Self-reported Rates of Abuse, Neglect, and Bullying Experienced by Transgender and Gender-Nonbinary Adolescents in China

open access articleImportance This is the first comprehensive national study reporting the rates of abuse, neglect, and bullying from family and classmates or teachers among Chinese transgender and gender-nonbinary adolescents and identifying risk factors associated with poor mental health in this population. Objective To assess the rates of abuse, neglect, and bullying and their association with poor mental health among Chinese transgender and gender nonbinary adolescents. Design, Setting, and Participants This national survey study used an online self-selecting survey conducted between January 1, 2017, and September 29, 2017, in China. Eligibility criteria included reporting being aged 12 to 18 years and being transgender or gender nonbinary. Data analysis was performed from March 25 to 28, 2019. Main Outcomes and Measures The main outcome was self-reported poor mental health, including depressive symptoms, anxiety symptoms, and suicidal ideation. Depressive symptoms were measured using the Center for Epidemiological Studies Depression 9-item scale. Anxiety symptoms were measured using the 7-item General Anxiety Disorder scale. Suicidal ideation was measured using standardized questions adapted from previous Chinese studies. Abuse, neglect, and bullying were measured using specifically designed questions. Results Of 564 responses collected, 385 respondents (mean [SD] age, 16.7 [1.2] years) met inclusion criteria, including 109 (28.3%) transgender adolescent boys, 167 (43.4%) transgender adolescent girls, and 109 (28.3%) gender-nonbinary adolescents. Among 319 respondents who reported that their parents were aware of their gender identity, 296 (92.8%) reported having experienced parental abuse or neglect. Among the full cohort, 295 respondents (76.6%) reported having experienced abuse or bullying owing to being transgender or gender nonbinary in school from classmates or teachers. There were 173 respondents (44.9%) with Center for Epidemiological Studies Depression 9-item scale scores indicating they were at risk of major depressive disorder, and 148 respondents (38.4%) had 7-item General Anxiety Disorder scale scores indicating they were at risk of an anxiety disorder. In univariate analysis, reporting experiences of bullying from a classmate or teacher was significantly associated with suicidal ideation (odds ratio, 1.68 [95% CI, 1.04-2.70]; P = .03), but the association was no longer statistically significant after controlling for level of educational attainment, aversion to assigned sex, and depressed mood at the onset of puberty (odds ratio, 1.63 [95% CI, 0.97-2.73]; P = .06). Conclusions and Relevance In this survey study, transgender and gender-nonbinary adolescents in China reported high rates of abuse, neglect, and bullying at home and in school and high rates of symptoms associated with poor mental health. This study highlights the importance of reducing home- and school-based abuse, neglect, and bullying of transgender and gender-nonbinary adolescents in China to improve mental health outcomes; however, broader change in the social environment may be required to address the prejudice and stigma aimed at gender minorities

Loss-of-function mutations in centrosomal protein 112 is associated with human acephalic spermatozoa phenotype.

Acephalic spermatozoa, characterized by the headless sperm in the ejaculate, is a rare type of teratozoospermia. Here, we recruited two infertile patients with an acephalic spermatozoa phenotype to investigate the genetic pathology of acephalic spermatozoa. Whole-exome sequencing analysis was performed and found mutations in CEP112 in the two patients: homozygous mutation c.496C > T:p.(Arg166X) in exon 5 from P1; and the biallelic mutations c.2074C > T:p.(Arg692Trp) in exon 20 and c.2104C > T:p.(Arg702Cys) in exon 20 from P2. Sanger sequencing confirmed the CEP112 mutations in the two patients. In silico analysis revealed that these CEP112 mutations are deleterious and rare, and all the mutations impact the coiled-coil domain of CEP112, which may affect the protein function. The c.496C > T:p.Arg166X resulted in a truncated CEP112, which was verified by the mutation expression plasmid. The CEP112 expression was significantly reduced in the P2, suggesting the biallelic mutations c.2074C > T and c.2104C > T may affect the function and stability of CEP112. Therefore, we speculate that the loss-of-function mutations in CEP112 may be account for the human acephalic spermatozoa phenotype

Suicidal ideation and attempted suicide amongst Chinese transgender persons:National population study

