Estimate and needs of the transgender adult population: the SPoT study.

BACKGROUND: Despite the increasing interest in transgender health research, to date little is known about the size of the transgender and gender diverse (TGD) population. METHODS: A web-based questionnaire survey was developed, including a collection of socio-demographic characteristics and disseminated online through social media. Gender incongruence was evaluated by using a 2-item approach assessing gender recorded at birth and gender identity. The primary objective of the present population-based study was to estimate the proportion of TGD people across ages among a large sample of people who answered a web-based survey. The secondary endpoints were to identify gender-affirming needs and possible barriers to healthcare access. RESULTS: A total of 19,572 individuals participated in the survey, of whom 7.7% reported a gender identity different from the sex recorded at birth. A significantly higher proportion of TGD people was observed in the youngest group of participants compared with older ones. Among TGD people who participated in the study, 58.4% were nonbinary, and 49.1% experienced discrimination in accessing health care services. Nonbinary TGD participants reported both the need for legal name and gender change, along with hormonal and surgical interventions less frequently compared to binary persons. CONCLUSIONS: Being TGD is not a marginal condition In Italy. A large proportion of TGD persons may not need medical and surgical treatments. TGD people often experience barriers to healthcare access relating to gender identity.

Sociodemographic profile, health-related behaviours and experiences of healthcare access in Italian transgender and gender diverse adult population.

PURPOSE: Information on the general health of transgender and gender diverse (TGD) individuals continues to be lacking. To bridge this gap, the National Institute of Health in Italy together with the National Office against Racial Discriminations, clinical centres, and TGD organizations carried out a cross-sectional study to define the sociodemographic profile, health-related behaviours, and experiences of healthcare access in Italian TGD adult population. METHODS: A national survey was conducted by Computer-Assisted Web Interviewing (CAWI) technique. Collected data were compared within the TGD subgroups and between TGD people and the Italian general population (IGP). RESULTS: TGD respondents were 959: 65% assigned female at birth (AFAB) and 35% assigned male at birth (AMAB). 91.8% and 8.2% were binary and non-binary TGD respondents, respectively. More than 20% of the TGD population reported to be unemployed with the highest rate detectable in AMAB and non-binary people. Cigarette smoking and binge drinking were higher in the TGD population compared with IGP (p < 0.05), affecting TGD subgroups differently. A significant lower percentage of AFAB TGD people reported having had screening for cervical and breast cancer in comparison with AFAB IGP (p < 0.0001, in both cases). Over 40% was the percentage of AFAB and non-binary TGD people accessing healthcare who felt discriminated against because of their gender identity. CONCLUSIONS: Our results are a first step towards a better understanding of the health needs of TGD people in Italy in order to plan the best policy choices for a more inclusive public health.

Manipulation of temporal localized structures in a vertical external-cavity surface-emitting laser with optical feedback.

We analyze the effect of optical feedback on the dynamics of an external-cavity passively mode-locked surface-emitting laser operating in the regime of temporal localized structures. Depending on the ratio between the cavity round trip time and the feedback delay, we show experimentally that feedback acts as a solution selector that either reinforces or hinders the appearance of one of the multistable harmonic arrangements of pulses. Our theoretical analysis reproduces well the experiment and allows us to evidence asymmetrical resonance tongues due to the parity symmetry-breaking induced by gain depletion.

Testing Critical Slowing Down as a Bifurcation Indicator in a Low-Dissipation Dynamical System.

We study a two-dimensional low-dissipation nonautonomous dynamical system, with a control parameter that is swept linearly in time across a transcritical bifurcation. We investigate the relaxation time of a perturbation applied to a variable of the system and we show that critical slowing down may occur at a parameter value well above the bifurcation point. We test experimentally the occurrence of critical slowing down by applying a perturbation to the accessible control parameter and we find that this perturbation leaves the system behavior unaltered, thus providing no useful information on the occurrence of critical slowing down. The theoretical analysis reveals the reasons why these tests fail in predicting an incoming bifurcation.

Experimental study of speckle patterns generated by low-coherence semiconductor laser light.

Speckle is a wave interference phenomenon that has been studied in various fields, including optics, hydrodynamics, and acoustics. Speckle patterns contain spectral information of the interfering waves and of the scattering medium that generates the pattern. Here, we study experimentally the speckle patterns generated by the light emitted by two types of semiconductor lasers: conventional laser diodes, where we induce low-coherence emission by optical feedback or by pump current modulation, and coupled nanolasers. In both cases, we analyze the intensity statistics of the respective speckle patterns to inspect the degree of coherence of the light. We show that the speckle analysis provides a non-spectral way to assess the coherence of semiconductor laser light.

Third Order Dispersion in Time-Delayed Systems.

Time-delayed dynamical systems materialize in situations where distant, pointwise, nonlinear nodes exchange information that propagates at a finite speed. However, they are considered devoid of dispersive effects, which are known to play a leading role in pattern formation and wave dynamics. We show how dispersion may appear naturally in delayed systems and we exemplify our result by studying theoretically and experimentally the influence of third order dispersion in a system composed of coupled optical microcavities. Dispersion-induced pulse satellites emerge asymmetrically and destabilize the mode-locking regime.

Nonlocality Induces Chains of Nested Dissipative Solitons.

Dissipative solitons often behave as quasiparticles, and they may form molecules characterized by well-defined bond distances. We show that pointwise nonlocality may lead to a new kind of molecule where bonds are not rigid. The elements of this molecule can shift mutually one with respect to the others while remaining linked together, in a manner similar to interlaced rings in a chain. We report experimental observations of these chains of nested dissipative solitons in a time-delayed laser system.

Asymmetric mode scattering in strongly coupled photonic crystal nanolasers.

We investigate the basic mechanism of nonlinear mode competition in two semiconductor-coupled nanocavities operating in the laser regime. For this, we study energy transfer between bonding (in-phase) and anti-bonding (out-of-phase) modes of the system formed by two strongly coupled photonic crystal nanolasers. We experimentally observe mode switching from the blue-detuned to the red-detuned mode as the pump power is increased. A semi-classical description in terms of mean-field equations allows us to explain this phenomenon as stimulated scattering due to carrier population oscillations in the cavities at the mode splitting frequency. We predict such asymmetrical mode interaction to be universal in arrays of optically coupled semiconductor micro and nanocavities.

Dynamics of Localized Structures in Systems with Broken Parity Symmetry.

A great variety of nonlinear dissipative systems are known to host structures having a correlation range much shorter than the size of the system. The dynamics of these localized structures (LSs) has been investigated so far in situations featuring parity symmetry. In this Letter we extend this analysis to systems lacking this property. We show that the LS drifting speed in a parameter varying landscape is not simply proportional to the parameter gradient, as found in parity preserving situations. The symmetry breaking implies a new contribution to the velocity field which is a function of the parameter value, thus leading to a new paradigm for LSs manipulation. We illustrate this general concept by studying the trajectories of the LSs found in a passively mode-locked laser operated in the localization regime. Moreover, the lack of parity affects significantly LSs interactions which are governed by asymmetrical repulsive forces.

PCDD/Fs in the soils in the province of Trento: 10 years of monitoring.

This paper presents a 10-year overview of the dioxins and furans (PCDD/Fs) content in soils in the province of Trento (Italy). The aim was to compare the results found in the Valsugana valley where there is a steel-making plant with other locations within the province. During 2002 and from 2005 to 2010, campaigns were carried out in order to obtain a background reference in terms of micropollutants, in view of the possible construction of a municipal solid waste (MSW) incinerator in Trento. In 2009, a campaign was performed for the environmental characterization of the Valsugana valley, the town of Trento and its surroundings, in order to help assess the impact of the steel-making plant. In 2012, another campaign was carried out by the Department of Civil and Environmental Engineering of Trento, in order to monitor the soils in the area around the steel mill. All the campaigns showed relatively low concentrations of PCDD/Fs, both in protected areas and in the areas close to the industrial plants. No critical situations were identified, as also confirmed by an estimation of the potential daily PCDD/F intake by children subject to accidental ingestion of soil.

How lasing localized structures evolve out of passive mode locking.

We investigate the relationship between passive mode locking and the formation of time-localized structures in the output intensity of a laser. We show how the mode-locked pulses transform into lasing localized structures, allowing for individual addressing and arbitrary low repetition rates. Our analysis reveals that this occurs when (i) the cavity round-trip is much larger than the slowest medium time scale, namely the gain recovery time, and (ii) the mode-locked solution coexists with the zero intensity (off) solution. These conditions enable the coexistence of a large quantity of stable solutions, each of them being characterized by a different number of pulses per round-trip and with different arrangements. Then, each mode-locked pulse becomes localized, i.e., individually addressable.

Time localized tilted beams in nearly-degenerate laser cavities.

We show that nearly-degenerate Vertical External-Cavity Surface-Emitting Lasers may emit a set of tilted beams of individually addressable mode-locked pulses. These time localized beams feature a Gaussian profile and they are emitted in pairs with opposite transverse k-vector. Because they are phase locked, their interference leads to a non homothetic pattern in the near-field emission of the laser. In the simplest situation, when a single pair is emitted, this is a stripe pattern. Our analysis discloses the role of third order (spherical) aberrations of the cavity in stabilizing this spatio-temporal mode-locked regime and in selecting the value of the transverse k-vector.

Multichannel Doppler fiber-imager spectrometer for spatiotemporal characterization of high-intensity laser-driven plasmas.

We demonstrate a flexible multichannel fiber-based imaging Doppler spectrometer to characterize plasmas in high intensity (≥1 × 1018 W/cm2) laser-plasma experiments at high repetition rates. This instrument collects data from ×21 different plasma locations combining optical fibers and a single imaging spectrometer. This diagnostic maps the plasma velocity evolution as a function of time with sub-pico-second resolution. Experimental results showing 2D velocity measurements of plasma with 20 µm spatial resolution are presented. Intensities of the order of 1018 W/cm2 were used to generate a plasma, while a much less intense, frequency doubled (400 nm), probe beam (1011 W/cm2) was used to measure the Doppler shift from the plasma critical surface. The instrument can be scaled to a larger number of channels (e.g., 100) still using a single spectrometer.

Single-shot soft x-ray laser linewidth measurement using a grating interferometer.

The linewidth of a 14.7 nm wavelength Ni-like Pd soft x-ray laser was measured in a single shot using a soft x-ray diffraction grating interferometer. The instrument uses the time delay introduced by the gratings across the beam to measure the temporal coherence. The spectral linewidth of the 4d1S0-4p1P1 Ni-like Pd lasing line was measured to be Δλ/λ=3×10(-5) from the Fourier transform of the fringe visibility. This single shot linewidth measurement technique provides a rapid and accurate way to determine the temporal coherence of soft x-ray lasers that can contribute to the development of femtosecond plasma-based soft x-ray lasers.

Defect-tolerant extreme ultraviolet nanoscale printing.

We present a defect-free lithography method for printing periodic features with nanoscale resolution using coherent extreme ultraviolet light. This technique is based on the self-imaging effect known as the Talbot effect, which is produced when coherent light is diffracted by a periodic mask. We present a numerical simulation and an experimental verification of the method with a compact extreme ultraviolet laser. Furthermore, we explore the extent of defect tolerance by testing masks with different defect layouts. The experimental results are in good agreement with theoretical calculations.

Sequential single-shot imaging of nanoscale dynamic interactions with a table-top soft x-ray laser.

We demonstrate the first real-space recording of nanoscale dynamic interactions using single-shot soft x-ray (SXR) full-field laser microscopy. A sequence of real-space flash images acquired with a table-top SXR laser was used to capture the motion of a rapidly oscillating magnetic nanoprobe. Changes of 30 nm in the oscillation amplitude were detected when the nanoprobe was made to interact with stray fields from a magnetic sample. The table-top visualization of nanoscale dynamics in real space can significantly contribute to the understanding of nanoscale processes and can accelerate the development of new nanodevices.

Evidence for malaria selection of a CR1 haplotype in Sardinia.

Complement receptor 1 (CR1) levels have been associated with malarial susceptibility and/or severity of the disease in different population groups, and CR1 is a receptor for Plasmodium falciparum. In this study, multiple CR1 single-nucleotide polymorphisms (SNPs) showed strong evidence of population differentiation between Sardinian and other European ethnic groups. Cross population algorithms comparing haplotype structure and differences in haplotype and allele frequency distribution provided additional support for natural selection of CR1 in Sardinia. The predominant Sardinian CR1 haplotype included SNPs that are associated with decreased CR1 levels in Europeans and other population groups. Previous studies have shown that the SNPs within the dominant Sardinian haplotype have a significantly higher frequency in a malaria endemic compared with non-endemic regions in India. Together with the historical evidence of the prevalence of malaria in Sardinia, these data support the role of malaria leading to positive selection of this CR1 haplotype in Sardinia.

Color Doppler ultrasound imaging in varicoceles: is the venous diameter sufficient for predicting clinical and subclinical varicocele?

PURPOSE: Investigating the diagnostic value of color Doppler ultrasound for defining the varicocele grade according to WHO criteria. METHODS: A total of 217 men (129 with clinical varicocele and 88 without clinical varicocele) were investigated by physical examination and color Doppler ultrasound and categorized according to WHO varicocele criteria (0, subclinical, I, II, and III). Diameter and reflux of the largest vein in the pampiniform plexus were measured bilaterally with the patient in the supine position in rest and during the Valsalva maneuver. To assess the possibility of differentiating varicocele grade by venous diameter, optimal cut-point values were determined by receiver-operator characteristic (ROC) analysis. RESULTS: With increased varicocele grade, a larger vein diameter was more significant in rest and during Valsalva (in all cases P < 0.05), except between grade I and grade II. Retrograde peak flow velocities were similar in every group (in all cases P > 0.1). Only grade III varicoceles demonstrated significantly increased peak flow values compared with all other grades (P < 0.001). There were no side-related differences when comparing identical varicocele grades (in all cases P > 0.1). Venous diameters above 2.45 mm in rest (sensitivity 84%, specificity 81%) or 2.95 mm during Valsalva (sensitivity 84%, specificity 84%) predicted the presence of a clinical varicocele. CONCLUSIONS: Our findings support the hypothesis that clinical varicoceles can be predicted with high accuracy based only on the diameter of testicular veins using cut-point values of >2.45 mm in rest or >2.95 mm during Valsalva maneuver in the supine position.

Treatment of recalcitrant ulcers with allogeneic platelet gel from pooled platelets in aged hypomobile patients.

We evaluated growth factor contents and clinical efficacy of allogeneic platelet gel (PG) prepared with standard blood banking procedures from routine platelet concentrates (PCs) obtained from buffy coats. The PGs were used to treat 11 hypomobile very elderly patients unable to undergo autologous blood processing and previously ineffectively treated with expensive advanced medications for 8-275 weeks. PGs were prepared by platelet activation with human thrombin or commercial batroxobin. Median and range growth factor contents (ng/mL) were: platelet derived growth factor (PDGF-AB/-BB) 112 (31-157) and 20 (3.8-34); transforming growth factor (TGF-ß1/-ß2) 214 (48-289) and 0.087 (0.03-0.28); basic-fibroblast growth factor (b-FGF) 0.03 (0.006-0.214); vascular endothelial growth factor (VEGF) 1.15 (0.18-2.46); epidermal growth factor (EGF) 4.50 (0.87-6.64); insulin-like growth factor (IGF-l) 116 (72-156). In the clinical study, 222 PGs were used within 2 h of activation to treat 14 chronic skin ulcers in the 11 patients. No improvement was seen in 3 patients with 24, 27 and 30 cm(3) ulcers who could be treated for no more than 4, 7 and 8 weeks due to progressively worsening clinical conditions, while 11 ulcers with 3.2 cm(3) median size (range 0.2-3.6) in the remaining 8 patients showed 91 ± 14 % reduction after a median of 12 weeks (range 1-20). Cost of PG treatment (19,976 euro) amounted to about 10% of the ineffective advanced medication hospital reimbursement fees (191,236 euro). This study supports efficacy and feasibility of allogeneic PG to treat recalcitrant ulcers in very elderly hypomobile patients for whom autologous blood processing may be difficult.