Bridging the Gap Between Practice Guidelines and the Therapy Room: Community-Derived Practice Adaptations for Psychological Services with Transgender and Gender Diverse Adults in the Central United States.

Individuals who identify as transgender or gender diverse (TGD) are presenting at mental health clinicians' offices with increasing frequency. Many TGD clients are seeking care related to affirming their gender identity but also may present with anxiety, depression, trauma, substance abuse, or other problems for which a clinician may commonly provide services. Some clinicians may hesitate to accept TGD clients into their practice if they have little specialized training to work with this population in an affirming manner, especially in more underserved areas where a generalist practice is the norm. Numerous professional associations and experts have developed guidelines for affirmative behavioral health care for TGD people. However, what is needed are community informed recommendations to bridge from the official guidelines to clinicians' in-session activities. The Trans Collaborations Practice Adaptations for Psychological Interventions for Transgender and Gender Diverse Adults are derived from iterative interviews with TGD community members and affirming mental health clinicians in the Central United States. The 12 practice adaptations are intended to guide clinicians to adapt their usual treatment approach to be TGD affirming, especially in underserved and rural areas. The practice adaptations cover numerous aspects of practice including the office setting and paperwork, understanding gender identity and incorporating it into the case conceptualization, therapist's self-awareness, and referrals. The Trans Collaborations Practice Adaptations will help clinicians work confidently and competently with adult TGD clients, regardless of the presenting problem, to ensure TGD communities receive the best interventions for their behavioral health concerns.

Fifteen compelling open questions in plant cell biology.

As scientists, we are at least as excited about the open questions-the things we do not know-as the discoveries. Here, we asked 15 experts to describe the most compelling open questions in plant cell biology. These are their questions: How are organelle identity, domains, and boundaries maintained under the continuous flux of vesicle trafficking and membrane remodeling? Is the plant cortical microtubule cytoskeleton a mechanosensory apparatus? How are the cellular pathways of cell wall synthesis, assembly, modification, and integrity sensing linked in plants? Why do plasmodesmata open and close? Is there retrograde signaling from vacuoles to the nucleus? How do root cells accommodate fungal endosymbionts? What is the role of cell edges in plant morphogenesis? How is the cell division site determined? What are the emergent effects of polyploidy on the biology of the cell, and how are any such "rules" conditioned by cell type? Can mechanical forces trigger new cell fates in plants? How does a single differentiated somatic cell reprogram and gain pluripotency? How does polarity develop de-novo in isolated plant cells? What is the spectrum of cellular functions for membraneless organelles and intrinsically disordered proteins? How do plants deal with internal noise? How does order emerge in cells and propagate to organs and organisms from complex dynamical processes? We hope you find the discussions of these questions thought provoking and inspiring.

In search of function: nuclear bodies and their possible roles as plant environmental sensors.

Plants must adjust their physiology, development and reproductive decisions in response to a fluctuating environment. Understanding how these adjustments are achieved is fundamental for predicting plant reactions to global environmental changes and for designing mitigation strategies. An often overlooked plant-environmental response is the formation of intranuclear membrane-less organelles known as 'nuclear bodies'. Currently, the functional role of nuclear bodies remains largely unclear. However, in recent years, they have received increased attention as possible hubs or integrators of environmental signals, and for possibly being part of the sensing machinery itself. Here, we will explore the formation of nuclear bodies under changing light, osmotic, and temperature conditions. We will then hypothesize on their potential functions in facilitating environmentally driven plant responses.

First plant cell atlas workshop report.