BACKGROUND: This study aims to understand suicidal ideation and suicide attempts among transgender individuals through an in-depth analysis of a nation-wide population general survey in China. METHODS: Transgender Men (TM) and Women (TW) were investigated through a cross-sectional survey. A structured questionnaire was used to investigate participants\u27 demographic information, perceived sexuality conflicts, childhood adversity and mental health conditions. Logistic regression models were utilized to investigate risk factors associated with suicidal ideation and suicide attempts in these groups. We also conducted a quasi-meta-analysis in order to compare the prevalence of suicidal ideation and attempted suicide between general and transgender populations in China. RESULTS: A total of 1309 participants across 32 provinces and municipalities in China took part in this survey, out of 2060 valid questionnaires. In this transgender population, the lifetime prevalence of suicidal ideation and an attempt at suicide were 56.4% and 16.1%, respectively. This estimated prevalence rate is far greater than in Chinese community samples. For all transgender people, disliking birth-assigned sex, seeking sex reassignment surgery, having intense conflicts with parents, lifetime history of suffering from major depressive disorder, a recent episode of depression, self-harm, and seeking mental health services were significantly associated with increased risk of suicidal ideation. An education level of high school or equivalent, being married and/or separated/divorced, having intense conflicts with parents, or self-harm and seeking mental health services were all significantly associated with increased risk of suicide attempt. Although most risk factors for TM and TW were equivalent across groups, differences were observed in both suicidal ideation and suicide attempt models. LIMITATIONS: The cross-sectional study design and lack of follow-up data are limitations of this study. CONCLUSIONS: This is the first study to examine suicide within a Chinese transgender population. The clinical implications of these findings for Chinese mental health professionals are discussed. Also, the evidence from this study can be used to inform the practices of suicide prevention workers, and policy makers working with the transgender population

Population pharmacokinetics of Amisulpride in Chinese patients with schizophrenia with external validation: the impact of renal function

Introduction: Amisulpride is primarily eliminated via the kidneys. Given the clear influence of renal clearance on plasma concentration, we aimed to explicitly examine the impact of renal function on amisulpride pharmacokinetics (PK) via population PK modelling and Monte Carlo simulations.Method: Plasma concentrations from 921 patients (776 in development and 145 in validation) were utilized.Results: Amisulpride PK could be described by a one-compartment model with linear elimination where estimated glomerular filtration rate, eGFR, had a significant influence on clearance. All PK parameters (estimate, RSE%) were precisely estimated: apparent volume of distribution (645 L, 18%), apparent clearance (60.5 L/h, 2%), absorption rate constant (0.106 h−1, 12%) and coefficient of renal function on clearance (0.817, 10%). No other significant covariate was found. The predictive performance of the model was externally validated. Covariate analysis showed an inverse relationship between eGFR and exposure, where subjects with eGFR= 30 mL/min/1.73 m2 had more than 2-fold increase in AUC, trough and peak concentration. Simulation results further illustrated that, given a dose of 800 mg, plasma concentrations of all patients with renal impairment would exceed 640 ng/mL.Discussion: Our work demonstrated the importance of renal function in amisulpride dose adjustment and provided a quantitative framework to guide individualized dosing for Chinese patients with schizophrenia

Pricing Game Models of Hybrid Channel Supply Chain: A Strategic Consumer Behavior Perspective

The current sales model combining online and offline channels meets the diverse requirements of consumers. However, consumers’ inter-channel switching behavior and strategic behavior also pose significant challenges to pricing decisions in the hybrid channel. Using game theory and consumer utility theory, a retailer-driven pricing model is developed to study the optimal pricing problem for each channel in a mixed-channel supply chain considering the characteristics of channel competition and the waiting behavior of strategic consumers. Study results show there is a negative correlation between the proportion of strategic consumers and the optimal pricing and profit of each channel, and as the proportion of strategic consumers rises, the optimal pricing and profit of manufacturers and retailers all trend downward. Incorporating strategic consumers into the pricing model will assist the supply chain in elucidating the behavior of consumer heterogeneity during various decision-making periods and in making reasonable pricing decisions. Effective guiding strategies, such as pre-discount and purchase restrictions, can reduce the profit loss caused by strategic consumer behavior. The optimal combination of pre-announcement discount and strategic consumer ratio can generate the greatest profit for retailers and the supply chain

What kind of factors influence the effective enforcement of smoke-free law in China?

