit among transgender and nonbinary adults. Key PointsWe assessed the Eating Disorder Examination‐Questionnaire in transgender men, transgender women, and gender‐expansive people.Confirmatory factor analysis of a seven‐item model had the best fit among gender minority people.The three factors included dietary restraint, shape and weight overvaluation, and body dissatisfaction.Internal consistencies of the three subscales and measurement invariance were adequate in all groups. [ABSTRACT FROM AUTHOR]

Although reading fluency is one of the five essential early-reading skills students must develop, many elementary-aged students in the United States do not read age-appropriate material fluently. As such, small-group interventions are practical and often more time efficient than individualized interventions aimed to address this problem. However, few small-group interventions targeting students' reading fluency have been empirically evaluated. The primary purpose of this study was to examine three small-group reading interventions that have been used to improve students' reading fluency (repeated reading, listening passage preview, and listening only). Using an alternating-treatments design, the effects of each intervention were evaluated with four-second-grade students with average to below average reading skills. Students' words read correctly per minute (immediately following and 2 days after intervention) served as the outcome measures. Results supported the repeated reading intervention, followed by listening passage preview, as most effective. Findings also suggested that improvements from each intervention remained 2 days later.

Results of a study involving 340 Japanese and 272 U.S. college students and another study with 206 Japanese and 681 U.S. college students found that 21 scenarios did contain different Japanese and American behavioral rules. Results of the second study showed the multidimensionality of the behavioral rules and the difficulties of intercultural situations. (SLD)

In July 2023, the US Food and Drug Administration approved the first nonprescription oral contraceptive, a progestin-only pill, in the United States. Transgender, nonbinary, and gender-expansive people assigned female or intersex at birth face substantial contraceptive access barriers and may benefit from over-the-counter oral contraceptive access. However, no previous research has explored their perspectives on this topic. This study aimed to measure interest in over-the-counter progestin-only pill use among transgender, nonbinary, and gender-expansive individuals assigned female or intersex at birth. We conducted an online, cross-sectional survey from May to September 2019 (before the US Food and Drug Administration approval of a progestin-only pill) among a convenience sample of transgender, nonbinary, and gender-expansive people assigned female or intersex at birth who were aged 18 to 49 years from across the United States. Using descriptive statistics and logistic regression analyses, we estimated interest in over-the-counter progestin-only pill use (our outcome) overall and by sociodemographic and reproductive health characteristics (our exposures). We evaluated separate logistic regression models for each exposure. In each model, we included the minimally sufficient adjustment set to control for confounding pathways between the exposure and outcome. For the model for age, we ran a univariable logistic regression model; for all other exposures, we ran multivariable logistic regression models. Among 1415 participants in our sample (median age, 26 years), 45.0% (636/1415; 95% confidence interval, 42.3–47.6) were interested in over-the-counter progestin-only pill use. In separate logistic regression models for each exposure, there were higher odds of interest among participants who were aged 18 to 24 years (odds ratio, 1.67; 95% confidence interval, 1.33–2.10; vs those aged 25–34 years), those who were uninsured (adjusted odds ratio, 1.91; 95% confidence interval, 1.24–2.93; vs insured), those who currently used oral contraceptives (adjusted odds ratio, 1.69; 95% confidence interval, 1.17–2.44; vs non-users), had ≤high school degree (adjusted odds ratio, 3.02; 95% confidence interval, 1.94–4.71; vs college degree), had ever used progestin-only pills (adjusted odds ratio, 2.32; 95% confidence interval, 1.70–3.17; vs never users), and who wanted to avoid estrogen generally (adjusted odds ratio, 1.32; 95% confidence interval, 1.04–1.67; vs those who did not want to avoid estrogen generally) or specifically because they viewed it as a feminizing hormone (adjusted odds ratio, 1.72; 95% confidence interval, 1.36–2.19; vs those who did not want to avoid estrogen because they viewed it as a feminizing hormone). There were lower odds of interest among participants with a graduate or professional degree (adjusted odds ratio, 0.70; 95% confidence interval, 0.51–0.96; vs college degree), those who were sterilized (adjusted odds ratio, 0.31; 95% confidence interval, 0.12–0.79; vs not sterilized), and those who had ever used testosterone for gender affirmation (adjusted odds ratio, 0.72; 95% confidence interval, 0.57–0.90; vs never users). Transgender, nonbinary, and gender-expansive individuals were interested in over-the-counter progestin-only pill use, and its availability has the potential to improve contraceptive access for this population. [ABSTRACT FROM AUTHOR]