The societal challenges posed by a growing human population and climate change necessitate technical advances in plant science. Plant research makes vital contributions to society by advancing technologies that improve agricultural food production, biological energy capture and conversion, and human health. However, the plant biology community lacks a comprehensive understanding of molecular machinery, including their locations within cells, distributions and variations among different cell types, and real-time dynamics. Fortunately, rapid advances in molecular methods, imaging, proteomics, and metabolomics made in the last decade afford unprecedented opportunities to develop a molecular-level map of plant cells with high temporal and spatial resolution. The Plant Cell Atlas (PCA) initiative aims to generate a resource that will provide fresh insight into poorly understood aspects of plant cell structure and organization and enable the discovery of new cellular compartments and features. The PCA will be a community resource (www.plantcellatlas.org/) that describes the state of various plant cell types and integrates high-resolution spatio-temporal information of nucleic acids, proteins, and metabolites within plant cells. This first PCA initiative workshop convened scientists passionate about developing a comprehensive PCA to brainstorm about the state of the field, recent advances, the development of tools, and the future directions of this initiative. The workshop featured invited talks to share initial data, along with broader ideas for the PCA. Additionally, breakout sessions were organized around topics including the conceptual goals of the PCA, technical challenges, and community wants and needs. These activities connected scientists with diverse expertise and sparked important discussions about how to leverage and extend leading-edge technologies and develop new techniques. A major outcome of the workshop was that the community wishes to redefine concepts of plant cell types and tissues quantitatively. A long-term goal is to delineate all molecules within the cell at high spatio-temporal resolution, obtain information about interacting molecular networks, and identify the contribution of these networks to development of the organism as a whole. As a first step, we wish to create comprehensive cellular and subcellular biomolecular maps of transcripts, proteins, and metabolites, track the dynamic interactions of these molecules intra- and intercellularly, discern complete states and transitions of specialized cell types, and integrate these disparate data points to generate testable models of cellular function. Ultimately, the PCA initiative will have a substantial positive impact by empowering a broad, diverse group of scientists to forge exciting paths in the field of plant science, facilitating connections with interested stakeholders beyond the scientific community, and enabling new agricultural technologies for a sustainable future.

Unmet Expectations in Health Care Settings: Experiences of Transgender and Gender Diverse Adults in the Central Great Plains.

Transgender and gender diverse (TGD) individuals face a long-term, multifaceted process if they choose to begin a gender affirmation journey. Decisions to go on hormone therapy and/or have a surgical procedure necessitate the TGD individual to set up an appointment with a health care provider. However, when TGD patients interact with health care practitioners, problems can arise. This article documents and categorizes the types of unmet expectations that are common in the TGD patient-health care provider social dynamic in the Central Great Plains of the United States. Utilizing a community-based participatory research model, qualitative in-depth interviews were conducted with 27 TGD individuals about their health care experiences. From this, the researchers identified four main themes of unmet expectations: probing, gatekeeping, stigmatizing stance, and misgendering/deadnaming. Steps that can be taken by both the health care provider and the TGD individual to have a more successful encounter are discussed.

The provider perspective on behavioral health care for transgender and gender nonconforming individuals in the Central Great Plains: A qualitative study of approaches and needs.

Transgender and gender nonconforming (TGNC) individuals interact with mental health care systems at high rates and experience substantial barriers to care. Rural TGNC individuals face additional disparities in accessing appropriate mental health services. Little research has focused on the mental health care providers who work with TGNC individuals in underserved areas. The current study sought to describe the mental health care services delivered by providers perceived as affirming by TGNC community members in the Central Great Plains. We conducted qualitative interviews with 10 providers to understand how providers seek cultural competency and conceptualize and work with their TGNC clients given the barriers to care. Providers held diverse theoretical orientations and described challenges to working with TGNC clients, including the impact of stigma and marginalization and financial and structural barriers to care. Emphasis was placed on individualizing care, helping clients to manage stigma and build resiliency, connecting clients to resources (when available) and support systems, and navigating the intersections of physical health care and mental health care, such as writing letters for medical transition. Providers largely educated themselves on TGNC topics and had previous experience working with marginalized populations. Overall, the providers' approaches to working with TGNC clients mapped onto models of cultural competency, but few providers described their work in the context of an evidence-based model. Implications for increasing the quality and availability of mental health care services for TGNC individuals in underserved areas are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Rise of Transgender and Gender Diverse Representation in the Media: Impacts on the Population.

In recent years, the transgender and gender diverse (TGD) population has gained a stronger voice in the media. Although these voices are being heard, there are limits on the types of TGD representation displayed in media. The current study interviewed 27 TGD individuals. These interviews exposed how participants view the rise of TGD media representation. The main themes that emerged were TGD awareness and TGD identity discovery and role modeling. Clearly, there is a disconnect between transnormativity in the media and transnormativity in reality.

Fluctuations of the transcription factor ATML1 generate the pattern of giant cells in the Arabidopsis sepal.

Multicellular development produces patterns of specialized cell types. Yet, it is often unclear how individual cells within a field of identical cells initiate the patterning process. Using live imaging, quantitative image analyses and modeling, we show that during Arabidopsis thaliana sepal development, fluctuations in the concentration of the transcription factor ATML1 pattern a field of identical epidermal cells to differentiate into giant cells interspersed between smaller cells. We find that ATML1 is expressed in all epidermal cells. However, its level fluctuates in each of these cells. If ATML1 levels surpass a threshold during the G2 phase of the cell cycle, the cell will likely enter a state of endoreduplication and become giant. Otherwise, the cell divides. Our results demonstrate a fluctuation-driven patterning mechanism for how cell fate decisions can be initiated through a random yet tightly regulated process.

Variability and Constancy in Cellular Growth of Arabidopsis Sepals.

Growth of tissues is highly reproducible; yet, growth of individual cells in a tissue is highly variable, and neighboring cells can grow at different rates. We analyzed the growth of epidermal cell lineages in the Arabidopsis (Arabidopsis thaliana) sepal to determine how the growth curves of individual cell lineages relate to one another in a developing tissue. To identify underlying growth trends, we developed a continuous displacement field to predict spatially averaged growth rates. We showed that this displacement field accurately describes the growth of sepal cell lineages and reveals underlying trends within the variability of in vivo cellular growth. We found that the tissue, individual cell lineages, and cell walls all exhibit growth rates that are initially low, accelerate to a maximum, and decrease again. Accordingly, these growth curves can be represented by sigmoid functions. We examined the relationships among the cell lineage growth curves and surprisingly found that all lineages reach the same maximum growth rate relative to their size. However, the cell lineages are not synchronized; each cell lineage reaches this same maximum relative growth rate but at different times. The heterogeneity in observed growth results from shifting the same underlying sigmoid curve in time and scaling by size. Thus, despite the variability in growth observed in our study and others, individual cell lineages in the developing sepal follow similarly shaped growth curves.

Stochasticity in plant cellular growth and patterning.

Plants, along with other multicellular organisms, have evolved specialized regulatory mechanisms to achieve proper tissue growth and morphogenesis. During development, growing tissues generate specialized cell types and complex patterns necessary for establishing the function of the organ. Tissue growth is a tightly regulated process that yields highly reproducible outcomes. Nevertheless, the underlying cellular and molecular behaviors are often stochastic. Thus, how does stochasticity, together with strict genetic regulation, give rise to reproducible tissue development? This review draws examples from plants as well as other systems to explore stochasticity in plant cell division, growth, and patterning. We conclude that stochasticity is often needed to create small differences between identical cells, which are amplified and stabilized by genetic and mechanical feedback loops to begin cell differentiation. These first few differentiating cells initiate traditional patterning mechanisms to ensure regular development.

The counselor's trauma as counseling motivation: vulnerability or stress inoculation?

Should counselors with interpersonal trauma histories work with similarly traumatized clients? How does the work affect them? Current research is inconsistent. This study examines 101 sexual assault and domestic violence counselors' recalled motivations for trauma work, their reported subjective personal changes, and their secondary and vicarious trauma symptoms and burnout. Counselors motivated by interpersonal trauma report both more symptoms and positive changes (including dealing with their own trauma). Those seeking personal meaning report becoming more hypervigilant and self-isolating. Those saying they learned from clients rate symptoms lower, suggesting stress inoculation. Supervisors of trauma counselors should facilitate learning from clients separately from processing the counselor's trauma.

Comparison of conventional susceptibility testing, penicillin-binding protein 2a latex agglutination testing, and mecA real-time PCR for detection of oxacillin resistance in Staphylococcus aureus and coagulase-negative Staphylococcus.

Penicillin-binding protein (PBP) 2a latex agglutination was compared with conventional susceptibility testing and mecA real-time PCR for the detection of oxacillin resistance in Staphylococcus aureus. Inoculum volume and induction with oxacillin were PBP 2a testing variables. For coagulase-negative Staphylococcus, an increased inoculum volume of 10 microl greatly reduced the number of isolates requiring induction.