Thriving and Mental Health Outcomes Among Transgender and Gender Non-Conforming Youth in Oregon

A growing body of literature associates transgender and gender non-conforming (TGNC) identity with adverse mental and emotional health outcomes. Only a handful of studies have been conducted using population-based samples of adolescents to study mental health outcomes in TGNC youth (e.g., Eisenberg et al., 2017; Perez-Brumer, Day, Russell, & Hatzenbuehler, 2017; Rider, McMorris, Gower, Coleman, & Eisenberg, 2018; Toomey, Syvertsen, & Shramko, 2018) and only one has looked at outcomes that may indicate thriving (Eisenberg et al., 2017). The current study analyzes data from the 2017 Oregon Heathy Teens Survey (OHTS) (N = 26,747), a population-based biannual survey of eighth and eleventh graders. In 2017, the OHTS included three gender variables: youth report their gender identity, gender presentation (rated on a spectrum from very feminine to very masculine), and perception of others’ evaluation of their gender presentation. The current study examined associations between gender identity and four measures of thriving (emotional/mental health and wellbeing, grades, self-efficacy, and the presence of a caring adult at school) and three measures of adverse mental health outcomes (depressive symptoms, suicidal ideation, and suicide attempt). Multiple and logistic regression were used to test two sets of models. The first set of models included only one indicator of gender identity as a predictor of thriving and adverse mental health outcomes. The second set of models included all three indicators of gender identity as well as interactions between them to provide comparison as to how a more nuanced understanding of gender relates to youth outcomes. Results showed that youth who identified with a TGNC gender identity had the most adverse scores for every outcome compared to their female and male peers. In addition, youth who identified with either a female or a male gender identity, but who reported presenting and/or believing others perceived them as presenting in a non-gender-conforming way (i.e., something other than feminine for females or something other than masculine for males) often reported more adverse outcomes than their fully gender-conforming peers. Finally, outcomes for youth who identified with a TGNC gender identity varied depending on the category of self-presentation or others’ perception that the youth reported. Those outcomes often mirrored results for the gender-conforming gender identity of the category of self-presentation or others’ perception endorsed by the youth (e.g., a TGNC youth who presents as feminine and believes others perceive them as feminine reports lower emotional and mental wellbeing than a TGNC youth who presents as masculine and believes other perceive them as masculine). On this survey, 5.48% of youth claimed a TGNC gender identity, an unprecedented rate for population-based surveys. In addition, only 57.52% of females and 56.04% of males chose the fully gender-conforming options on the self-presentation and others’ perception questions (i.e. feminine for females and masculine for males), a notable outcome given the connection between any degree of gender non-conformity and the lower levels of thriving and higher levels of mental health risk found in this study. Implications include the need for greater support of youth who identify as TGNC, as well as the need for researchers and service providers to not only ask about gender identity beyond the traditional female/male binary, but also to include items on surveys and forms that assess more than one dimension of gender

Youth Wellbeing During the First School Year of the Covid-19 Pandemic: An Intersectional Analysis