Regional‐scale estimations of sorghum biomass production allow identification of optimum genotype×environment×management (G×E×M) combinations for bioenergy generation. The objective of this study was to determine the degree of contributions of G, E, and M toward variability in sorghum biomass in the United States. Using the Agricultural Production Systems sIMulator in a grid computing platform, biomass was simulated for irrigated and rainfed conditions for 30 years across the United States for four sorghum varietal types (grain—GS, sudangrass—SS, photosensitive—PS, and photo‐insensitive—PI). Simulated biomass was assessed by environments clustered using the sum of intercepted solar radiation (ir), mean of temperature stress factor (tp) and water stress factor (sw). Simulated biomass ranged from 5.8 t ha−1 (GS‐rainfed) to 27.5 t ha−1 (PI‐irrigated). Under high‐temperature environments (mean annual temperature = 25°C), rainfed biomass between 40 and 80 days after planting (DAP) was strongly correlated with sw (r = 0.64–0.86) and irrigated biomass with ir (r = 0.68–0.81). Under low‐temperature environments (mean annual temperature = 18°C) after 40 DAP, tp and ir had greater effects than sw (r = 0.55–0.82). Biomass variance was mainly explained by varietal type (50%–76%) in all environments×irrigation combinations, except in the high‐ and mid‐temperature environments under rainfed conditions where rainfall had the major effect (25%–45%). However, when mean temperature during the growing season decreased from 25°C (high environments) to 18°C (low environments), the contribution of mean temperature to biomass variance increased from 7% to 34% (rainfed) and from 4% to 36% (irrigated). Varietal type had the larger interactions with other factors independently of the environment and irrigation. We demonstrated a need to quantify (i) the main G×E×M drivers of biomass variability based on environmental stress factors and (ii) the variance contribution of these drivers on sorghum biomass. Our regional‐scale estimations are key inputs for future robust biomass projections of energy sorghum genotypes integrating G×E×M under climate change scenarios. [ABSTRACT FROM AUTHOR]

Testosterone use among transgender people likely impacts their experience of sexual function and vulvovaginal pain via several complex pathways. Testosterone use is associated with decreased estrogen in the vagina and atrophic vaginal tissue, which may be associated with decreased vaginal lubrication and/or discomfort during sexual activity. At the same time, increased gender affirmation through testosterone use may be associated with improved sexual function. However, data on pelvic and vulvovaginal pain among transgender men and nonbinary people assigned female at birth are scarce. This study aimed to assess the association between testosterone and sexual function with a focus on symptoms that are commonly associated with vaginal atrophy. We conducted a cross-sectional analysis of 1219 participants aged 18 to 72 years using data collected from 2019 to 2021 from an online, prospective, longitudinal cohort study of sexual and/or gender minority people in the United States (The Population Research in Identity and Disparities for Equality Study). Our analysis included adult transgender men and gender diverse participants assigned female at birth who were categorized as never, current, and former testosterone users. Sexual function was measured across 8 Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction domains. Overall, 516 (42.3%) participants had never used testosterone, and 602 (49.4%) currently used testosterone. The median duration of use was 37.7 months (range, 7 days to >27 years). Most participants (64.6%) reported genital pain or discomfort during sexual activity in the past 30 days, most commonly in the vagina or frontal genital opening (52.2%), followed by around the clitoris (29.1%) and labia (24.5%). Current testosterone use was associated with a greater interest in sexual activity (β=6.32; 95% confidence interval, 4.91–7.74), higher ability to orgasm (β=1.50; 95% confidence interval, 0.19-2.81), and more vaginal pain or discomfort during sexual activity (β=1.80; 95% confidence interval, 0.61–3.00). No associations were observed between current testosterone use and satisfaction with sex life, lubrication, labial pain or discomfort, or orgasm pleasure. Testosterone use among transgender men and gender diverse people was associated with an increased interest in sexual activity and the ability to orgasm, as well as with vaginal pain or discomfort during sexual activity. Notably, the available evidence demonstrates that >60% of transgender men experience vulvovaginal pain during sexual activity. The causes of pelvic and vulvovaginal pain are poorly understood but are likely multifactorial and include physiological (eg, testosterone-associated vaginal atrophy) and psychological factors (eg, gender affirmation). Given this high burden, there is an urgent need to identify effective and acceptable interventions for this population. [ABSTRACT FROM AUTHOR]

This Note addresses whether the president may take action on immigration as an exercise of foreign affairs power. In particular, it focuses on DACA and DAPA, two Obama-era policies of deferred action for certain classes of undocumented immigrants. Exactly how much authority a president and his executive departments should have over immigration without running afoul of Congress's Article I power "to create a uniform Rule of Naturalization" is still unsettled. Furthermore, it is shaded in public debate by partisan views on immigration and how much power a given party thinks its own president should have. As immigrants still formally owe their allegiance to a foreign sovereign, might the executive branch perform lenient or ameliorative actions over them via executive foreign affairs power? Would that only add to the trend of creating a more monarchical presidency? What would the boundaries of this power look like? This Note posits that presidential foreign affairs authority, based on past practice, supports the president's power to offer limited forms of immigration relief, at least in the absence of clear congressional prohibition, if the president judges that denying such relief might have foreign affairs consequences. [ABSTRACT FROM AUTHOR]

Concomitant spine and hip disease in patients undergoing total hip arthroplasty (THA) presents a management challenge. Degenerative lumbar spine conditions are known to decrease lumbar lordosis and limit lumbar flexion and extension, leading to altered pelvic mechanics and increased demand for hip motion. In this study, the effect of lumbar spine disease on complications after primary THA was assessed. The Medicare database was searched from 2005 to 2012 using International Classification of Diseases, Ninth Revision, procedure codes for primary THA and diagnosis codes for preoperative diagnoses of lumbosacral spondylosis, lumbar disk herniation, acquired spondylolisthesis, and degenerative disk disease. The control group consisted of all patients without a lumbar spine diagnosis who underwent THA. The risk ratios for prosthetic hip dislocation, revision THA, periprosthetic fracture, and infection were significantly higher for all 4 lumbar diseases at all time points relative to controls. The average complication risk ratios at 90 days were 1.59 for lumbosacral spondylosis, 1.62 for disk herniation, 1.65 for spondylolisthesis, and 1.53 for degenerative disk disease. The average complication risk ratios at 2 years were 1.66 for lumbosacral spondylosis, 1.73 for disk herniation, 1.65 for spondylolisthesis, and 1.59 for degenerative disk disease. Prosthetic hip dislocation was the most common complication at 2 years in all 4 spinal disease cohorts, with risk ratios ranging from 1.76 to 2.00. This study shows a significant increase in the risk of complications following THA in patients with lumbar spine disease. [Orthopedics. 2017; 40(3):e520-e525.]. [ABSTRACT FROM AUTHOR]

