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Transgender individuals struggle with a misalignment between their biological and interpersonal self, in order to rectify this issue gender affirming health care is used to re-align the two aspects of themselves. The American Psychiatric Association defines transgender individuals as those who are assigned one gender identity at birth and identify as another later in life (Yarbrough 2023). There are various different gender orientations that a person canidentify with but most of the examples will focus on male-to-female (MTF) or female-to-male (FTM) transgender experiences. The current standard on gender affirming care focuses on various steps of diagnosis, traditional therapy, hormone therapy and surgical interventions (Yarbrough 2023). Transgender children suffer academically and socially due to having an internal struggle with their gender dysphoria, often affecting their everyday life (Boyle 2022). The argument against gender affirming care for minors focuses on the ability of minors to conceptualize the long-lasting effects the care will have on their body as well as the fear theindividual will change their mind over time. The argument for gender affirming care for minors views the issue as necessary medical care that treats a life-threatening issue. This paper will conduct a thorough review of current opinions on gender affirming care for minors, addressing gaps in understanding of what care is given and the effects the care has on the individual with a special note on beneficence, non-maleficence, and autonomy using a deontological ethical framework.

This qualitative study explored how 249 transgender and non-binary (TNB) adolescents (ages 14-18) described salient supports in their lives, and ways in which key social-ecological contexts could better support TNB adolescents' wellbeing. Participants were recruited through social media, and completed online surveys; all study procedures were approved by the Boston University Institutional Review Board. Most (84.7%) participants identified as White, and as sexual minorities (96.4%). Modified consensual qualitative research (CQR-M) methods were used to examine TNB adolescents' responses to two questions: "In your life, which people, if any, would you describe as most supportive, and why?" and "What can individuals/groups within families, schools, and communities do to best support the well-being of transgender and non-binary adolescents?" Results indicated that the most common source of support for TNB participants was peers, followed by family members. Participants also highlighted the centrality of supportive environments that offer access to resources, as well as support derived through policies and practices that reduce stigma. Collectively, results have implications for how individuals and systems can foster wellbeing among TNB adolescents.

Abstract Background Asians and Asian Americans have the lowest rate of mental health service utilization (25%) in the US compared to other racial/ethnic groups (39 − 52%), despite high rates of depression, anxiety, and suicidal ideation. The lack of culturally-responsive mental health trainings hinders access to mental health services for these populations. We assessed the mental health priorities of Asian communities in Greater Boston and evaluated cultural responsiveness of the Mental Health First Aid (MHFA), a first-responder training teaching participants skills to recognize signs of mental health and substance use challenges, and how to appropriately respond. Methods This is community-based participatory research with the Boston Chinatown Neighborhood Center (BCNC), Asian Women For Health (AWFH), and the Addressing Disparities in Asian Populations through Translational Research (ADAPT) Coalition. We conducted focus groups with community-based organization staff and community members to assess mental health priorities of Asian populations in Boston, MA. We then evaluated the utility and cultural-responsiveness of the English-language MHFA for Asian populations through pre- and post-training questionnaires and focus groups with community participants. Paired t-tests were used to evaluate questionnaire responses. Thematic analysis was used to analyze interviews. Results In total, ten staff and eight community members participated in focus groups, and 24 community members completed the MHFA and pre- and post-training questionnaires. Common mental health challenges in the Asian communities reported by participants were loneliness, high stigma around mental illnesses, academic pressure, and acculturation stress. Compared to pre-training, MHFA participants demonstrated lower personal mental health stigma (p

Abstract Mammalian inner ear hair cell loss leads to permanent hearing and balance dysfunction. In contrast to the cochlea, vestibular hair cells of the murine utricle have some regenerative capacity. Whether human utricular hair cells regenerate in vivo remains unknown. Here we procured live, mature utricles from organ donors and vestibular schwannoma patients, and present a validated single-cell transcriptomic atlas at unprecedented resolution. We describe markers of 13 sensory and non-sensory cell types, with partial overlap and correlation between transcriptomes of human and mouse hair cells and supporting cells. We further uncover transcriptomes unique to hair cell precursors, which are unexpectedly 14-fold more abundant in vestibular schwannoma utricles, demonstrating the existence of ongoing regeneration in humans. Lastly, supporting cell-to-hair cell trajectory analysis revealed 5 distinct patterns of dynamic gene expression and associated pathways, including Wnt and IGF-1 signaling. Our dataset constitutes a foundational resource, accessible via a web-based interface, serving to advance knowledge of the normal and diseased human inner ear.