During the first full school year of the Covid-19 pandemic, two central contexts for adolescent development—home and school—changed utterly. In Oregon, most middle- and high schoolers attended school entirely remotely from the beginning of the pandemic, in March, 2020, through the end of April, 2021, removing both the supports available and the threats present in in-person school contexts. At the same time, the home context was altered, with parents juggling the implementation of new technology and modes of education for their youth along with parental employment concerns—either working at home with their own needs for technology and physical space or attending work in person under the threat of illness and/or death from Covid-19 (French et al., 2021; Lawson et al., 2020). Supports or harms in physical and social contexts are especially impactful for youth as they undergo rapid development of their cognitive, emotional, and physical systems, and changes in these contexts are likely to impact youth wellbeing (Blakemore & Mills, 2014; Patton et al., 2016). These supports or harms have the potential to affect wellbeing both during the adolescent years and well into adulthood (Chen & Harris, 2019). Influences in proximal contexts like school and home, where adolescents spend most of their time, have the potential to either intensify or buffer social support or hostility for cultural attitudes toward a youth’s developing identity (Masten, 2018; Masten & Shaffer, 2006). The wellbeing of youth with marginalized identities, who are subject to more harmful feedback from the cultural context, may have been particularly impacted, for better or for worse, by the dramatic change in proximal contexts during the pandemic-related disruption of in-person schooling during the first full school year of the pandemic. For these youth, research based on Minority Stress Theory has found that when youth experience cultural hostility related to their identity, youth are likely to internalize that hostility, developing internalized stigma (Meyer, 2003, 2015). Internalized stigma is related to a host of negative mental health, academic, and relational outcomes (Hatzenbuehler & Pachankis, 2016; Meyer, 2003, 2015; U.S. Department of Health and Human Services, 2001). In contrast, when feedback related to youth identity is supportive, the resulting positive identity development may serve as protection against the harms of cultural hostility and bias (K. R. Bogart et al., 2018; García-Coll et al., 1996; Ponzetti, 2016; Tynes et al., 2012). In addition, the climate at school or at home has the potential to either intensify or buffer social support or hostility for cultural attitudes toward a youth’s developing identity (Masten, 2018; Masten & Shaffer, 2006). The U.S. Surgeon General issued a warning in 2021 that youth mental health, facing potential harms at every level of the developmental system, was at increased risk (Office of the Surgeon General, 2021). These risks included increased cultural virulence against youth with marginalized racial/ethnic or identities and youth with disabilities (Office of the Surgeon General, 2021). Some research has found that depressive symptoms and suicidal behavior increased while general mental health declined for youth during the first year of the pandemic (Mayne et al., 2021; Racine et al., 2021). Other research, however, has found that youth reported improved mental health outcomes after the pandemic shut schools down (Patra et al., 2020; Penner et al., 2021; Widnall et al., 2020). From a Minority Stress Theory perspective, if youth have a minoritized identity and have been experiencing amplified cultural hostility in school toward that identity, spending months away from that environment might lessen internalized stigma and improve mental health outcomes. Alternatively, if their parents and family members or others in their home environment are not supportive of their minoritized identity, youth may experience more adverse mental health at home. In school and online, stigma-based peer victimization is a major vector of hostile cultural and community attitudes toward youth with identities that are stigmatized, or minoritized, on the basis of non-dominant gender identity, racial/ethnic identity, or disability status (Lund, 2021; Smith & Juvonen, 2017; Xu et al., 2020). Bullying is related to multiple aspects of youth wellbeing, with well-documented negative impacts on mental and physical health and academic achievement (L. M. Bogart et al., 2014; Juvonen & Graham, 2014; Martín-Castillo et al., 2020; Tang et al., 2020). In addition to these more noticeable impacts, though, bullying also has an effect on a youth’s view of themselves (e.g., their identity development), their society, and their place in that society. Stigma-based peer victimization is one way that oppressive systems are perpetuated, as victims, perpetrators, and witnesses are all immersed in a process in which the power relationships of the larger culture are enacted (Olewus, 1993). Youth with multiple stigmatized identities experience more peer victimization than their peers with fewer or no stigmatized identities (Cyrus, 2017; Garnett et al., 2014; Park et al., 2022) Currently, there is a gap in research involving the wellbeing of youth during the first full school year of the pandemic and especially for youth with marginalized identities and intersectional marginalized identities. Guided by Relational Development Systems Theory and Minority Stress Theory, this dissertation aims to add to knowledge of youth wellbeing during that year, by comparing data from the 2019 Oregon Healthy Teen Survey (N = 28,090) and the 2020 Oregon Student Health Survey (N = 25,762). In this dissertation, I used OLS and logistic regression analyses to explore how youth reports of wellbeing were associated with gender identity, racial/ethnic identity, disability status, and intersections among these aspects of identity by examining two areas of youth wellbeing: mental health and peer victimization (i.e., bullying). The dissertation consisted of two studies. The first examined youth mental health outcomes, and the second analyzed peer victimization outcomes. In Study I, I compared youth mental health outcomes for general emotional and mental health, depressive symptoms, suicidal ideation, and suicide attempt in the 2020-21 school year, the first full school year of the Covid-19 pandemic (referred to in this dissertation as “2020”) with the same outcomes in the 2018-19 school year, the last full school year before the Covid-19 pandemic (referred to in this dissertation as “2019”). In addition, I analyzed whether any differences in outcomes between the two years differed by youth gender identity, racial/ethnic identity, disability status, or intersections among these aspects of identity. In Study II, I compared youth reports of their experience of cyberbullying and stigma-based peer victimization in 2020 to the same outcomes in 2019. As in Study I, I analyzed whether any differences in outcomes between the two years differed by youth gender identity, racial/ethnic identity, disability status, or intersections among these aspects of identity. Together, results from these studies indicated differential experiences during the first full school year of the pandemic among youth with marginalized identities compared to their peers with culturally dominant identities. Youth overall reported more adverse outcomes for general emotional and mental health and depressive symptoms when comparing wellbeing in 2020 to 2019, but were less likely to report suicidal behavior. Youth also were less likely to report bullying on all measures during 2020 compared to 2019. Youth with marginalized identities, especially gender minoritized youth and youth with disabilities, reported more adverse outcomes for general emotional mental health and depressive symptoms than their non-marginalized peers in 2020 compared to 2019. Similarly, although marginalized youth followed the overall pattern in the sample of reporting less likelihood of adverse outcomes for suicidal behavior and bullying in 2020 compared to 2019, the benefit for these groups was smaller than it was for their non-marginalized peers. Each study discusses practical implications of these outcomes and recommendations for policy and practice along with directions for future research. To improve youth mental health, policymakers and program developers should implement programs and policies at local, state, and federal levels that focus on supporting positive identity development related to youth in ways that recognize and honor intersectional identities. To effectively reduce bullying, future research, practice, and policies should focus on the critical importance of whole-school/whole-district programs that focus on positive school climate and culture in identify-affirming ways. To be effective, efforts to improve youth wellbeing must address bias at every level of youth developmental systems, including individual, family, school/school district, community, state, federal, and cultural levels