Background As WHO FCTC took effect in China, more and more cities have legislated or amended laws against smoking in public places. There still existed many kinds of barriers and problems about the law enforcement. This study focused on the activities took by enforcers and owners of places to evaluate situations that influence the effect of laws and regulations against SHS. Methods This study combines methods of interviews and field observation. Study of compliance of net bars: 20 net bars at each city were observed.84 observations were accomplished. Invited 15 officers, 30 enforcers and 14 owners of net bar. Focus group and in-depth interviews were conducted at five cities. Results 1. Smoking behaviors were found in 69 net bars, attendants from only 2 bars discouraged smokers but failed. Smoking ban in bars didn't improve no-smoking environments in the bars. 2. City supervision and enforcement environments need to be improved. Comprehensive and partial smoke-free, penalty process and amounts bring about barriers in enforcement activities. The enforcement coordination mechanism and enforcement pattern is limited by authority, function, initiative and focus of enforcers. 3. Various factors influenced owners to take responsibility in the enforcement of law, et al, afraid of losing customers and incomes for owners; Lack of knowledge of hazards of SHS. Conclusions Not all of the net bars comply with the law. Power of the coordination, initiation and knowledge of hazards of SHS of the enforcers, all of these influence power of enforcement of net bars. Failure of creating social atmosphere of smoking ban before and after the law impairs effect of enforcement of the law. Recommendation: Amending the law to achieve a comprehensive smoke in the indoor public places and develop a detailed enforcement guideline; building effective supervision mechanism, and mobilizing initiation of the enforcers; completing social supervision mechanism and motivating the public

Explicit Facial Expression Transfer via Fine-Grained Representations

Facial expression transfer between two unpaired images is a challenging problem, as fine-grained expression is typically tangled with other facial attributes. Most existing methods treat expression transfer as an application of expression manipulation, and use predicted global expression, landmarks or action units (AUs) as a guidance. However, the prediction may be inaccurate, which limits the performance of transferring fine-grained expression. Instead of using an intermediate estimated guidance, we propose to explicitly transfer facial expression by directly mapping two unpaired input images to two synthesized images with swapped expressions. Specifically, considering AUs semantically describe fine-grained expression details, we propose a novel multi-class adversarial training method to disentangle input images into two types of fine-grained representations: AU-related feature and AU-free feature. Then, we can synthesize new images with preserved identities and swapped expressions by combining AU-free features with swapped AU-related features. Moreover, to obtain reliable expression transfer results of the unpaired input, we introduce a swap consistency loss to make the synthesized images and self-reconstructed images indistinguishable. Extensive experiments show that our approach outperforms the state-of-the-art expression manipulation methods for transferring fine-grained expressions while preserving other attributes including identity and pose.Comment: This paper has been accepted by IEEE Transactions on Image Processing (TIP

Aminoalkyldisiloxane as effective electrolyte additive for improving high temperature cycle life of nickel-rich LiNi0.6Co0.2Mn0.2O2/graphite batteries

A novel aminoakyldisiloxane compound, (3-(N,N-dimethylamino)diethoxypropyl) pentamethyldisiloxane (DSON), is reported as an effective electrolyte additive for improving the electrochemical performances of high energy density power batteries of nickel-rich LiNi0.6Co0.2Mn0.2O2 (NCM622)/graphite. The NCM622/graphite cells using DSON addition in the carbonate-based reference electrolyte exhibit enhanced electrochemical performances, especially high temperature performances including long cycle life and high temperature storage. The pouch cell (1 Ah) with 0.2 wt% DSON retained a capacity of 88% as compared with 84% for that without DSON in electrolyte after 200 cycles at 45 degrees C. The mechanism investigation reveals that DSON acts as a film-forming additive for constructing uniform conductive cathode electrolyte interphase (CEI) layer upon NCM622 particles, which suppresses the internal cracks and prohibits the irreversible phase transformation of NCM622. DSON also serves as an effective water/acid scavenger and inhibits the hydrolysis of LiPF6, thus effectively blocking the occurrence of side reactions and the dissolution of transition metal ions from cathode. Therefore, NCM622 cathode sheet maintains a better integrity surface morphology after 100 cycles. This work demonstrates that aminoakyldisiloxane is promising for practical use as effective electrolyte additive for high energy density power batteries of nickel-rich NCM/graphite

A Bioinspired Functionalization of Polypropylene Separator for Lithium-Sulfur Battery

Lithium-sulfur batteries have received intensive attention, due to their high specific capacity, but the shuttle effect of soluble polysulfide results in a decrease in capacity. In response to this issue, we develop a novel tannic acid and Au nanoparticle functionalized separator. The tannic acid and gold nanoparticles were modified onto commercial polypropylene separator through a two-step solution process. Due to a large number of phenolic hydroxyl groups contained in the modified layer and the strong polarity of the gold nanoparticles, the soluble polysulfide generated during battery cycling is well stabilized on the cathode side, slowing down the capacity fade brought by the shuttle effect. In addition, the modification effectively improves the electrolyte affinity of the separator. As a result of these benefits, the novel separator exhibits improved battery performance compared to the pristine polypropylene separator