To identify rare variants (RVs) of gout, we sequenced the whole genomes of 321 male gout patients and combined these with those of 64 male gout patients and 682 normal controls at Taiwan Biobank. We performed ACAT-O to identify 682 significant RVs (p < 3.8 × 10−8) clustered on chromosomes 1, 7, 10, 16, and 18. To prioritize causal variants effectively, we sifted them by Combined Annotation-Dependent Depletion score >10 or |effect size| ≥ 1.5 for those without CADD scores. In particular, to the best of our knowledge, we identified the rare variants rs559954634, rs186763678, and 13-85340782-G-A for the first time to be associated with gout in Taiwanese males. Importantly, the RV rs559954634 positively affects gout, and its neighboring gene NPHS2 is involved in serum urate and expressed in kidney tissues. The kidneys play a major role in regulating uric acid levels. This suggests that rs559954634 may be involved in gout. Furthermore, rs186763678 is in the intron of NFIA that interacts with SLC2A9, which has the most significant effect on serum urate. Note that gene-gene interaction NFIA-SLC2A9 is significantly associated with serum urate in the Italian MICROS population and a Croatian population. Moreover, 13-85340782-G-A significantly affects gout susceptibility (odds ratio 6.0; P = 0.038). The >1% carrier frequencies of these potentially pathogenic (protective) RVs in cases (controls) suggest the revealed associations may be true; these RVs deserve further studies for the mechanism. Finally, multivariate logistic regression analysis shows that the rare variants rs559954634 and 13-85340782-G-A jointly are significantly associated with gout susceptibility.

Schema instruction improves word-problem solving for students with mathematics difficulty (MD; e.g., Powell et al., 2015); however, prior research suggests that students need word-problem-specific language comprehension in addition to schema knowledge to build word-problem models (Fuchs et al., 2015, 2018). Students have general word knowledge (e.g., "more, less") but require word-problem-specific word knowledge to solve word problems successfully (e.g., "more than, less than"; Kintsch & Greeno, 1985). Prior word-problem schema interventions have not provided explicit instruction in word-problem vocabulary to support students' development of word-problem models. We aimed to determine if word-problem vocabulary instruction combined with schema instruction provided an advantage to word-problem solving for third-grade students with MD. We randomly assigned 75 third graders with MD to three conditions: Word-problem intervention with explicit vocabulary instruction (WP + V), word-problem intervention without explicit vocabulary instruction (WP-only), and business-as-usual intervention (BAU). Students in the treatment conditions received 22, 50-min lessons provided virtually in small groups. On a word-problem vocabulary measure, students in the WP + V condition significantly outperformed students in the WP-only (ES = 0.43) and BAU (ES = 0.83) conditions. On a word-problem measure, students in the WP + V condition outperformed students in the WP-only (ES = 0.08) and BAU conditions (ES = 0.43), although these were not statistically significant. These findings provide preliminary support for the benefits of incorporating explicit vocabulary instruction in a word-problem schema intervention; future research is needed to fully understand the effect of vocabulary instruction on word-problem outcomes.

Abstract Pacu (Piaractus mesopotamicus) is a fish with a high production potential in Brazil. However, one limitation is the excessive amount of ether extract in its carcass, an undesirable characteristic for the consumer. One approach to overcome this limitation is to improve carcass quality through zootechnical additives such as caffeine. The aim of this study was to evaluate the effect of supplementing the diet of pacu with caffeine on cut yield, biological indices, and carcass composition. Two hundred pacu with an initial weight of 1,687 g were used. The animals were allocated to 20 aquaculture cages of 1 m³, with 10 animals per cage. A completely randomized design with four treatments and five replicates was used. The treatments evaluated consisted of four inclusion levels of caffeine: T1 = 0.00 g; T2 = 0.16 g; T3 = 0.32 g, and T4 = 0.48 g caffeine.kg-1 of feed. The findings show that caffeine can be recommended as a diet supplement for carcass improvement of pacu, reducing the fat content and increasing the protein content of the carcass. Caffeine up to 0.32 g.kg-1 of feed can be added to the diet of pacu without affecting its performance or cut yield.

