Long term effect of gender affirming hormone treatment on depression and anxiety symptoms in transgender people: A prospective cohort study

BackgroundCross?sectional studies show that transgender people are more likely than cisgender people to experience depression and anxiety before Gender Affirming Hormone Treatment (GAHT). However, the effect of GAHT on mental health in transgender people, and the role of other factors that may have a predictive effect, is poorly explored.ObjectivesUsing a longitudinal methodology, this study investigated the effect of 18 months GAHT on depression and anxiety symptomatology and the predictors on mental health outcomes in a large population of transgender people.Materials and MethodsParticipants (n=178) completed a socio?demographic questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Autism Spectrum Quotient Short Version (AQ?short) at pre?assessment (T0) and at 18 months after initiation of GAHT (T1).ResultsFrom T0 to T1, symptomatology was significantly decreased for depression (P[less than]0.001) and non?significantly reduced for anxiety (P=0.37). Scores on the MSPSS predicted reduction in depression, while scores on the AQ?short predicted reduction in anxiety.DiscussionGAHT reduces symptoms of depression which are predicted by having higher levels of social support. Although anxiety symptoms also reduce the changes are not significant and high levels of anxiety still remain post GAHT.ConclusionsThese results highlight the important mental health benefits of GAHT. Support services (professional, third sector or peer?support) aiming at increasing social support for transgender individuals should be made available

Impact of alternate wetting and drying irrigation on rice growth and resource-use efficiency

Crop-based irrigationRiceFertilizersNitrogenRainCrop yieldPercolationSeepagePaddy fieldsExperiments

A polar surface eddy obscured by thermal stratification

Mesoscale and submesoscale eddies play an important role in the distribution of heat and biogeochemical properties throughout the global oceans. Such eddies are important in the Arctic Ocean, particularly in the frontal regions, but are difficult to detect using traditional satellite‐based methods. Here we use high‐resolution in situ data from an underwater glider to identify a surface eddy that was masked from remote‐sensing observations. We hypothesize that this masking was driven by thermal stratification driven by surface heat fluxes. The eddy was likely generated north of the Polar Front, before crossing the front and traveling south. We estimate that the observed eddy contained 4 × 1010 m3 of Arctic Water. The observation of this eddy, masked in satellite observations of sea surface temperature, suggests a historical underestimation of the prevalence and importance of eddies in this key mixing region. The water column of the Barents Sea, one of the circumpolar Arctic seas has a seemingly simple structure. In the south, warm Atlantic Water dominates; in the north, cold Arctic Water dominates; while at their boundary, the Arctic Water overlies the Atlantic Water. In the summer, the Arctic Water is largely devoid of the nutrients required to fuel the growth of phytoplankton, which is key to maintaining life in the ocean. In contrast, the Atlantic Water is one of the primary sources of nutrient‐rich water into the Arctic. In this study, we have used an underwater robotic instrument to identify a patch of Arctic Water which has been shed from the Arctic sector of the Barents Sea into the Atlantic sector. This patch of water is seen to have lower phytoplankton concentrations than the surrounding water. Due to atmospheric heating of the surface, this patch would be indistinguishable from the surrounding Atlantic Water and so would be absent for satellite observations of sea surface temperature. We suggest that this temperature masking has meant that we have previously underestimated how much water is moved within these patches in the Arctic seas

Computed Tomography-Based Body Composition Is Not Consistently Associated with Outcome in Older Patients with Colorectal Cancer

Background: Current literature is inconsistent in the associations between computed tomography (CT)-based body composition measures and adverse outcomes in older patients with colorectal cancer (CRC). Moreover, the associations with consecutive treatment modalities have not been studied. This study compared the associations of CT-based body composition measures with surgery- and chemotherapy-related complications and survival in older patients with CRC. Materials and Methods: A retrospective single-center cohort study was conducted in patients with CRC aged ≥65 years who underwent elective surgery between 2010 and 2014. Gender-specific standardized scores of preoperative CT-based skeletal muscle (SM), muscle density, intermuscular adipose tissue (IMAT), visceral adipose tissue (VAT), subcutaneous adipose tissue, IMAT percentage, SM/VAT, and body mass index (BMI) were tested for their associations with severe postoperative complications, prolonged length of stay (LOS), readmission, and dose-limiting toxicity using logistic regression and 1-year and long-term survival (range 3.7–6.6 years) using Cox regression. Bonferroni correction was applied to account for multiple testing. Results: The study population consisted of 378 patients with CRC with a median age of 73.4 (interquartile range 69.5–78.4) years. Severe postoperative complications occurred in 13.0%, and 39.4% of patients died during follow-up. Dose-limiting toxicity occurred in 77.4% of patients receiving chemotherapy (n = 53). SM, muscle density, VAT, SM/VAT, and BMI were associated with surgery-related complications, and muscle density, IMAT, IMAT percentage, and SM/VAT were associated with long-term survival. After Bonferroni correction, no CT-based body composition measure was significantly associated with adverse outcomes. Higher BMI was associated with prolonged LOS. Conclusion: The associations between CT-based body composition measures and adverse outcomes of consecutive treatment modalities in older patients with CRC were not consistent or statistically significant. Implications for Practice: Computed tomography (CT)-based body composition, including muscle mass, muscle density, and intermuscular, visceral, and subcutaneous adipose tissue, showed inconsistent and nonsignificant associations with surgery-related complications, dose-limiting toxicity, and overall survival in older adults with colorectal cancer. This study underscores the need to verify whether CT-based body composition measures are worth implementing in clinical practice

Satellite Radiation Products for Ocean Biology and Biogeochemistry: Needs, State-of-the-Art, Gaps, Development Priorities, and Opportunities