Purpose: Solid organ transplants (SOT) continue to increase with recipients living longer than ever before. The lifelong immunosuppression in these patients also may place them at increased risk for postoperative complications. The efficacy of total hip arthroplasty (THA) in this patient population is undisputed but previous studies investigating the complication profiles in these patients often are underpowered to identify rare complications as well as make comparisons between individual organs. The purpose of this study was to use a large database to compare complications of a combined SOT cohort as well as each individual organ to a control population.Methods: A search of the entire Medicare database from 2005 to 2011 was performed using International Classification of Disease version 9 (ICD-9) codes to identify patients who underwent THA after one or more solid organ transplants. A large cohort of patients served as a control with minimum 2-year follow-up. Post-operative complications at 30-day, 90-day, and overall time points were investigated.Results: Transplant patients carry more medical comorbidities and are prone to increased medical complications, dislocations (OR 1.45, p < 0.001), need for irrigation and debridement (OR 1.90, p < 0.001), and periprosthetic infection (OR 1.69, p < 0.001) compared to patients without SOT. Total hip arthroplasty after renal transplantation has the worst complication profile of the individual organs whereas lung and pancreas transplants were no different than control with regard to overall surgical complications.Conclusions: The complications of THA after SOT vary by individual organ and these results may aid in patient selection and perioperative patient counseling. [ABSTRACT FROM AUTHOR]

Purpose We evaluated the short and long-term surgical outcomes of urinary diversion done for urinary adverse events arising from prostate radiation therapy. We hypothesized that patient characteristics are associated with complications after urinary diversion. Materials and Methods We performed a retrospective cohort study of 100 men who underwent urinary diversion (urinary conduit or continent catheterizable pouch) due to urinary adverse events after prostate radiotherapy from 2007 to 2016 from 9 academic centers in the United States. Outcome measurements included predictors of short and long-term complications, and readmission after urinary diversion of patients who had prostate cancer treated with radiotherapy. The data were summarized using descriptive statistics and univariate associations with complications were identified with logistic regression controlling for center. Results Mean patient age was 71 years and median time from radiotherapy to urinary diversion was 8 years. Overall 81 (81%) patients had combined modality therapy (radical prostatectomy plus radiotherapy or various combinations of radiotherapy). Grade 3a or greater Clavien-Dindo complications occurred in 31 (35%) men, including 4 deaths (4.5%). Normal weight men had more short-term complications compared to overweight (OR 4.9, 95% CI 1.3–23.1, p=0.02) and obese men (OR 6.3, 95% CI 1.6–31.1, p=0.009). Hospital readmission within 6 weeks of surgery occurred for 35 (38%) men. Surgery was needed to treat long-term complications after urinary diversion in 19 (22%) patients with a median followup of 16.3 months. Conclusions Urinary diversion after prostate radiotherapy has a considerable short and long-term surgical complication rate. Urinary diversion most often cannot be avoided in these patients but appreciation of the risks allows for informed shared decision making between surgeons and patients. [ABSTRACT FROM AUTHOR]

Purpose We determined the rates of deep venous thromboembolism and pulmonary embolism after common urological procedures in the United States. Materials and Methods The NSQIP database was used to identify common urological procedures performed between January 1, 2005 and December 31, 2011. A total of 82,808 patients were included in the study. Results Overall 633 (0.76% of 82,808 subjects) deep venous thromboses occurred within 30 days of surgery in this cohort of patients treated with common urological procedures. Among procedures performed at least 500 times the rates of deep venous thrombosis were highest for cystectomy/urinary diversion (3.96% [71/1,792]), partial cystectomy (2.35% [17/722]) and open radical nephrectomy (1.67% [45/2,702]). The rates of deep venous thrombosis were lowest in patients undergoing laparoscopic colpopexy (0.00% [0/707]), placement of a female sling (0.08% [9/10,648]) and hydrocelectomy/spermatocelectomy/varicocelectomy (0.13% [3/2,333]). A total of 349 (0.42%) pulmonary embolisms occurred in this cohort, with cystectomy/urinary diversion having the highest rate overall (2.85% [51/1,792]). Multivariate logistic regression revealed that age greater than 60 years, functional status, history of disseminated cancer, congestive heart failure, anesthesia time greater than 120 minutes and chronic steroid use were independently associated with the formation of deep venous thrombosis/pulmonary embolism. A limitation of the study is that no data were available on thromboembolic prophylaxis. Conclusions While deep venous thrombosis and pulmonary embolism are uncommon after urological surgery, this study is the first to our knowledge to provide a comprehensive comparison of deep venous thrombosis/pulmonary embolism rates across a full spectrum of various urological procedures in American patients. This study should give the reader a better understanding of the exact risk faced by the patient when undergoing common urological procedures. [ABSTRACT FROM AUTHOR]