A dominant clonal lineage of Streptococcus uberis in cattle in Germany

Bovine mastitis causes enormous economic losses in the dairy industry with Streptococcus uberis as one of the most common bacterial pathogens causing clinical and subclinical variations. In most cases mastitis can be cured by intramammary administration of antimicrobial agents. However, the severity of the clinical manifestations can vary greatly from mild to severe symtoms. In this study, a comparative genomic analysis of 24 S. uberis isolates from three dairy farms in Germany, affected by different courses of infection was conducted. While there were sporadic mild infections in farm A and B, a large number of infections were observed within a very short period of time in farm C. The comparison of virulence genes, antimicrobial resistance genes and prophage regions revealed no features that might be responsible for this severe course. However, almost all isolates from farm C showed the same, novel MLST profile (ST1373), thus a clonal outbreak cannot be excluded, whereby the actual reason for the particular virulence remains unknown. This study demonstrates the importance of extensive metagenomic studies, including the host genomes and the environment, to gain further evidence on the pathogenicity of S. uberis.Peer Reviewe

Genome-based retrospective analysis of a Providencia stuartii outbreak in Rome, Italy. Broad spectrum IncC plasmids spread the NDM carbapenemase within the hospital

Providencia stuartii is a member of the Morganellaceae family, notorious for its intrinsic resistance to several antibiotics, including last-resort drugs such as colistin and tigecycline. Between February and March 2022, a four-patient outbreak sustained by P. stuartii occurred in a hospital in Rome. Phenotypic analyses defined these strains as eXtensively Drug-Resistant (XDR). Wholegenome sequencing was performed on the representative P. stuartii strains and resulted in fully closed genomes and plasmids. The genomes were highly related phylogenetically and encoded various virulence factors, including fimbrial clusters. The XDR phenotype was primarily driven by the presence of the (NDM)-N-bla- 1 metallo- beta-lactamase alongside the rmtC 16S rRNA methyltransferase, conferring resistance to most beta-lactams and every aminoglycoside, respectively. These genes were found on an IncC plasmid that was highly related to an NDM-IncC plasmid retrieved from a ST15 Klebsiella pneumoniae strain circulating in the same hospital two years earlier. Given its ability to acquire resistance plasmids and its intrinsic resistance mechanisms, P. stuartii is a formidable pathogen. The emergence of XDR P. stuartii strains poses a significant public health threat. It is essential to monitor the spread of these strains and develop new strategies for their control and treatment

Metabolic Profile and Metabolite Analyses in Extreme Weight Responders to Gastric Bypass Surgery

Background: Roux-en-Y gastric bypass (RYGB) surgery belongs to the most frequently performed surgical therapeutic strategies against adiposity and its comorbidities. However, outcome is limited in a substantial cohort of patients with inadequate primary weight loss or considerable weight regain. In this study, gut microbiota composition and systemically released metabolites were analyzed in a cohort of extreme weight responders after RYGB. Methods: Patients (n = 23) were categorized based on excess weight loss (EWL) at a minimum of two years after RYGB in a good responder (EWL 93 ± 4.3%) or a bad responder group (EWL 19.5 ± 13.3%) for evaluation of differences in metabolic outcome, eating behavior and gut microbiota taxonomy and metabolic activity. Results: Mean BMI was 47.2 ± 6.4 kg/m2 in the bad vs. 26.6 ± 1.2 kg/m2 in the good responder group (p = 0.0001). We found no difference in hunger and satiety sensation, in fasting or postprandial gut hormone release, or in gut microbiota composition between both groups. Differences in weight loss did not reflect in metabolic outcome after RYGB. While fecal and circulating metabolite analyses showed higher levels of propionate (p = 0.0001) in good and valerate (p = 0.04) in bad responders, respectively, conjugated primary and secondary bile acids were higher in good responders in the fasted (p = 0.03) and postprandial state (GCA, p = 0.02; GCDCA, p = 0.02; TCA, p = 0.01; TCDCA, p = 0.02; GDCA, p = 0.05; GUDCA, p = 0.04; TLCA, p = 0.04). Conclusions: Heterogenous weight loss response to RYGB surgery separates from patients’ metabolic outcome, and is linked to unique serum metabolite signatures post intervention. These findings suggest that the level of adiposity reduction alone is insufficient to assess the metabolic success of RYGB surgery, and that longitudinal metabolite profiling may eventually help us to identify markers that could predict individual adiposity response to surgery and guide patient selection and counseling.Peer reviewe