Collagen VI-related dystrophies (COL6-RDs) are a group of severe, congenital-onset muscular dystrophies for which there is no effective causative treatment. Dominant-negative mutations are common in COL6A1, COL6A2, and COL6A3 genes, encoding the collagen α1, α2, and α3 (VI) chains. They act by incorporating into the hierarchical assembly of the three α (VI) chains and consequently produce a dysfunctional collagen VI extracellular matrix, while haploinsufficiency for any of the COL6 genes is not associated with disease. Hence, allele-specific transcript inactivation is a valid therapeutic strategy, although selectively targeting a pathogenic single nucleotide variant is challenging. Here, we develop a small interfering RNA (siRNA) that robustly, and in an allele-specific manner, silences a common glycine substitution (G293R) caused by a single nucleotide change in COL6A1 gene. By intentionally introducing an additional mismatch into the siRNA design, we achieved enhanced specificity toward the mutant allele. Treatment of patient-derived fibroblasts effectively reduced the levels of mutant transcripts while maintaining unaltered wild-type transcript levels, rescuing the secretion and assembly of collagen VI matrix by reducing the dominant-negative effect of mutant chains. Our findings establish a promising treatment approach for patients with the recurrent dominantly negative acting G293R glycine substitution.

Sleep-wake disturbances (SWDs) are common after TBI and often extend into the chronic phase of recovery. Such disturbances in sleep can lead to deficits in executive functioning, attention, and memory consolidation, which may ultimately impact the recovery process. We examined whether SWDs post-TBI were associated with morbidity during the post-acute period. Particular attention was placed on the impact of sleep architecture on learning and memory. Because women are more likely to report SWDs, we examined sex as a biological variable. We also examined subjective quality of life, depression, and disability levels. Data were retrospectively analyzed for 57 TBI patients who underwent an overnight polysomnography. Medical records were reviewed to determine cognitive and functional status during the period of the sleep evaluation. Consideration was given to medications, owing to the fact that a high number of these are likely to have secondary influences on sleep characteristics. Women showed higher levels of disability and reported more depression and lower quality of life. A sex-dependent disruption in sleep architecture was observed, with women having lower percent time in REM sleep. An association between percent time in REM and better episodic memory scores was found. Melatonin utilization had a positive impact on REM duration. Improvements in understanding the impact of sleep-wake disturbances on post-TBI outcome will aid in defining targeted interventions for this population. Findings from this study support the hypothesis that decreases in REM sleep may contribute to chronic disability and underlie the importance of considering sex differences when addressing sleep.

The municipality of Del Carmen, Siargao Island, hosts one of the Philippines’ most important contiguous mangrove stands. However, there is limited knowledge about the area’s floral assemblages and communities. Hence, we provide a comprehensive species list through exhaustive botanical explorations within its 11 barangays. We report 166 species in 145 genera and 73 families, of which 20 are true mangrove species. Twenty species are Philippine endemics, and seven are threatened based on the IUCN listing. The most dominant families in the area in terms of density are Rhizophoraceae and Rubiaceae, and the dominating species include Rhizophora mucronata Lam. and R. apiculata Blume. Our results exhibit a very high diversity for the entire municipality, with barangays Del Carmen and Katipunan demonstrating the highest diversity among the 11 barangays. We emphasize the value of floristic surveys as essential baseline information in formulating effective conservation and management strategies for these vital wetland ecosystems.

The objective of this study is to present a method for developing fragility curves for soil liquefaction that align with seismic hazards using Monte Carlo simulation. This approach can incorporate all uncertainties and variabilities in the input parameters. The seismic parameters, including earthquake magnitude (M) and associated peak ground acceleration (PGA), are jointly considered for the liquefaction assessment. The liquefaction potential and the resulting damages obtained by this method are more realistic. A case study is conducted using data from a sand-boil site in Yuanlin, Changhua County, where liquefaction occurred during the 1999 Chi-Chi earthquake in Taiwan. The findings indicate that the liquefaction potential index, IL, the post-liquefaction settlement, St, and the liquefaction probability index, PW, are all appropriate parameters for assessing liquefaction damages. The fragility curves for soil liquefaction developed through this method can support the performance-based earthquake engineering (PBEE) approach, provide guidance for liquefaction evaluation to the Taiwan Earthquake Loss Estimation System (TELES), and serve as a foundation for scenario simulation and an earthquake early warning system for liquefaction damages.