Knowing the spatial and temporal distribution of the underwater light field, i.e., the spectral and angular structure of the radiant intensity at any point in the water column, is essential to understanding the biogeochemical processes that control the composition and evolution of aquatic ecosystems and their impact on climate and reaction to climate change. At present, only a few properties are reliably retrieved from space, either directly or via water-leaving radiance. Existing satellite products are limited to planar photosynthetically available radiation (PAR) and ultraviolet (UV) irradiance above the surface and diffuse attenuation coefficient. Examples of operational products are provided, and their advantages and drawbacks are examined. The usefulness and convenience of these products notwithstanding, there is a need, as expressed by the user community, for other products, i.e., sub-surface planar and scalar fluxes, average cosine, spectral fluxes (UV to visible), diurnal fluxes, absorbed fraction of PAR by live algae (APAR), surface albedo, vertical attenuation, and heating rate, and for associating uncertainties to any product on a pixel-by-pixel basis. Methodologies to obtain the new products are qualitatively discussed in view of most recent scientific knowledge and current and future satellite missions, and specific algorithms are presented for some new products, namely sub-surface fluxes and average cosine. A strategy and roadmap (short, medium, and long term) for usage and development priorities is provided, taking into account needs and readiness level. Combining observations from satellites overpassing at different times and geostationary satellites should be pursued to improve the quality of daily-integrated radiation fields, and products should be generated without gaps to provide boundary conditions for general circulation and biogeochemical models. Examples of new products, i.e., daily scalar PAR below the surface, daily average cosine for PAR, and sub-surface spectral scalar fluxes are presented. A procedure to estimate algorithm uncertainties in the total uncertainty budget for above-surface daily PAR, based on radiative simulations for expected situations, is described. In the future, space-borne lidars with ocean profiling capability offer the best hope for improving our knowledge of sub-surface fields. To maximize temporal coverage, space agencies should consider placing ocean-color instruments in L1 orbit, where the sunlit part of the Earth can be frequently observed

What can we learn from a race with one runner? A comment on Foreman-Peck and Zhou, ‘Late marriage as a contributor to the industrial revolution in England’

Foreman-Peck and Zhou’s claim that late marriage was a major contributor to the Industrial Revolution in England cannot be sustained. They consider neither other influences on English industrialisation nor other European economies where marriage age was high throughout the early modern period but industrialisation came much later. It is not possible to argue that late marriage age was a major contributor to English industrialisation without analysing other possible contributing factors. Any consideration of this question must assess marriage age alongside other causes of industrialisation and explain why other European economies with higher marriage age industrialised much later than England

Spectral Reflectance as a Covariate for Estimating Pasture Productivity and Composition

Pasturelands are inherently variable. It is this variability that makes sampling as well as characterizing an entire pasture difficult. Measurement of plant canopy reflectance with a ground-based radiometer offers an indirect, rapid, and noninvasive characterization of pasture productivity and composition. The objectives of this study were (i) to determine the relationships between easily collected canopy reflectance data and pasture biomass and species composition and (ii) to determine if the use of pasture reflectance data as a covariate improved mapping accuracy of biomass, percentage of grass cover, and percentage of legume cover across three sampling schemes in a central Iowa pasture. Reflectance values for wavebands most highly correlated with biomass, percentage of grass cover, and percentage of legume cover were used as covariates. Cokriging was compared with kriging as a method for estimating these parameters for unsampled sites. The use of canopy reflectance as a covariate improved prediction of grass and legume percentage of cover in all three sampling schemes studied. The prediction of above-ground biomass was not as consistent given that improvement with cokriging was observed with only one of the sampling schemes because of the low amount of spatial continuity of biomass values. An overall improvement in root mean square error (RMSE) for predicting values for unsampled sites was observed when cokriging was implemented. Use of rapid and indirect methods for quantifying pasture variability could provide useful and convenient information for more accurate characterization of time consuming parameters, such as pasture composition

Predictors of women's sexual outcomes after implant-based breast reconstruction

Objective: Although breast reconstruction has become an important treatment modality following mastectomy, few studies assessed predictors of postoperative sexual outcomes after breast reconstruction. Therefore, we aimed to study three sexual outcomes following implant-based breast reconstruction (IBBR), and associate multiple biopsychosocial factors with these outcomes. Methods: Data collection was part of a multicenter prospective study on IBBR. A predictive model was tested including medical, background and psychological predictors, partner relationship factors and physical sexual function. Data collection included clinical and questionnaire data (preoperatively and 1 year following reconstruction) using the BREAST-Q Sexual well-being scale (BQ5), and questions regarding sexual dysfunction and sexual satisfaction questions (Female Sexual Function Index). Results: The study sample consisted of 88 women who underwent mastectomy and IBBR. Mean postoperative BQ5 scores were lower than before surgery (M = 58 [SD = 18] vs 65 [SD = 20]; P =.01, Wilks' Lamdba =.88). Sexual dysfunctions were related strongest to orgasm inability and vaginal lubrication issues. The tested models predicted 37%-46% of the sexual outcomes: sexual outcomes were mostly predicted by psychosocial well-being, physical sexual function and partner support. Preoperative sexual and psychosocial well-being were positively associated with postoperative sexual well-being (r = 0.45 and r = 0.47). Conclusions: Although moderately positive sexual outcomes were reported after IBBR, some women reported issues with vaginal lubrication, breast sensation and orgasm. Sexual dysfunctions were predicted by vaginal lubrication and medical treatments, while sexual well-being and satisfaction were more predicted by psychosocial well-being and partner support. We advocate supportive care that includes partners and psychosocial functioning to optimize sexual outcomes after IBBR