Race-specific genotypes of Pseudomonas syringae pv. tomato are defined by the presence of mobile DNA elements within the genome

Pseudomonas syringae pv. tomato is the causal agent of bacterial speck of tomato, an important disease that results in severe crop production losses worldwide. Currently, two races within phylogroup 01a (PG01a) are described for this pathogen. Race 0 strains have avirulence genes for the expression of type III system-associated effectors AvrPto1 and AvrPtoB, that are recognized and targeted by the effector-triggered immunity in tomato cultivars having the pto race-specific resistance gene. Race 1 strains instead lack the avrPto1 and avrPtoB genes and are therefore capable to aggressively attack all tomato cultivars. Here, we have performed the complete genome sequencing and the analysis of P. syringae pv. tomato strain DAPP-PG 215, which was described as a race 0 strain in 1996. Our analysis revealed that its genome comprises a 6.2 Mb circular chromosome and two plasmids (107 kb and 81 kb). The results indicate that the strain is phylogenetically closely related to strains Max13, K40, T1 and NYS-T1, all known race 1 strains. The chromosome of DAPP-PG 215 encodes race 1-associated genes like avrA and hopW1 and lacks race 0-associated genes like hopN1, giving it a race 1 genetic background. However, the genome harbors a complete ortholog of avrPto1, which allows the strain to display a race 0 phenotype. Comparative genomics with several PG01a genomes revealed that mobile DNA elements are rather involved in the evolution of the two different races

Challenges in Using Cultured Primary Rodent Hepatocytes or Cell Lines to Study Hepatic HDL Receptor SR-BI Regulation by Its Cytoplasmic Adaptor PDZK1

Background: PDZK1 is a four PDZ-domain containing cytoplasmic protein that binds to a variety of membrane proteins via their C-termini and can influence the abundance, localization and/or function of its target proteins. One of these targets in hepatocytes in vivo is the HDL receptor SR-BI. Normal hepatic expression of SR-BI protein requires PDZK1 - <5% of normal hepatic SR-BI is seen in the livers of PDZK1 knockout mice. Progress has been made in identifying features of PDZK1 required to control hepatic SR-BI in vivo using hepatic expression of wild-type and mutant forms of PDZK1 in wild-type and PDZK1 KO transgenic mice. Such in vivo studies are time consuming and expensive, and cannot readily be used to explore many features of the underlying molecular and cellular mechanisms. Methodology/Principal Findings: Here we have explored the potential to use either primary rodent hepatocytes in culture using 2D collagen gels with newly developed optimized conditions or PDZK1/SR-BI co-transfected cultured cell lines (COS, HEK293) for such studies. SR-BI and PDZK1 protein and mRNA expression levels fell rapidly in primary hepatocyte cultures, indicating this system does not adequately mimic hepatocytes in vivo for analysis of the PDZK1 dependence of SR-BI. Although PDZK1 did alter SR-BI protein expression in the cell lines, its influence was independent of SR-BI’s C-terminus, and thus is not likely to occur via the same mechanism as that which occurs in hepatocytes in vivo. Conclusions/Significance: Caution must be exercised in using primary hepatocytes or cultured cell lines when studying the mechanism underlying the regulation of hepatic SR-BI by PDZK1. It may be possible to use SR-BI and PDZK1 expression as sensitive markers for the in vivo-like state of hepatocytes to further improve primary hepatocyte cell culture conditions.National Institutes of Health (U.S.) (Grant HL052212)National Institutes of Health (U.S.) (Grant HL066105)National Institutes of Health (U.S.) (Grant ES015241)National Institutes of Health (U.S.) (Grant GM068762

IARC Monographs: 40 Years of Evaluating Carcinogenic Hazards to Humans

Background: Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans. Objectives: The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed. Discussion: We concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed. Conclusions: The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public’s health

IARC Monographs: 40 Years of Evaluating Carcinogenic Hazards to Humans

Background: Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans