bluuebunny/crossref_metadata_2025 huggingface dataset:
186 Does Medicaid Cover Male Urethral Sling Surgery? A State-by-State Analysis
Authors: Loeb C. , Barnard J. , Yafi F. , Schneider D.
Published: April 2022

Introduction

Male suburethral slings are one treatment option for stress urinary incontinence (SUI) due to intrinsic sphincter deficiency post-prostatectomy in appropriately selected patients. Some studies report up to 55% social continence, and 23% of respondents reduced use of pads by greater than 50%. Male slings may be preferred in men with limited manual dexterity who have difficulty manipulating an artificial urinary sphincter, or in men with more mild SUI, particularly if there is no history of prior radiation. Existing literature regarding insurance coverage and physician reimbursement overwhelmingly focuses on Medicare and commercial plans, leaving a knowledge gap with respect to the Medicaid population which may contribute to inequitable utilization of this treatment modality for SUI.

Objective

To quantify Medicaid coverage for placement and revision of male suburethral slings for correction of male SUI by state.

Methods

State Medicaid websites were utilized to access publicly available physician fee schedules. Individual search queries were performed for CPT codes 53440 and 53442, which represent sling operation for correction of male urinary incontinence and removal or revision of sling for male urinary incontinence, respectively. Data were recorded for each device, including the coverage status and physician fees.

Results

Medicaid physician fee schedules were accessible for 49 out of 50 US states. All 49 of these states reported coverage for placement of a male urethral sling, and 48 states reported coverage for removal or revision of a male urethral sling. Means and range of physician reimbursement for each procedure were $834.26 ($198.00-$5,237.35) for placement of a male urethral sling (53440) and $616.88 ($104.27-$2,288.93) for removal or revision of a male urethral sling (53442).

Conclusions

Male suburethral sling placement and revision for SUI in the Medicaid population are covered by nearly all states as confirmed by publicly available data. Knowledge of Medicaid coverage for SUI related surgery may result in improvement in the utilization of this treatment option for male SUI and may improve quality of life in the Medicaid cancer survivorship population.

Disclosure

No
189 Anal Sex Practices and Rectal Erogenous Zones: An Anatomic Questionnaire Based Study
Authors: Walton A. , Stelmar J , Carter E. , Duralde E. , Isaacson D. , Zaliznyak M. , Garcia M.
Published: April 2022

Introduction

There is a lack of research that explores the prevalence, pleasure, and erogenous zones associated with anal sex.

Objective

To report the results of a cross-sectional study questionnaire that queries receptive anal intercourse (RAI) (e.g., when a partner inserts any part of themselves, like a penis, finger, tongue, or toy into their anus).

Methods

We used an anonymous online survey platform (Qualtrics), to query respondents’ experiences with RAI. Respondents who reported a history of ever engaging in RAI were asked questions about their ability to orgasm from RAI. These respondents were further shown anatomic illustrations of the rectum divided into four quadrants and were asked to designate regions they found “pleasurable when touched during sex.” Respondent demographics were collected and used to analyze data by gender identity, age, and sexuality. Chi-squared tests were used to evaluate the statistical differences between cisgender men (CM) and cisgender women (CW). Statistically significant differences existed where P<0.05.

Results

A total of 489 CM (mean age ± SD, 46.3 ± 17.5 years) and 501 CW (48.1 ± 16 years) completed the survey. Comparative analysis revealed CW were significantly more likely to endorse ever engaging in RAI, as compared to CM (34% vs 24%, p=0.00181). By different age groups: middle-aged CW [40-59 yo] were significantly more likely to endorse RAI (and older [>60yo] CM were significantly less likely; 41% vs. 20% respectively, p=0.00122). By sexuality: bisexual CM (73%), homosexual CM (40%), and homosexual CW (41%) were significantly more likely to report engaging in RAI while heterosexual CM (18%) were significantly less likely to endorse it (p<0.00001). By ability to orgasm: CM were significantly more likely to endorse achieving orgasm from RAI alone, as compared to CW (38.5% vs 18.6% respectively, p<0.001). By erogenous zone location: the superficial aspects of the rectum were more frequently selected by CM and CW as sites of pleasure when touched during RAI, as compared to the deep aspects (39% vs 14.6%). Also, respondents more frequently selected the anterior aspects of the rectum over the posterior aspects (36.6% vs 28.3%).

Conclusions

Our findings show that anal sex is practiced by many adults, across age, gender and sexual identity categories. Universally, both more CM and CW report pleasure from the superficial areas of the rectum. These findings may prove useful in elucidating the practice of RAI to improve patient sexual satisfaction.

Disclosure

No
196 IIEF-EF Improvements are more Pronounced with Nutraceuticals Compared to Placebo Medications: A Systematic Review and Meta-analysis
Authors: Arthur M. , Feustel P. , Welliver C.
Published: April 2022

Introduction

Nutraceuticals are pharmacological alternatives to conventional medications that have been used to treat a variety of ailments or conditions however frequently these compounds are used without rigorous assessment of safety and efficacy.

Objective

Our goal was to assess the placebo and nutraceutical effect on erectile function as measured by the change in baseline international index of erectile function-erectile function (IIEF-EF) score.

Methods

The search terms ‘(erectile dysfunction OR erectile function OR sexual dysfunction) AND (placebo OR sham)’ were queried via Pubmed. For inclusion in analysis, studies had to be blinded, placebo controlled, and use the IIEF-EF to measure outcomes. Studies were excluded if data was missing, articles could not be retrieved, or if protocol was ambiguous or unblinded. Data was then extracted and analyzed via meta-analysis. Differences between groups were considered statistically significant if p<0.05.

Results

A total of 12 studies were identified that utilized a natural medication (“nutraceutical”) and placebo (“placebo”) control group with 602 patients receiving nutraceutical and 559 patients receiving placebo in total. A variety of different compounds were tested. While improvements in IIEF-EF were more pronounced in the nutraceutical group (16.6 increasing to 20.6, p=0.0008) the placebo control group also demonstrated a statistically significant increase (17.0 to 18.4, p=0.0021).

Conclusions

Studies demonstrate an increase in subjective measures of erectile function both in placebo and nutraceutical groups. Nutraceuticals did have a more pronounced effect despite not containing active drug compounds. The mechanism of response to placebo for erectile function is unclear however the increases in both nutraceutical and placebo group points towards a contributory psychological effect of the medications.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Compensated Reviewer for Oakstone Publishing, Medscape
199 A Free Listing Assessment of Sexual Function and Relationships for Penile Prosthesis and Intracavernosal Injection Therapy for Erectile Dysfunction
Authors: Berry K. , Salib A. , Tidwell T. , Chung P.
Published: April 2022

Introduction

Most erectile dysfunction (ED) studies focus predominantly on sexual function leaving self-esteem and relationships understudied. Free listing is a technique for gathering data about a specific topic by asking participants to list items that relate to the topic. We evaluated free listing responses of patients undergoing treatment with penile prosthesis (PP) and intracavernosal injection (ICI).

Objective

To compare free listing responses about sexual function and relationships between patients treated with penile prosthesis (PP) and intracavernosal injection (ICI).

Methods

IRB-approval was obtained to interview patients by phone who underwent ED treatment by a single surgeon. Participants were asked to give three one-word responses to questions about sexual function and relationships. Responses with like terms were grouped together to avoid redundancy in reporting results. All words reported at least four times were included.

Results

Fifty patients (25 PP, 25 ICI) agreed to be interviewed for this study. For Q1 (What are some words that describe how your current sexual function makes you feel?) responses for PP included positive (n=13), content (n=12), confident (n=5), dependable (n=5), nervous (n=4), nonfunctional (n=4), and unsatisfied (n=4), while responses for ICI were positive (n=9), content (n=6), excited (n=4), fine (n=4), and nonfunctional (n=4). For Q2 (what are some words that come to mind that describe your ability to have sex by yourself or with others?) responses for PP included positive (n=7), unsatisfied (n=5), dependable (n=5), and confident (n=4), while the responses for ICI were nonfunctional (n=5), dependable (n=5), and positive (n=4). For Q3 (what are some words that describe your intimate relationships with others?) the responses for PP included positive (n=7) and content (n=7), while responses for ICI were positive (n=9), content (n=8), and love (n=8).

Conclusions

PP and ICI patients reported predominantly positive statements but did report psychosocial concerns despite undergoing ED treatment. Further discussion into patient expectations both before and after treatment may help to improve patient satisfaction and self-perception.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific
225 Male Hypogonadism Significantly Increases the Risk of Perinatal Birth Complications: Retrospective Analysis of US Claims Data
Authors: Hernandez-Vegas E , Hotaling J , Horns J , Paudel N , Crump J , Gross K , Pastuszak A , Patel D
Published: April 2022

Introduction

Hypogonadism is common in men with male factor infertility and hormone therapies may improve semen parameters and pregnancy rates in affected men. However, compared to paternal factors such as advanced age, male infertility or obesity, it is uncertain whether hypogonadism itself impacts perinatal birth outcomes and complications.

Objective

This study evaluates the association between male hypogonadism and perinatal birth complications in the United States.

Methods

We performed a retrospective analysis of the IBM MarketScan™ Commercial Claims and Encounters database between 2011-2017. We identified birth records using birth or pregnancy-related major diagnostic categories associated with persons age 0. Fathers were considered to be adult (> 18) male individuals with the same family identifier as the neonates listed as either the primary insurance beneficiary or spouse. Birth records were excluded if there was no family identifier or the father was unable to be linked. For each birth, we recorded whether they were preterm, diagnosed as low birth weight, or diagnosed with birth defects. For the fathers linked with each birth record, we determined paternal age, hypogonadism status, geographic region, and other associated comorbidities. Births were stratified based on whether the father had hypogonadism or not and we performed univariate tests for variation. Additionally, we conducted a multivariate logistic model of birth complication (preterm, low weight, or growth defect) against father's age, hypogonadism status, and paternal comorbidities.

Results

Between 2011 and 2017, paternal hypogonadism was found in 3.97% of fathers among 468,546 birth records. In contrast, no paternal hypogonadism was found in 96.03% of fathers among 468,546 birth records. Overall, our study reveals that paternal hypogonadism is positively associated with perinatal birth complications (odds ratio (OR) 1.10; 95% CI: 1.06, 1.13). Additionally, low birth weight was found in 46, 96% of birth among 196,607 birth records with paternal hypogonadism, follow by preterm birth with 7.64% of birth among 26,886 birth records with paternal hypogonadism.

Conclusions

Male hypogonadism was associated with a statistically significant increase in perinatal birth complications. However, these results should be interpreted with caution because patients with male hypogonadism are also likely to have male infertility. For hypogonadism to be considered as a separate risk factor for perinatal birth complications further investigation will be needed.

Disclosure

No
241 Salvage of Infected Penile Prosthesis using Novel High-Pressure Pulse Irrigation System Adapted to Urological Use in Conjunction with a new Antimicrobial Solution
Authors: Shteynshlyuger A , Rabinowitz D
Published: April 2022

Introduction

Infection of a penile implant is a catastrophic event necessitating removal of the infected device. Removal of an infected implant is associated with significant morbidity, including penile fibrosis with associated shortening. Delayed reimplantation is associated with difficulty or maybe technically impossible. Mulcahy salvage protocol with modifications is the preferred approach when possible. Adequate irrigation is a challenge given the ‘deep-in-a-hole’ surgical anatomy where the implants are placed. In addition, there is no agreed-upon irrigant that is ideal for irrigation infected wounds.

Objective

We describe adaptation and modification of orthopedic high-pressure irrigation system for use in the salvage of penile prosthesis. In addition, we describe novel use in urology of a hypochlorous washing solution capable of removing microorganisms, disrupting biofilm, while being non-cytotoxic and skin-neutral.

Methods

Stryker Interpulse Pulsed Lavage System generating 15 pounds per square inch (PSI) of pressure was adapted for urological use in deep cavities using 16F red rubber Bard urethral catheter. Infected implant in a high-risk multiple comorbidities vasculopath was successfully salvaged without complications.

Results

Successful salvage of an infected penile prosthesis with a novel adaptation of existing high-pressure irrigation system. Demonstrated safely of use of antibiotic solution for penile irrigation.

Conclusions

In-vivo studies show significantly greater effectiveness of high-pressure pulsed salvage irrigation compared to bulb syringe irrigation. We present a practical, accessible, and effective modification of an existing high-pressure irrigation syringe for use in deep cavities, proximal and distal penile shaft. In addition, we report safe use of a new antimicrobial irrigant, hypochloric acid, for salvage of infected penile prosthesis.

Disclosure

No
121 Factors Associated With Inflatable Penile Prosthesis Underutilization After Prostate Cancer Treatment
Authors: Abdelmalek G , Warren C , Shen C , Shah T , Lulla T , Schaefer E , Zhou S , Fried D , Helemer D , Sadeghi-Nejad H
Published: April 2022

Introduction

Penile Prosthesis (IPP) is an effective treatment for men with ED that significantly improves quality of life but is likely being underutilized in men who were treated for prostate cancer (Pca).

Objective

To better characterize the utilization of IPP treatment after Pca therapy, we explored the relationship between timing of ED diagnosis (before vs after treatment), treatment modality (radiation vs. prostatectomy), and various sociodemographic factors in a national cohort.

Methods

We performed a retrospective review of SEER-Medicare patients who were diagnosed with local/regional Pca between 2006 and 2011.Using ICD9/CPT/HCPCS codes, we created a subset of patients who were diagnosed with ED 12 months prior to their Pca treatment, until 5 years after. Chi-square/Wilcoxon tests were used to detect significant differences between the use of IPP among those with ED prior to Pca treatment compared to after. In addition, various sociodemographic factors were examined.

Results

Of the 31,854 patients in our cohort, 14,482 (45.5%) were diagnosed with ED within 12 months prior to Pca diagnosis or 5 years after diagnosis. Among those diagnosed with ED prior to treatment (4366, 30.1%), 119 (2.7%) received IPP while among the 10,116 patients (69.9%) with ED diagnosis after treatment, 232 (2.3%) received IPP. Among patients with ED, factors decreasing the likelihood of receiving an IPP were diagnosis of ED prior to Pca treatment (OR=1.33, 95% CI: 1.06-1.66), relationship status of single (OR=1.88, 95% CI: 1.28-2.77) or divorced/separated (OR=2.13, 95% CI: 1.46-3.10), and identifying as Non-Hispanic Black (OR=1.72, 95% CI:1.24-2.37) or Hispanic (OR=1.81, 95% CI: 1.22-2.67) as compared to Non-Hispanic White men. Factors decreasing the likelihood of receiving an IPP were being treated with radiation therapy as opposed to prostatectomy (OR=0.38, 95% CI: 0.29-0.49), and increased age (OR=0.75 95% CI: 0.63-0.88).

Conclusions

Although more men have their ED treated with an IPP if they received their diagnosis prior to Pca treatment (2.7% vs. 2.3%), IPPs appear to be underutilized in all patients with ED after Pca therapy. This data suggests that factors (i.e. prior ED diagnosis, being single, Black or Hispanic) outside of the typically accepted medical indications may influence IPP selection as a treatment option for ED. Conversely, counseling pertaining to IPP surgery after Pca treatment may be lacking in men with newly diagnosed ED, married men, white men, older men, and men who received radiation therapy. More thorough evaluation of these demographic factors is warranted.

Disclosure

No
125 Extrinsic Compression of Inflatable Penile Prosthesis Secondary to Prone Positioning for COVID-19 Pneumonia: A Case Series of Two Patients
Authors: Roadman D , Anderson L , Tsambarlis P
Published: April 2022

Introduction

Complications of extrinsic compression on an inflatable penile prosthesis (IPP) due to prone positioning for COVID-19 pneumonia have not been described. Patients with an IPP present a unique challenge for managing compression injuries secondary to proning due to the dependent position of the penis and ability of the device to restrict blood flow to the distal penis when externally compressed for long periods of time. We present two patients with previous IPP placement who experienced glans and penile ischemia secondary to extrinsic compression of the penis from proning, who were monitored conservatively and avoided urgent explantation.

Objective

To describe two patients with IPPs who were intubated and proned for COVID-19 pneumonia who experienced IPP-related complications due to pressure injury, one of whom survived for follow-up.

Methods

Two male patients, ages 68 and 74 years, who developed penile injury following proning for COVID-19 pneumonia. The first patient presented with skin breakdown of the ventral aspect of the penis and scrotum without exposed implant. The second patient presented with a pale and dusky glans.

Results

The first patient was managed by scrotal elevation with bacitracin application to the wound twice daily. There was no surgical intervention or debridement of the penile and scrotal wounds. The patient was then followed on an outpatient basis without need for explantation at 4-months from initial consultation (Figure 1). He underwent a CT of the abdomen and pelvis as well as a CT Urogram as an outpatient that confirmed appropriate positioning of all components of the device without evidence of underlying infection. On exam, the penile prosthesis was well-positioned and cycled normally, with a freely mobile pump within the scrotum. The second patient expired during hospitalization from COVID-19 respiratory failure, but was monitored for six days without glans necrosis (Figure 2) once external pressure was removed.

Conclusions

Patients with IPPs who require prone positioning are a unique population that are at risk for extrinsic compression injury of the penis. In contrast to ischemia related to instrinsic compression, such as with the sliding technique, which results in glans necrosis and necessitates urgent explantation, conservative treatment and serial examination in the setting of external compression from prone intubation was a viable and safe option to immediate explantation in these patients. Prevention, in the form of proper padding and minimization of external compression, remains paramount as we obtain more long term data from this unique patient population.

Disclosure

No
135 Impedance Rates for Novel Bipolar Radiofrequency Sealing Tool for Transdermal Vasectomy: A Rabbit Model
Authors: Hakky TS , Labrecque M , Marmar J , Henry GD
Published: April 2022

Introduction

Radiofrequency ablation functions by delivering thermal energy within a tissue resulting in coagulative necrosis and seals vessels. This tool has been successfully applied to other areas of the body.

Objective

We evaluate the safety and efficacy of radiofrequency ablation in transdermal vasectomy in rabbits. This was done by examining impedance rates through the tissue and its effect on wound healing.

Methods

Two groups of 5 male New Zealand white rabbits were given IV sedation and local anesthetic and subsequent transdermal bilateral partial vasectomy using a high lateral scrotal approach. We isolated the vas with a novel insulated clamp fitting the U-shape electrode of the sealing tool (Figure 1). All tissue layers were removed enbloc. In Group 1 (n=5), the device was set at 60 watts for 20 seconds. In the second group (n=5), the size of the U-shape electrode was reduced and the device was set at 40 and 60 watts using thermal sensors with impedance alarms to shut off if there was excessive energy. All 10 rabbits underwent a semen analysis, wound evaluation, post-mortem biopsies and histology was performed.

Results

We sacrificed 4 of the 5 (80%) of Group 1 rabbits due to poor wound healing due to excessive tissue damage, and all of Group 2 healed and survived. All rabbits had a negative semen analysis and on histology had occluded vas deferens. Impedance energy levels were variable and stopped at a predetermined level. We found that a 5 second interval is optimal for vas ligation. (Figure 1)

Conclusions

The novel transdermal bipolar radiofrequency ablation tool successfully occludes the vas deferens in the rabbit model. Impedance alarms with a predetermined Ohms level was reached at 5 seconds. This energy transfer rate and duration is paramount for wound healing. Future studies are needed before its application in humans.

Disclosure

Yes, this is sponsored by industry/sponsor: Signati

Clarification: Industry initiated, executed and funded study

Any of the authors act as a consultant, employee or shareholder of an industry for: Signati
Effects of Stigma on the Relationship Between Perceived Social Support and Sexual Satisfaction Among Breast Cancer Survivors
Authors: Zhang Yuxin , Zhao Jie , Jiang Nan , Wang Ting , Cao He , Wang Quqing , Wei Xiaomin , Wang Jiwei , Yu Jinming
Published: April 2022

Background

Sexual satisfaction is one of the issues faced by breast cancer survivors (BCSs).

Aim

This study aims to explore the mediation of stigma in the relationship between perceived social support (PSS) and sexual satisfaction among breast cancer survivors.

Methods

A cross-sectional study was conducted among 918 BCSs in Shanghai Cancer Rehabilitation Club. Data were collected using an online questionnaire including questions on sociodemographic characteristics, health status, PSS, stigma and sexual satisfaction of participants. The bootstrap method was used to test the significance of the simple mediation model.

Outcomes

The simple mediation of stigma was found significant in the relationship between PSS and sexual satisfaction.