This study explored gender differences in stressors experienced by teacher education students at the University of Ghana, and adaptation stratagems they might utilise to manage stress. In 2018-2019 academic year, a total of two hundred and seventy (270) second- and third-year students were selected using random sampling procedure to respond to closed-ended and open-ended questions in a survey questionnaire. The questionnaire was adapted from Dental Environmental Stress (DES) to measure stressors students encounter and the Brief Coping Orientation to Problems Experienced (Brief COPE) to measure students' coping stratagems they might use to minimise their stress levels (Folkman & Lazarus, 1984). It was pre-tested to learners of the faculty of education at the University of Cape Coast, Ghana, to ensure the reliability and validity of the statements. The findings show that the students use multiple strategies, such as praying/meditating and self-distracting activities to cope with stress. Although, females had higher overall perceived stress levels regarding encountered academic stressors and health stressors, the difference between genders was insignificant. Similarly, females had a higher perception of stress from psychosocial stressors when likened to males, however, the difference between genders was also insignificant. Regarding perceived coping stratagems, females utilised adaptive coping stratagems whilst males utilised maladaptive and avoidance coping stratagems although the difference between genders was also not significant. The study recommended among others that males be urged to likewise utilise increasingly adaptive strategies to control strain.

A population of neurons interconnected by synapses constitutes a neural circuit, which performs specific functions upon activation. It is essential to identify both anatomical and functional entities of neural circuits to comprehend the components and processes necessary for healthy brain function and the changes that characterize brain disorders. To date, few methods are available to study these two aspects of a neural circuit simultaneously. In this study, we developed FLIPSOT, or functional labeling of individualized postsynaptic neurons using optogenetics and trans-Tango. FLIPSOT uses (1) trans-Tango to access postsynaptic neurons genetically, (2) optogenetic approaches to activate (FLIPSOTa) or inhibit (FLIPSOTi) postsynaptic neurons in a random and sparse manner, and (3) fluorescence markers tagged with optogenetic genes to visualize these neurons. Therefore, FLIPSOT allows using a presynaptic driver to identify the behavioral function of individual postsynaptic neurons. It is readily applied to identify functions of individual postsynaptic neurons and has the potential to be adapted for use in mammalian circuits.

People form social evaluations of others following brief exposure to their voices, and these impressions are calibrated based on recent perceptual experience. Participants adapted to voices with fundamental frequency (f o; the acoustic correlate of perceptual pitch) manipulated to be gender-typical (i.e. masculine men and feminine women) or gender-atypical (i.e. feminine men and masculine women) before evaluating unaltered test voices within the same sex. Adaptation resulted in contrastive aftereffects. Listening to gender-atypical voices caused female voices to sound more feminine and attractive (Study 1) and male voices to sound more masculine and attractive (Study 2). Studies 3a and 3b tested whether adaptation occurred on a conceptual or perceptual level, respectively. In Study 3a, perceivers adapted to gender-typical or gender-atypical voices for both men and women (i.e. adaptors pitch manipulated in opposite directions for men and women) before evaluating unaltered test voices. Findings showed weak evidence that evaluations differed between conditions. In Study 3b, perceivers adapted to masculinized or feminized voices for both men and women (i.e. adaptors pitch manipulated in the same direction for men and women) before evaluating unaltered test voices. In the feminized condition, participants rated male targets as more masculine and attractive. Conversely, in the masculinized condition, participants rated female targets as more feminine and attractive. Voices appear to be evaluated according to gender norms that are updated based on perceptual experience as well as conceptual knowledge.

PurposeRestriction spectrum imaging (RSI) decomposes the diffusion-weighted MRI signal into separate components of known apparent diffusion coefficients (ADCs). The number of diffusion components and optimal ADCs for RSI are organ-specific and determined empirically. The purpose of this work was to determine the RSI model for breast tissues.MethodsThe diffusion-weighted MRI signal was described using a linear combination of multiple exponential components. A set of ADC values was estimated to fit voxels in cancer and control ROIs. Later, the signal contributions of each diffusion component were estimated using these fixed ADC values. Relative-fitting residuals and Bayesian information criterion were assessed. Contrast-to-noise ratio between cancer and fibroglandular tissue in RSI-derived signal contribution maps was compared to DCE imaging.ResultsA total of 74 women with breast cancer were scanned at 3.0 Tesla MRI. The fitting residuals of conventional ADC and Bayesian information criterion suggest that a 3-component model improves the characterization of the diffusion signal over a biexponential model. Estimated ADCs of triexponential model were D1,3 = 0, D2,3 = 1.5 × 10-3 , and D3,3 = 10.8 × 10-3 mm2 /s. The RSI-derived signal contributions of the slower diffusion components were larger in tumors than in fibroglandular tissues. Further, the contrast-to-noise and specificity at 80% sensitivity of DCE and a subset of RSI-derived maps were equivalent.ConclusionBreast diffusion-weighted MRI signal was best described using a triexponential model. Tumor conspicuity in breast RSI model is comparable to that of DCE without the use of exogenous contrast. These data may be used as differential features between healthy and malignant breast tissues.