Background and Purpose: No published data to date have assessed the insurance-related disparities among patients undergoing percutaneous nephrolithotomy (PCNL). Our objective was to examine whether being uninsured is associated with more perioperative complications after PCNL in the United States and to determine possible risk factors that influence PCNL outcomes. Patients and Methods: This retrospective cohort study evaluated 13,982 patients who underwent PCNL and were included in Nationwide Inpatient Sample from 1998 through 2010. The main outcome measure was ≥1 perioperative complication stratified by insurance status. Associations between this outcome and insurance status were examined using logistic regression models. Results: The overall percentage of patients with ≥1 perioperative complication after PCNL was 14.4% ( n=2008). When stratified by insurance status, the unadjusted analysis showed significantly higher complication rates among Medicare (17.1%) and Medicaid (16.9%) beneficiaries than privately insured (12.3%) and uninsured (13.4%) patients ( P<0.001). In a fully adjusted analysis of patients without medical comorbidity, however, these differences were no longer statistically significant, even when stratified by hospital teaching status. Multivariable-adjusted analysis of preoperative medical comorbidity showed that pulmonary disorders (odds ratio [OR], 7.77; 95% confidence interval [CI], 4.54-13.31), coagulopathy (OR, 6.16; 95% CI, 4.27-8.89), deficiency anemias (OR, 3.82; 95% CI, 3.29-4.44), and paralysis (OR, 2.16; 95% CI, 1.78-2.61) were the strongest predictors of ≥1 perioperative complication. Conclusions: Perioperative morbidity after PCNL varied significantly with insurance status, but this variation was explained mostly by differences in overall health status. [ABSTRACT FROM AUTHOR]

Abstract: The potential of continental low-angle normal faults (LANF) to nucleate large (>6.0 Mw) earthquakes at low-angles remains unclear despite much focused research. We document evidence for ancient seismicity along a continental LANF (detachment fault) that formed and slipped at low-angles and produced tectonic pseudotachylyte. These thick and laterally persistent pseudotachylyte accumulations along the West Salton detachment fault (WSDF), Salton Trough, USA, preserve convincing evidence for a frictional melt origin including: spherulitic microlites, ductile-flow structures, preservation of high temperature phases as clasts, and injection veins. Cumulative thickness of pseudotachylyte along the fault ranges from 0.1 to 1.5 m, and pseudotachylyte–cataclasite in the fault core and damage zone are exposed along ∼2.6 km length of the fault. Reworked fragments of pseudotachylyte in cataclasites, and multiple generations of cataclasites provide evidence for the preservation of multiple earthquake cycles. The limited exposure (<3% of the total exposed length), and unusually large volumes of pseudotachylyte along this section of the WSDF suggest special conditions for generation of frictional melt. Prior work, documenting the low dip of the WSDF throughout its history and abundant evidence for ancient seismicity presented here, shows that research must focus on explanations for LANF formation and slip that incorporate seismic slip. A new synthesis of pseudotachylyte along detachment faults from diverse tectonic settings provides convincing evidence that repeated ancient seismicity is common along detachment faults. These data constrain models for low-angle normal fault formation and strength. These results also have important implications for the evaluation of seismic hazards associated with active examples of LANF. [Copyright &y& Elsevier]

OBJECTIVE To determine the extent to which the year of diagnosis, year of birth, and age at diagnosis influence the incidence trends of kidney cancer in the United States. METHODS Cancer registry data from the National Cancer Institute's Surveillance, Epidemiology, and End- Results (SEER) program were obtained for 64,041 patients with kidney cancer diagnosed between 1973 and 2008. Overall and age-specific incidence rates were calculated and adjustments were made for birth cohort and period effects. Results were stratified by race and sex. Age-period-cohort analysis was used to examine the effects of age, year of diagnosis (period), and year of birth (cohort) on incidence trends. RESULTS The overall age-standardized annual incidence per 100,000 increased during the study period (1973 to 2008) by race, from 6.75 (95% confidence interval, 6.18-7.36) to 19.56 (18.85-20.20) among whites, from 5.31 (3.50-7.71) to 25.38 (23.00-27.92) among blacks, and from 5.61 (3.50-8.50) to 13.98 (12.41-15.71) among other races; and by sex, from 9.44 (8.49-10.47) to 26.48 (25.39-27.60) among men and from 4.21 (3.65-4.84) to 13.38 (12.64-14.11) among women. Age-period-cohort analysis revealed a strong influence from period and cohort effects. The 1983 birth cohort, for example, had a 2-fold increase in kidney cancer (incidence rate ratio, 1.93 [1.63-2.25]) compared with the referent 1948 cohort. CONCLUSION From 1973 to 2008, the incidence rate of kidney cancer increased for each sex and race across all age groups. Age-period-cohort models revealed that period-related factors, although significant, cannot alone account for these unfavorable temporal trends. [ABSTRACT FROM AUTHOR]

Weed management is one of the most important considerations impacting sorghum [Sorghum bicolor (L.) Moench] production in the United States today. The objectives of this study were to evaluate the level of resistance, type of inheritance, and causal mutation of wild sorghum accessions that are resistant to acetyl-coenzyme A carboxylase (ACCase)-inhibiting herbicides compared to susceptible grain sorghum seed parents. Acetyl-coenzyme A carboxylase-inhibiting herbicides used in this study were fluazifop-P and quizalofop-P from the aryloxyphenoxypropionate (APP) family and clethodim and sethoxydim from the cyclohexanedione (CHD) family. Dose-response studies indicated the level of resistance was very high for APP herbicides but low to nonexistent for CHD herbicides. Estimates of the resistance factors to APP herbicides based on herbicide rate required for 50% growth reduction (GR50) were 54 to 64 for homozygous plants and 9 to 19 for heterozygous plants. Resistance to CHD herbicides was very low with resistance factors ranging from one to about five. Genetic segregation studies indicated a single gene is the cause of resistance to APP herbicides. Polymerase chain reaction (PCR) amplicons from the carboxyl transferase (CT) domain of the chloroplast directed ACCase gene were sequenced and a single point mutation that results in a cysteine replacing tryptophan (conversion from tryptophan at amino acid position 2027 to cysteine [Trp-2027-Cys]) was discovered. Given the high level of herbicide resistance and simple inheritance, these sources of APP resistance may provide useful herbicide resistance traits for use in sorghum. [ABSTRACT FROM AUTHOR]

The capacity of perennial grasses to affect change in soil properties is well documented but information on switchgrass ( Panicum virgatum L.) managed for bioenergy is limited. An on-farm study (10 fields) in North Dakota, South Dakota, and Nebraska was sampled before switchgrass establishment and after 5 years to determine changes in soil bulk density (SBD), pH, soil phosphorus (P), and equivalent mass soil organic carbon (SOC). Changes in SBD were largely constrained to near-surface depths (0-0.05 m). SBD increased (0-0.05 m) at the Nebraska locations (mean=0.16 Mg m−3), while most South Dakota and North Dakota locations showed declines in SBD (mean=−0.18 Mg m−3; range=−0.42-0.07 Mg m−3). Soil pH change was significant at five of the 10 locations at near surface depths (0-0.05 m), but absolute changes were modest (range=−0.67-0.44 pH units). Available P declined at all sites where it was measured (North Dakota and South Dakota locations). When summed across the surface 0.3 m depth, annual decreases in available P averaged 1.5 kg P ha−1 yr−1 (range=0.5-2.8 kg P ha−1 yr−1). Averaged across locations, equivalent mass SOC increased by 0.5 and 2.4 Mg C ha−1 yr−1 for the 2500 and 10 000 Mg ha−1 soil masses, respectively. Results from this study underscore the contribution of switchgrass to affect soil property changes, though considerable variation in soil properties exists within and across locations. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined lesbian, gay, bisexual and transgender (LGBT)-related medical curricula and associated curricular development practices, as well as deans' assessments of their institutions' LGBT-related curricular content. It cites the participation of allopathic or osteopathic medical schools in Canada and the U.S. in the study. Results of the study showed that five hours are the median reported time dedicated to teaching LGBT-related content. Findings also revealed lower teaching frequency of LGBT-specific topic areas in the required curriculum.

Sweet sorghum has the potential to become a versatile feedstock for large-scale bioenergy production given its sugar from stem juice, cellulose/hemicellulose from stalks, and starch from grain. However, for researchers to maximize its feedstock potential a first step includes additional evaluations of the 2,180 accessions with varied origins in the US historic sweet sorghum collection. To assess genetic diversity of this collection for bioenergy breeding and population structure for association mapping, we selected 96 accessions and genotyped them with 95 simple sequence repeat markers. Subsequent genetic diversity and population structure analysis methods identified four subpopulations in this panel, which correlated well with the geographic locations where these accessions originated or were collected. Model comparisons for three quantitative traits revealed different levels of population structure effects on flowering time, plant height, and brix. Our results suggest that diverse germplasm accessions curated from different geographical regions should be considered for plant breeding programs to develop sweet sorghum cultivars or hybrids, and that this sweet sorghum panel can be further explored for association mapping. [ABSTRACT FROM AUTHOR]

Objectives: We sought to review the clinical sequelae and imaging manifestations of thoracic aortic endograft collapses and infoldings and to evaluate minimally invasive methods of repairing such collapses. Methods: Two hundred twenty-one Gore endografts (Excluder, TAG; W. L. Gore & Associates, Inc, Flagstaff, Ariz) were deployed in 145 patients for treatment of pathologies including aneurysms and pseudoaneurysms, dissections, penetrating ulcers, transections, fistulae, mycotic aneurysms, and neoplastic invasions in 6 different prospective trials at a single institution from 1997 to 2007. Device collapses and infoldings were analyzed retrospectively, including review of anatomic parameters, pathologies treated, device sizing and selection, clinical sequelae, methods of repair, and outcome. Results: Six device collapses and infoldings were identified. Oversized devices placed into small-diameter aortas and imperfect proximal apposition to the lesser curvature were seen in all proximal collapses, affecting patients with transections and pseudoaneurysms. Infoldings in patients undergoing dissection represented incomplete initial expansion rather than delayed collapse. Delayed collapse occurred as many as 6 years after initial successful deployment, apparently as a result of changes in the aortic configuration from aneurysmal shrinkage. Clinical manifestations ranged from life-threatening ischemia to complete lack of symptoms. Collapses requiring therapy were remedied percutaneously by bare stenting or in one case by branch vessel embolization. Conclusions: Use of oversized devices in small aortas carries a risk of device failure by collapse, which can occur immediately or after years of delay. When clinically indicated, percutaneous repair can be effectively performed. [Copyright &y& Elsevier]

Radiance Research M903 nephelometers have been operated at remote Australian Outback sites since April 1998. This paper describes the calibration procedures applied to these instruments and reports on the noise performance and other operational issues. It is found that instrument noise leads to a detection limit of ∼0.2 Mm-1 in scattering coefficient at the 95% confidence interval for a 5-min integration. Changes in ambient temperature cause drift with a coefficient of ∼0.06 Mm-1 K-1, leading to a typical diurnal drift of amplitude ∼0.9 Mm-1. Over the 10-yr deployment at an Outback station, the accuracy of the derived scattering coefficient is compromised by drifts in sensitivity and offset, in part related to gross changes in bandpass filter characteristics resulting from environmental degradation. A method is developed to track these changes. An uncertainty analysis suggests that the typical background scattering coefficient of ∼10 Mm-1 can be measured to within 15% at the 95% confidence level. For events where the scattering coefficient is >100 Mm-1, the uncertainty falls to ∼5%. Correction factors are derived for angular truncation error and inlet efficiency for the particular inlet configuration adopted and illustrated via a case study using size distributions guided by collocated NASA Aerosol Robotic Network (AERONET) data. [ABSTRACT FROM AUTHOR]

As state funding for community colleges continues not to keep pace with programming needs, more community colleges are taking the initiative to seek funding from private sources. Four-year colleges and universities have long used alumni programs as major outside sources of funding. Since a high percentage of today's students embark on their higher education experience at the community college, it is natural for more two-year institutions to begin alumni programs. Based on in-depth interviews with directors of successful community college alumni programs, this article suggests "best practices" for community colleges that are considering the development of an alumni program. It offers practical and relevant ideas for practitioners and institutional leaders,including changes being planned in existing programs to ensure continued success. [ABSTRACT FROM AUTHOR]

Purpose: The latest digital ureteroscope, the DUR-D (Gyrus ACMI Inc., Southborough, Massachusetts) offers image quality that greatly exceeds current analog image capabilities. The purpose of this report was to document the applicability of this device in studying the earliest stages of stone formation. Materials and Methods: Symptomatic patients with nephrolithiasis (less than 1 cm in diameter) were prospectively enrolled and their renal papilla digitally mapped prior to stone removal. Recovered stones were photographed and analyzed using micro-computerized tomography. If the procedure could not be completed with the DUR-D, a conventional ureteroscope was used. Minors, pregnant patients and those with systemic disorders were excluded. Results: Eight patients (10 renal units), 2 cystine and 6 calcium oxalate stone formers, were studied with a mean age of 50.1 years. Excellent images were collected for all papilla except in 2 cases; a proximal ureteral stricture and acute angulation of the lower pole collecting system, respectively. There were no mechanical device failures. Of the 10 renal units 7 had stents postoperatively and there were no patient complications. Conclusions: The ease of use and high quality images of digital ureterorenoscopy will allow the documentation of the earliest stages of calcium oxalate stone formation and, thereby, advance our understanding of the pathogenesis of calcium oxalate stone formation. [Copyright &y& Elsevier]

Association mapping is a powerful strategy for identifying genes underlying quantitative traits in plants. We have assembled and characterized genetic and phenotypic diversity of a sorghum [Sorghum bicolor (L.) Moench] panel suitable for association mapping, comprised of 377 accessions representing all major cultivated races (tropical lines from diverse geographic and climatic regions), and important U.S. breeding lines and their progenitors. Accessions were phenotyped for eight traits, and levels of population structure and familial relatedness were assessed with 47 simple sequence repeat (SSR) loci. The panel exhibited substantial morphological variation and little genotypic differentiation was observed between the converted tropical and breeding lines. The phenotypic and genotypic data were used to evaluate the performance of several association models in controlling for spurious associations. Our analysis indicated that association models that accounted for both population structure and kinship performed better than those that did not. In addition, we found that the optimal number of subpopulations used to correct for population structure was trait dependent. Although augmentation of the genotypic data with additional SSR loci may be necessary, the association models, genotypic data, and germplasm panel described here provide a starting point for sorghum researchers to begin association studies of traits and markers or candidate genes of interest. [ABSTRACT FROM AUTHOR]

The longleaf pine (Pinus palustris Mill.) forest ecosystems of the US southeastern Coastal Plain, among the most biologically diverse ecosystems in North America, originally covered over 24 × 106 ha but now occupy less than 5% of their original extent. The key factor for sustaining their high levels of diversity is the frequent application of prescribed fire uninterrupted in time and space. Pine fuels, critical to application of fire and regulated by canopy distribution, provide the nexus between silviculture and fire management in this system. Typical silvicultural approaches for this type were, in large part, developed to maximize the establishment and growth of regeneration as well as growth and yield of timber, with much less regard to how those practices might influence the ability to sustain prescribed burning regimes or the associated biodiversity. However, many landholdings in the region now include conservation of biodiversity as a primary objective with sustained timber yield as an important but secondary goal. This review synthesizes the literature related to controls of biodiversity for longleaf pine ecosystems, and silvicultural approaches are compared in their ability to sustain natural disturbance such as fire and how closely they mimic the variation, patterns, and processes of natural disturbance regimes while allowing for regeneration. [ABSTRACT FROM AUTHOR]

Analysis was completed of over 100 Hostage Negotiation Situation Reports completed by FBI/BOP negotiators during the ten day Cuban detainee siege at the Federal Corrections Institution in Talladega, Alabama from August 21 to August 30, 1991. Specifically, the number and types of interactions, demands and threats that occurred during this crisis incident were examined. Results indicate that the hostage takers were generally oriented toward a negotiated resolution of the conflict. This conclusion is supported by (1) the specific communicative efforts hostage takers made to insure that the negotiators did not misinterpret events during particularly chaotic times, (2) environmental demands made were primarily in response to feeling threatened, and (3) threats made by hostage takers were not generally linked with specific demands but, rather, were made as a response to feeling threatened by actions taken by the FBI/BOP command. [ABSTRACT FROM PUBLISHER]

Reports of the importance of partnership to address the costs and demands of operating effective leadership development programs in the U.S. Accounts on the challenges facing contemporary society; Recognition of the need to focus less upon individual; Emphasis on the planning process for leadership development programs; Type of partnerships exist in program sponsorship.

Abstract Restoration of the longleaf pine ecosystems of the southeastern United States has focused interest on the regeneration and establishment of Aristida sp. (wiregrass) as a means to reestablish ecological function and structure of the ecosystem. This study examined dispersal distance from planted adults and canopy cover and density effects on establishment and reproduction. In 1994 wiregrass plugs were planted in two densities (500 seedlings/100 m2 and 49 seedlings/100 m2 ) and three canopy-thinning treatments (25 m2 basal area/ha, 16 m2 basal area/ha, and 8 m2 basal area/ha) were implemented in a 20-year-old longleaf plantation in southwestern Georgia. Due to the intense site preparation and the density of pines planted, virtually no understory vegetation was present. The site was burned in June 1995, which promoted seed production of the planted wiregrass. Results indicate that the 8 m2 basal area/ha treatment results in larger plants that in turn produce a greater number of seedling recruits. No seedling recruitment occurred in control plots. Dispersal distances of up to 594 cm were recorded. Natural seedling recruitment occurred at low-density transplanting (5 plants/10 m2 ), denoting that high-density planting similar to natural density (5 plants/m2 ) is not required for successful establishment or reproduction. However, overstory thinning in dense pine plantations is required for reproduction and increases the survival of individual plants due to changes in the environmental conditions at the forest floor. [ABSTRACT FROM AUTHOR]

Cites a study to examine the extent to which various dimensions of intercultural effectiveness are similarity perceived as important by host country nationals from Japan, Mexico and the U.S. Methodology used to measure interpersonal skills; Implications of the application of a model to various sets of intracultural data to find the importance of social skills in successful functioning in a culture; Recommendation for future research on the subject.

This paper examines the readjustment of American Corporate managers and spouses to their professional and social environments upon their return to the United States. The study investigated the relationship of background variables (age, prior international experience), host country variables (length of sojourn, frequency and intimacy of social relations with host nationals) and the reentry variable of expectations to reentry satisfaction and reentry difficulties of 44 returning managers and 33 spouses from two multinational corporations. [ABSTRACT FROM AUTHOR]

This study examines the degree to which expatriate managers' adaptational difficulties in a foreign culture are influenced by the cultural patterns they encounter in the host country vis-à-vis the culturally learned patterns expatriates carry with them as members of their home cultures. The research focused on the adaptation of American managers to Japan, Japanese managers to the United States and both American and Japanese managers to Thailand. Results indicate that Japanese and American managers differ significantly in their attitudinal satisfaction with living in a foreign culture, perceived effectiveness in functioning well in a foreign culture, and judged intercultural abilities in managing stress, communicating effectively, and developing satisfying relationships in a foreign culture. These findings support the notion that the cultural background of the expatriate sojourner may be more important than the particular country-specific environment in influencing cross-cultural adaptation. [ABSTRACT FROM AUTHOR]

The article offers information on the welfare concerns for the U.S. sport horse. Topics discussed include information on the veterinarians in providing medical care and need to the sport horses in U.S.; discussions on the lack of good horsemanship of owners and trainers; and the information on the need of periodic therapy for the treatment of inflamed joints or other musculoskeletal issues.

Background: Transgender, nonbinary, and gender-expansive people who were assigned female or intersex at birth experience pregnancy and have abortions. Scarce data have been published on individual abortion experiences or preferences of this understudied population.Objective: This study aimed to fill existing evidence gaps on the abortion experiences and preferences of transgender, nonbinary, and gender-expansive people in the United States to inform policies and practices to improve access to and quality of abortion care for this population.Study Design: In 2019, we recruited transgender, nonbinary, and gender-expansive people who were assigned female or intersex at birth at the age of ≥18 years from across the United States to participate in an online survey about sexual and reproductive health recruited through The Population Research in Identities and Disparities for Equality Study and online postings. We descriptively analyzed closed- and open-ended survey responses related to pregnancy history, abortion experiences, preferences for abortion method, recommendations to improve abortion care for transgender, nonbinary, and gender-expansive people, and respondent sociodemographic characteristics.Results: Most of the 1694 respondents were <30 years of age. Respondents represented multiple gender identities and sexual orientations and resided across all 4 United States Census Regions. Overall, 210 respondents (12%) had ever been pregnant; these 210 reported 433 total pregnancies, of which 92 (21%) ended in abortion. For respondents' most recent abortion, 41 (61%) were surgical, 23 (34%) were medication, and 3 (5%) were another method (primarily herbal). Most recent abortions took place at ≤9 weeks' gestation (n=41, 61%). If they were to need an abortion today, respondents preferred medication abortion over surgical abortion in a 3:1 ratio (n=703 vs n=217), but 514 respondents (30%) did not know which method they would prefer. The reasons for medication abortion preference among the 703 respondents included a belief that it is the least invasive method (n=553, 79%) and the most private method (n=388, 55%). To improve accessibility and quality of abortion care for transgender, nonbinary, and gender-expansive patients, respondents most frequently recommended that abortion clinics adopt gender-neutral or gender-affirming intake forms, that providers use gender-neutral language, and that greater privacy be incorporated into the clinic.Conclusion: These data contribute substantially to the evidence base on individual experiences of and preferences for abortion care for transgender, nonbinary, and gender-expansive people. Findings can be used to adapt abortion care to better include and affirm the experiences of this underserved population. [ABSTRACT FROM AUTHOR]

A review of the article "Food Protein-Induced Enterocolitis Syndrome in the US Population-Based Study," by A. Nowak-Wegrzyn et al, which appeared in a 2019 issue of the "Journal of Allergy and Clinical Immunology" is presented.

The role of the local health department in working for guidance and service of workers is discussed. Ways in which such activities can be improved are indicated. [ABSTRACT FROM AUTHOR]

The etiology of Sea Star Wasting Syndrome is hypothesized to be caused by a densovirus, SSaDV, that has previously been reported on the Pacific and Atlantic coasts of the United States. In this study, we reevaluated the presence of SSaDV among sea stars from the North American Atlantic Coast and in doing so discovered a novel densovirus we have named Asterias forbesi associated densovirus (AfaDV) that shares 78% nucleotide pairwise identity to SSaDV. In contrast to previous studies, SSaDV was not detected in sea stars from the North American Atlantic Coast. Using a variety of PCR-based techniques, we investigated the tissue tropism, host specificity, and prevalence of AfaDV among populations of sea stars at five locations along the Atlantic Coast. AfaDV was detected in three sea star species (Asterias forbesi, Asterias rubens, and Henricia sp.) found in this region and was highly prevalent (>80% of individuals tested, n=134), among sampled populations. AfaDV was detected in the body wall, gonads, and pyloric caeca (digestive gland) of specimens but was not detected in their coelomic fluid. A significant difference in viral load was found between tissue types with the pyloric caeca having the highest viral loads. Further investigation of Asterias forbesi gonad tissue found germline cells (oocytes) to be virus positive, suggesting a potential route of vertical transmission. Taken together, these observations show that the presence of AfaDV is not an indicator of Sea Star Wasting Syndrome because AfaDV is a common constituent of these animals' microbiome, regardless of health. [ABSTRACT FROM AUTHOR]

Presents an approach to resolve the potential dilemma of treating patients with vascular disease in the U.S. Development of low-profile, high-pressure coronary balloon catheters; Use of laser-assisted angioplasty; Clinical evaluation of patients by a vascular surgeon or a cardiologist specializing in peripheral vascular disease.

• We found 5 cannabis risk trajectories exist among sexual and gender minority people. • Past-year discrimination and victimization related to greater cannabis use risk. • Internalized stigma was related to greater odds of higher cannabis use risk. • After accounting for minority stress, gender expansive people had higher cannabis risk. • After accounting for minority stress, transgender men had higher cannabis risk. Substance use disparities among sexual and gender minority (SGM) people are attributed to minority stress, but few studies have examined minority stress and cannabis use over time or investigated differences in cannabis use trajectories by less-studied gender subgroups. We examined if longitudinal cannabis use trajectories are related to baseline minority stressors and if gender differences persisted after accounting for minority stress. Cannabis use risk was measured annually over four years (2017–2021) within a longitudinal cohort study of SGM adults in the United States (N = 11,813). Discrimination and victimization, internalized stigma, disclosure and concealment, and safety and acceptance comprised minority stress (n = 5,673). Latent class growth curve mixture models identified five cannabis use trajectories: 'low or no risk', 'low moderate risk', 'high moderate risk', 'steep risk increase', and 'highest risk'. Participants who reported past-year discrimination and/or victimization at baseline had greater odds of membership in any cannabis risk category compared to the 'low risk' category (odds ratios [OR] 1.17–1.33). Internalized stigma was related to 'high moderate' and 'highest risk' cannabis use (ORs 1.27–1.38). After accounting for minority stress, compared to cisgender men, gender expansive people and transgender men had higher odds of 'low moderate risk' (ORs 1.61, 1.67) or 'high moderate risk' (ORs 2.09, 1.99), and transgender men had higher odds of 'highest risk' (OR 2.36) cannabis use. This study indicates minority stress is related to prospective cannabis use risk trajectories among SGM people, and transgender men and gender expansive people have greater odds of trajectories reflecting cannabis use risk. [ABSTRACT FROM AUTHOR]