Results

Stigma plays an intermediary role in the relationship between 2 dimensions of PSS (family and friends) and sexual satisfaction, but not in the relationship between the dimension of other significant people of PSS and sexual satisfaction.

Clinical Translation

It is important to reduce stigma when improving the sexual satisfaction of BCSs from the perspective of PSS.

Strengths & Limitations

The mediating role of stigma in the relationship between PSS and sexual satisfaction among BCSs has been shown for the first time. Study limitations include limitations in the representativeness of population by the study sample and the cross-sectional study design.

Conclusions

Stigma mediates the relationship between PSS and sexual satisfaction, which needs to be eliminated in intervention practice.
Classical First-Order Logic
Authors: Shapiro Stewart , Kissel Teresa Kouri
Published: April 2022

One is often said to be reasoning well when they are reasoning logically. Many attempts to say what logical reasoning is have been proposed, but one commonly proposed system is first-order classical logic. This Element will examine the basics of first-order classical logic and discuss some surrounding philosophical issues. The first half of the Element develops a language for the system, as well as a proof theory and model theory. The authors provide theorems about the system they developed, such as unique readability and the Lindenbaum lemma. They also discuss the meta-theory for the system, and provide several results there, including proving soundness and completeness theorems. The second half of the Element compares first-order classical logic to other systems: classical higher order logic, intuitionistic logic, and several paraconsistent logics which reject the law of ex falso quodlibet.
A Dilemma for Higher-Level Suspension
Authors: TAL EYAL
Published: April 2022

Is it ever rational to suspend judgment about whether a particular doxastic attitude of ours is rational? An agent who suspends about whether her attitude is rational has serious doubts that it is. These doubts place a special burden on the agent, namely, to justify maintaining her chosen attitude over others. A dilemma arises. Providing justification for maintaining the chosen attitude would commit the agent to considering the attitude rational—contrary to her suspension on the matter. Alternatively, in the absence of such justification, the attitude would be arbitrary by the agent's own lights, and therefore irrational from the agent's own perspective. So, suspending about whether an attitude of ours is rational does not cohere with considering it rationally preferable to other attitudes, and leads to a more familiar form of epistemic akrasia otherwise.
Post-Acute Level Of Consciousness scale revised (PALOC-sr): adaptation of a scale for classifying the level of consciousness in patients with a prolonged disorder of consciousness
Authors: Eilander Henk J. , van Erp Willemijn S. , Driessen Daniëlle M F. , Overbeek Berno U H. , Lavrijsen Jan C M.
Published: April 2022

Objective:

To present an updated version of the ‘Post-acute Level Of Consciousness scale’ (PALOC-s), in accordance with the latest scientific insights.

Methods:

Within the context of a research project, 20 years ago, the PALOC-s was developed for the purpose of following the development of the level of consciousness of young unconscious patients participating in a rehabilitation program. Meanwhile, the understanding of the behavior related to different levels of consciousness has developed and terminology has changed, resulting in the need to revise the PALOC-s. With the preservation of the original description of the eight hierarchical levels of PALOC-s, adaptations are made in the terminology and grouping of these levels.

Results and conclusion:

This manuscript presents the revised version of PALOC-sr, which is suitable for use in clinical practice. The validation of this scale is recommended for its optimal use in future (international) research projects.
Computing quantities of interest and their uncertainty using Bayesian simulation
Authors: Murr Andreas , Traunmüller Richard , Gill Jeff
Published: April 2022

When analyzing data, researchers are often less interested in the parameters of statistical models than in functions of these parameters such as predicted values. Here we show that Bayesian simulation with Markov-Chain Monte Carlo tools makes it easy to compute these quantities of interest with their uncertainty. We illustrate how to produce customary and relatively new quantities of interest such as variable importance ranking, posterior predictive data, difficult marginal effects, and model comparison statistics to allow researchers to report more informative results.
CULTURAL SHIFT OR SHORT-LIVED FASHION? INTERPRETING THE ROLE OF HELLENISTIC BRAZIERS FROM THE AGORA OF NEA PAPHOS, CYPRUS
Authors: Nocoń Kamila
Published: April 2022

This paper offers an overview of a number of fragments of Hellenistic braziers collected during several seasons of excavations in the Agora of Nea Paphos, Cyprus. Its primary aim is to demonstrate their presumably local production and the production of examples manufactured outside of Cyprus during the Hellenistic and Early Roman periods by using a methodology that combines the macroscopic analysis of fabrics and typological study. Special attention is given to what this collection tells us about some of the human practices in the city between the third century BCE and the Early Roman period. This study seeks to obtain data that will help to address gaps in the material culture of Hellenistic Nea Paphos and deepen the understanding of the broader process of Hellenisation.
Sonic Collaborations between Humans, Non-human Animals and Artificial Intelligences: Contemporary and future aesthetics in more-than-human worlds
Authors: ULLRICH MARTIN , TRUMP SEBASTIAN
Published: April 2022

This article sketches a theoretical framework that allows the conceptual inclusion of non-human animals and artificial intelligences in human sonic collaborations. Post-humanist concepts that question the categorical divide between nature and culture, following Donna Haraway and Bruno Latour, converge with contemporary, non-adaptationist evolutionary aesthetics. Therefore, the anthropocentric ‘othering’ of non-humans gives way to a concept of a more-than-human sociality of sound. We offer some theoretical propositions for the extension of socially engaged sound practices to collaborations between humans and non-human animals and between humans and artificial intelligences, and then exemplify such multispecies sonic collaborations by analysing some existing projects from the fields of sound art and musical performance. After drawing some more general conclusions from these analyses, we hint at potential aesthetical and ethical parallels between animal and AI creative agency. Finally, we point out a few questions we see as important for future advanced settings of such collaborations, especially when it comes to assemblages of different AI technologies and to future concepts of animal–computer interaction that might enable non-human animals and artificial intelligence to cooperate creatively.
Interactive effects between input and output technical inefficiencies
Authors: Esheba Muna , Serletis Apostolos
Published: April 2022

This paper derives a new set of results that provide corrective measures of overall technical inefficiency that either have been ignored or wrongly assumed in the literature. Using directional distance functions, we argue that overall technical inefficiency is not only a function of input and output technical inefficiencies as previous studies claim but also of the interaction between them. The derivation of the interactive effects between input and output technical inefficiencies (IEIOs) solves the arbitrary decomposition of overall technical inefficiency into input and output components. We also show that the IEIO depends on the choice of the directional vector and whether quantities and prices are taken into consideration. Using exogenous and endogenous directional vectors, we prove these results theoretically and empirically using the US commercial banking data set. Using Bayesian estimation with the monotonicity conditions imposed at each observation, we estimate input and output technical inefficiencies separately using directional input and output distance functions with the three commonly used directional vectors; the unit value, the observed input−output, and the optimal directional vectors. The overall technical inefficiency is estimated using systems of equations to incorporate the interactive effect equation and to address the endogeneity of inputs and outputs. Consistent with the theoretical results, we find significant evidence of the IEIO which has a negative effect on the overall technical inefficiency. This result is robust to alternative directional vectors and model specifications, suggesting that the adjustability of both inputs and outputs is required for the improvement of the efficiency of the US commercial banks.
Nutrition programmes for individuals living with disadvantage in supported residential settings: a scoping review
Authors: Vaiciurgis Verena T , Charlton Karen E , Clancy Annabel K , Beck Eleanor J
Published: April 2022

Objective:

Health inequities such as chronic disease are significantly higher among individuals living with disadvantage compared with the general population and many are reported to be attributable to preventable dietary risk factors. This study provides an overview of the current nutrition interventions for individuals living with extreme disadvantage, in supported residential settings, to develop insights into the development and implementation of policies and practices to promote long-term nutritional health and well-being.

Design:

A scoping review searched Scopus, ProQuest, CINAHL Plus, MEDLINE, and Web of Science databases using the terms ‘resident’, ‘nutrition’, ‘disadvantage’, ‘intervention’ and their synonyms, with particular emphasis on interventions in residential settings.

Setting:

Residential services providing nutrition provision and support.

Participants:

People experiencing extreme disadvantage.

Results:

From 5262 articles, seven were included in final synthesis. Most interventions focused on building food literacy knowledge and skills. Study designs and outcome measures varied; however, all reported descriptive improvements in behaviour and motivation. In addition to food literacy, it was suggested that interventions need to address behaviour and motivations, programme sustainability, long-term social, physical and economic barriers and provide support for participants during transition into independent living. Socio-economic issues remain key barriers to long-term health and well-being.

Conclusions:

In addition to food literacy education, future research and interventions should consider utilising an academic-community partnership, addressing nutrition-related mental health challenges, motivation and behaviour change and a phased approach to improve support for individuals transitioning into independent living.
Past the Precipice? Projected Coral Habitability Under Global Heating
Authors: Kalmus P. , Ekanayaka A. , Kang E. , Baird M. , Gierach M.
Published: April 2022

Coral reefs are rapidly declining due to local environmental degradation and global climate change. In particular, corals are vulnerable to ocean heating. Anomalously hot sea surface temperatures (SSTs) create conditions for severe bleaching or direct thermal death. We use SST observations and CMIP6 model SST to project thermal conditions at reef locations at a resolution of 1 km, a 16‐fold improvement over prior studies, under four climate emissions scenarios. We use a novel statistical downscaling method which is significantly more skillful than the standard method, especially at near‐coastal pixels where many reefs are found. For each location we present projections of thermal departure (TD, the date after which a location with steadily increasing heat exceeds a given thermal metric) for severe bleaching recurs every 5 years (TD5Y) and every 10 years (TD10Y), accounting for a range of post‐bleaching reef recovery/degradation. As of 2021, we find that over 91% and 79% of 1 km2reefs have exceeded TD10Y and TD5Y, respectively, suggesting that widespread long‐term coral degradation is no longer avoidable. We project 99% of 1 km2reefs to exceed TD5Y by 2034, 2036, and 2040 under SSP5‐8.5, SSP3‐7.0, and SSP2‐4.5 respectively. We project that 2%–5% of reef locations remain below TD5Y at 1.5°C of mean global heating, but 0% remain at 2.0°C. These results demonstrate the importance of further improving ecological projection capacity for climate‐vulnerable marine and terrestrial species and ecosystems, including identifying refugia and guiding conservation efforts. Ultimately, saving coral reefs will require rapidly reducing and eliminating greenhouse gas emissions.
A Multi‐Proxy Approach Using Zircon (U‐Th)/He Thermochronometry and Biomarker Thermal Maturity to Robustly Capture Earthquake Temperature Rise Along the Punchbowl Fault, California
Authors: Armstrong E. M. , Ault A. K. , Bradbury K. K. , Savage H. M. , Polissar P. J. , Thomson S. N.
Published: April 2022

