Transgender and Gender Diverse Clients’ Experiences in Therapy: Responses to Sociopolitical Events and Helpful and Unhelpful Experiences

We examined transgender and gender-diverse (TGD) people’s reports of their therapy experiences over the course of a year. We explored how participants’ therapists integrated discussions about current events, as well as their more general perspectives on helpful and unhelpful experiences. A total of 107 participants provided data on these questions at least once over 12 months of surveys (M age = 33.79; 70.1% White), reflecting on their current therapy experiences. Through thematic analysis of qualitative data, the following themes were constructed regarding discussing sociopolitical events: (a) facilitating coping via bearing witness to clients’ internal experiences and implementing other therapeutic interventions; (b) moving beyond the individual by integrating identity, systems, or contexts; (c) feeling disconnected and misunderstood. We grouped participants’ helpful experiences into the following themes: (1) availability, connection, and therapeutic approaches facilitate positive experiences; (2) the necessity of knowledge, education, and affirmation of TGD identities; (3) helpful therapy means seeing the world in which clients live. We grouped participants’ unhelpful experiences into the following themes: (1) logistical issues can interfere with therapy; (2) lack of depth and disconnection results in subpar therapy; (3) insufficient understandings of TGD identities results in potentially harmful practices. These findings deepen understandings of how to integrate discussions about current events into therapy and provide competent and affirming care to TGD clients

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Phase 3, Randomized, 20-Month Study of the Efficacy and Safety of Bimatoprost Implant in Patients with Open-Angle Glaucoma and Ocular Hypertension (ARTEMIS 2)

Objective- To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of 10 and 15 µg bimatoprost implant in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Methods- This randomized, 20-month, multicenter, masked, parallel-group, phase 3 trial enrolled 528 patients with OAG or OHT and an open iridocorneal angle inferiorly in the study eye. Study eyes were administered 10 or 15 µg bimatoprost implant on day 1, week 16, and week 32, or twice-daily topical timolol maleate 0.5%. Primary endpoints were IOP and IOP change from baseline through week 12. Safety measures included treatment-emergent adverse events (TEAEs) and corneal endothelial cell density (CECD). Results- Both 10 and 15 µg bimatoprost implant met the primary endpoint of noninferiority to timolol in IOP lowering through 12 weeks. Mean IOP reductions from baseline ranged from 6.2–7.4, 6.5–7.8, and 6.1–6.7 mmHg through week 12 in the 10 µg implant, 15 µg implant, and timolol groups, respectively. IOP lowering was similar after the second and third implant administrations. Probabilities of requiring no IOP-lowering treatment for 1 year after the third administration were 77.5% (10 µg implant) and 79.0% (15 µg implant). The most common TEAE was conjunctival hyperemia, typically temporally associated with the administration procedure. Corneal TEAEs of interest (primarily corneal endothelial cell loss, corneal edema, and corneal touch) were more frequent with the 15 than the 10 µg implant and generally were reported after repeated administrations. Loss in mean CECD from baseline to month 20 was ~ 5% in 10 µg implant-treated eyes and ~ 1% in topical timolol-treated eyes. Visual field progression (change in the mean deviation from baseline) was reduced in the 10 µg implant group compared with the timolol group. Conclusions- The results corroborated the previous phase 3 study of the bimatoprost implant. The bimatoprost implant met the primary endpoint and effectively lowered IOP. The majority of patients required no additional treatment for 12 months after the third administration. The benefit-risk assessment favored the 10 over the 15 µg implant. Studies evaluating other administration regimens with reduced risk of corneal events are ongoing. The bimatoprost implant has the potential to improve adherence and reduce treatment burden in glaucoma

Associations Between Transition-Specific Stress Experience, Nocturnal Decline in Ambulatory Blood Pressure, and C-Reactive Protein Levels Among Transgender Men

This study documents a number of important physiological manifestations of stress associated with the process of transition, describing the physical impacts of psychosocial stress during various stages of transition for trans men.Using a combination of interviews to assess stress levels and data on physical indicators and behaviors, the study finds that trans men in the early stages of transition who reported stress related to being “out” experienced significant physiological impacts in terms of blood pressure.  Trans men in the middle to later stages of transitioning who reported stress related to “passing” as having been assigned a male sex at birth had significantly higher levels of C-reactive protein levels, which has been linked to cardiovascular disease.Though some physical impacts related to stress are significant for trans men, stress related to transition tends to decline over time.  The study cites other studies that found trans men experience improved quality of life and decreased depression among those who have received testosterone therapy.  Furthermore, 100% of participants in the study reported that transitioning was “the right thing for them to do.

Associations Between Transition-Specific Stress Experience, Nocturnal Decline in Ambulatory Blood Pressure, and C-Reactive Protein Levels Among Transgender Men

This study documents a number of important physiological manifestations of stress associated with the process of transition, describing the physical impacts of psychosocial stress during various stages of transition for trans men.Using a combination of interviews to assess stress levels and data on physical indicators and behaviors, the study finds that trans men in the early stages of transition who reported stress related to being “out” experienced significant physiological impacts in terms of blood pressure.  Trans men in the middle to later stages of transitioning who reported stress related to “passing” as having been assigned a male sex at birth had significantly higher levels of C-reactive protein levels, which has been linked to cardiovascular disease.Though some physical impacts related to stress are significant for trans men, stress related to transition tends to decline over time.  The study cites other studies that found trans men experience improved quality of life and decreased depression among those who have received testosterone therapy.  Furthermore, 100% of participants in the study reported that transitioning was “the right thing for them to do.

Active Sites of O₂‑Evolving Chlorite Dismutases Probed by Halides and Hydroxides and New Iron–Ligand Vibrational Correlations

O₂-evolving chlorite dismutases (Clds) fall into two subfamilies, which efficiently convert ClO₂^– to O₂ and Cl^–. The Cld from <i>Dechloromonas aromatica</i> (<i>Da</i>Cld) represents the chlorite-decomposing homopentameric enzymes found in perchlorate- and chlorate-respiring bacteria. The Cld from the Gram-negative human pathogen <i>Klebsiella pneumoniae</i> (<i>Kp</i>Cld) is representative of the second subfamily, comprising homodimeric enzymes having truncated N-termini. Here steric and nonbonding properties of the <i>Da</i>Cld and <i>Kp</i>Cld active sites have been probed via kinetic, thermodynamic, and spectroscopic behaviors of their fluorides, chlorides, and hydroxides. Cooperative binding of Cl^– to <i>Kp</i>Cld drives formation of a hexacoordinate, high-spin aqua heme, whereas <i>Da</i>Cld remains pentacoordinate and high-spin under analogous conditions. Fluoride coordinates to the heme iron in <i>Kp</i>Cld and <i>Da</i>Cld, exhibiting ν­(Fe^III–F) bands at 385 and 390 cm^–1, respectively. Correlation of these frequencies with their CT1 energies reveals strong H-bond donation to the F^– ligand, indicating that atoms directly coordinated to heme iron are accessible to distal H-bond donation. New vibrational frequency correlations between either ν­(Fe^III–F) or ν­(Fe^III–OH) and ν­(Fe^II–His) of Clds and other heme proteins are reported. These correlations orthogonalize proximal and distal effects on the bonding between iron and exogenous π-donor ligands. The axial Fe–X vibrations and the relationships between them illuminate both similarities and differences in the H-bonding and electrostatic properties of the distal and proximal heme environments in pentameric and dimeric Clds. Moreover, they provide general insight into the structural basis of reactivity toward substrates in heme-dependent enzymes and their mechanistic intermediates, especially those containing the ferryl moiety