During an earthquake, work done to overcome fault friction is dissipated as heat. Coseismic temperature rise, critical for identifying and constraining the magnitude of past earthquakes, is difficult to accurately quantify. To address this issue, we compare two temperature‐sensitive geochemical systems, zircon (U‐Th)/He (ZHe) thermochronometry and thermal maturity of organic matter (biomarkers), which respond to short‐duration, high temperatures. Models of prior biomarker data from the Punchbowl fault (PF), CA, indicate coseismic temperatures of ∼465–1,065°C in the principal slip zone (PSZ; Savage & Polissar, 2019, https://doi.org/10.1029/2019gc008225) depending on prescribed thickness of the deforming zone. We resampled two PF sample sites and acquired high‐spatial resolution ZHe data (n = 45 individual analyses) from the PSZ and fault core gouge, together with adjacent crystalline basement and Punchbowl Formation rocks. Results define a positive ZHe date‐effective U (eU) trend from ∼10 to 60 Ma and ∼20–700 ppm eU with a plateau at ∼65 Ma at >700 ppm eU. This pattern suggests the PSZ and fault core gouge share a similar thermal history to material outside the PF. Individual apatite (U‐Th)/He dates (n = 5) from an undeformed Punchbowl Formation sample are ∼4 Ma for grains with ∼30–150 ppm eU, implying rapid cooling and exhumation at that time due to PF activity. Zircon damage‐diffusivity relationships inform a suite of numerical models that collectively bracket coseismic temperatures on the PF to <725–800°C for 90% He loss. Results support general compatibility between ZHe and biomarker‐derived temperature rise estimates, and spatio‐temporal variability in coseismic temperatures along the PF.
Reconciling Roles of External Forcing and Internal Variability in Indian Ocean Decadal Variability Since 1920
Authors: Hua Wenjian , Dai Aiguo , Qin Minhua
Published: April 2022

On decadal time scales, Indian Ocean sea surface temperatures (SSTs) exhibit coherent basin‐wide changes, but their origins are not well understood. Here we analyze observations and model simulations from Coupled Model Intercomparison Project Phase 6 and Community Earth System Model Version 1 to quantify the roles of external forcing and internal climate variability in causing Indian Ocean decadal SST variations. Results show that both external forcing and internal variability since 1920 have contributed to the observed decadal variations in linearly detrended Indian Ocean SSTs, and they exhibit an out‐of‐phase relationship since the 1950s. The internally‐generated variations arise from remote influences from the tropical Pacific and possible contributions from internal local processes, while the influence from the Atlantic Multidecadal Oscillation is opposite to that of the Interdecadal Pacific Oscillation. Decadal SST changes caused by nonlinear variations in greenhouse gases and aerosols are roughly out‐of‐phase with the internal variability, thus dampening observed SST variations since the 1950s.
Response of Eurasian Temperature to Barents–Kara Sea Ice: Evaluation by Multi‐Model Seasonal Predictions
Authors: Komatsu Kensuke K. , Takaya Yuhei , Toyoda Takahiro , Hasumi Hiroyasu
Published: April 2022

Barents–Kara (BK) sea ice conditions are considered a potential source of seasonal predictability in the midlatitudes, but confirmation or refutation of this possibility remains elusive. We focused on the Warm Arctic–Cold Eurasia (WACE) pattern and evaluated whether BK sea ice is related to winter conditions over Eurasia in multi‐model seasonal predictions. In the models analyzed, the WACE index is strongly depended on the BK temperature and did not rigorously reflect a sea ice–Eurasia causal link. The autumn BK sea ice anomaly was not a precursor of winter atmospheric conditions over Eurasia. Rather, the winter atmospheric circulation likely drives both winter BK sea ice and Eurasian temperature. However, the predicted winter sea ice–Eurasia links are likely weaker than the observed. This contrast is speciously related to the modest sea ice variance, but the actual influence of BK sea ice variation on Eurasian temperature anomalies is still questionable.
Increased Large‐Scale Convective Aggregation in CMIP5 Projections: Implications for Tropical Precipitation Extremes
Authors: Bläckberg C. P. O. , Singh M. S.
Published: April 2022

Convective aggregation refers to the clustering of convective events and occurs on a wide range of spatial scales. It has been suggested that the behavior of convective aggregation may change under global warming, with potential implications for future changes in precipitation extremes. Here, convective regions of the tropics are defined from a percentile threshold on gridded daily precipitation data and used to quantify large‐scale convective aggregation in an ensemble of global climate models. Applying three separate indices for aggregation, it is found that large‐scale convective aggregation increases in 17 of the 19 analyzed models under future warming. However, aggregation is found not to be correlated with tropical‐mean precipitation extremes, either climatologically or with respect to the sensitivity to warming. The large model spread in aggregation indices across the ensemble suggests the possible utility of large‐scale convective aggregation as a target for model evaluation.
The Influence of the Vietnam Offshore Current and Kuroshio Intrusion on Net Community Production in the Oligotrophic South China Sea in Summer
Authors: Qin Chuan , Zhang Guiling , Han Yu , Zhang Guicheng , Sun Jun
Published: April 2022

In summer, the Vietnam Offshore Current (VOC) and the Kuroshio intrusion are two important processes inducing considerable environmental fluctuations in the surface water of the South China Sea (SCS). Net community production (NCP) is an important proxy of the biological pump strength and can be estimated based on the dissolved oxygen to argon ratio (O2/Ar) in the mixed layer. To quantify the influence of the VOC and Kuroshio intrusion on NCP in the oligotrophic SCS, we obtained continuous measurements of O2/Ar in the upper mixed layer using membrane inlet mass spectrometry (MIMS) in the northeastern SCS in summer 2017. Average NCP was 2.6 ± 1.5 mmol C m−2 d−1 in Phase 1 (from 13 to 20 July), 5.3 ± 1.7 mmol C m−2 d−1 in Phase 2 (from 20 to 25 July), and 13.9 ± 2.3 mmol C m−2 d−1 in Phase 3 (from 30 July to 9 August). Data from the region influenced by vertical mixing were excluded. A strong correlation between the surface dissolved inorganic nitrogen (DIN) and NCP was obtained, indicating that DIN was an essential factor controlling NCP in the SCS surface water. During our sampling, the Kuroshio intruded into the northeastern SCS in a loop pattern through the Luzon Strait, approximately halving the surface DIN concentration and reducing NCP by 36%. In addition, the VOC drove Vietnam coastal upwelled water to extend northeastward, causing an increase of 140% in the surface DIN concentration and an associated elevation of 160% in NCP in the northeastern SCS.
Automatic Spread‐F Detection Using Deep Learning
Authors: Luwanga Christopher , Fang Tzu‐Wei , Chandran Amal , Lee Yu‐Ju
Published: April 2022

Spread‐F (SF) is a feature that can be visually observed on ionograms when the ionosonde signals are significantly impacted by plasma irregularities in the ionosphere. Depending on the scale of the plasma irregularities, radio waves of different frequencies are impacted differently when the signals pass through the ionosphere. An automated method for detecting SF in ionograms is presented in this study. Through detecting the existence of SF in ionograms, we can help identify instances of plasma irregularities that are potentially affecting the high‐frequency radio‐wave systems. The ionogram images from Jicamarca observatory in Peru, during the years 2008–2019, are used in this study. Three machine learning approaches have been carried out: supervised learning using Support Vector Machines, and two neural network‐based learning methods: autoencoder and transfer learning. Of these three methods, the transfer learning approach, which uses convolutional neural network architectures, demonstrates the best performance. The best existing architecture that is suitable for this problem appears to be the ResNet50. With respect to the training epoch number, the ResNet50 showed the greatest change in the metric values for the key metrics that we were tracking. Furthermore, on a test set of 2050 ionograms, the model based on the ResNet50 architecture provides an accuracy of 89%, recall of 87%, precision of 95%, as well as Area Under the Curve of 96%. The work also provides a labeled data set of around 28,000 ionograms, which is extremely useful for the community for future machine learning studies.
Greenhouse Gases Must Begin to Fall by 2025, Says U.N. Climate Report
Authors: Duncombe Jenessa
Published: April 2022

Emissions rates are still growing every year, though that growth has slowed. The world needs to reach negative growth soon to prevent a potential 3.2�C rise by the end of the century.
Giant Planet’s Formation Caught in Action
Authors: Japelj Jure
Published: April 2022

Astronomers took a direct image of a massive protoplanet embedded in a protoplanetary disk. The system provides strong evidence for an as-yet-unconfirmed theory of planet formation.
How a Newly Discovered Mineral Might Explain Weird Mantle Behavior
Authors: Tripathy-Lang Alka
Published: April 2022

Scientists not only synthesized davemaoite but deformed it at lower mantle conditions. They found its strength and viscosity to be substantially lower than those of other minerals that make up the lower mantle.
A Rapid Localized Deceleration of Earth's Radiation Belt Relativistic Electrons Driven by Storm Proton Injection
Authors: Chen Zewen , Su Zhenpeng , He Zhaoguo , Wu Zhiyong , Dai Guyue , Wang Bin , Xiong Ying , Zheng Huinan , Cui Jun , Wang Yuming
Published: April 2022

Earth's radiation belt relativistic electron dropouts frequently occur during the main phase of geomagnetic storms, which have been partially attributed to the ring current ion enhancements causing geomagnetic field reconfigurations. In contrast to early studies on the global radiation belt response to the ring current buildup on a timescale of several hours, we here describe a rapid, localized, significant decay of relativistic electrons driven by freshly injected energetic protons during the 27 May 2017 geomagnetic storm. Near the proton injection front, the magnetic field lines were stretched outward, with an inferred migration of their equatorial crossings by ∼0.5 RE during several minutes. Because of the betatron and Fermi decelerations, the relativistic electron fluxes decreased by 2–3 orders of magnitude with pitch‐angle distributions evolving from pancake/flat‐top type to cigar type. This rapid localized response pattern of relativistic electrons could be general over strong particle injections during both geomagnetic storms and substorms.