bluuebunny/crossref_metadata_2025 huggingface dataset:
234 Analyzing the Quality of YouTube Videos on Inflatable Penile Prosthesis Surgery
Authors: Paredes-Bhushan V , Patel R , Saunders J , Rezaee M , Gross M
Published: April 2022

Introduction

Video websites, predominantly YouTube.com, offer patients unfiltered and unregulated medical content. Patient commonly use these online medical resources to investigate intimate conditions. It remains unknown whether YouTube videos on penile prosthesis surgery are useful or informative for patients.

Objective

We assessed the quality and reliability of YouTube videos pertaining to penile prosthesis surgery.

Methods

We compiled penile prosthesis videos on YouTube using a combination of multiple pertinent keyword searches. Videos were initially screened by two reviewers. Videos that were irrelevant, not in English, or without audio and also without captioning were excluded. Video demographics and viewership information were collected and categorized by channel type. Videos were then scored by three reviewers. Videos were categorized by themes, which included useful, misleading, or patient views. Reliability was assessed using a modified 5-point DISCERN tool and videos were rated using 5-point Global Quality Scale (GQS). Video comprehensiveness was evaluated using a 5-point content score. Interobserver agreement was assessed using Cohen's kappa score (k) and intraclass correlation coefficient.

Results

Of the 165 videos that initially met inclusion criteria, 23 were hidden or deleted from YouTube at the time of analysis. The remaining 142 videos totaled 1.21 million views, with an average view count of 85,914. Of these, 57 (40.4%) were from universities, professional organizations, non-profits or physicians/physician groups. An additional 56 (39.7%) were medical advertisements from for-profit companies. 20 videos (14.2%) were from individual channels and 13 (9.2%) were stand-alone health information websites. The average reliability score was 3.49 (±1.32), k=0.489. The average GQS was 3.26 (±1.22), k=0.128. The average content score was 1.89 (±1.45), k=0.683. Intraclass correlation coefficient was calculated as for 0.755 for DISCERN and 0.822 for GQS, suggesting strong reliability. 76 videos (53.9%) were identified as self-promotional. 20 videos (14.1%) were identified as patient testimonials. 123 videos (86.6%) were identified as “useful”, 2 videos (1.41%) “misleading” and, 17 videos (12%) as “patient views”.

Conclusions

There is room for improvement in the quality and reliability of YouTube videos pertaining to penile prosthesis surgery. The analyzed YouTube videos also have low content comprehensiveness. Results were consistent across reviewers. Over half of penile prosthesis surgery videos on YouTube are clearly identified as self-promotional by reviewers.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast
243 Single Port Robotic-Assisted Removal of an Eroded Inflatable Penile Prosthesis Reservoir and Repair of an Associated Bladder Fistula
Authors: Simon D , Brockman S , Beer A , Tsambarlis P , Chow A
Published: April 2022

Introduction

We present the case of a 73-year-old man who underwent single port robotic removal of a retained Inflatable Penile Prosthesis (IPP) reservoir with intravesical erosion and repair of an associated bladder fistula. The patient had a 3-piece IPP placed in 2014 for erectile dysfunction after radical prostatectomy for prostate cancer. He underwent device explant two years later for infection, at which time the IPP reservoir was “drained and retained”. He developed re-infection one year later and was again taken to the operating room; however, surgery was aborted due to vascular injuries. He presented to us for evaluation of dysuria and gross hematuria six years after initial IPP placement. Work-up with CT imaging and cystoscopy demonstrated intravesical erosion of the retained reservoir.

Objective

We aim to provide a step-by-step video demonstration of our technique for single port robotic-assisted removal of the eroded penile prosthesis reservoir and repair of an associated bladder fistula.

Methods

Procedures were performed using the da Vinci SP single port robotic system. The SP robot port was placed through a 3 cm incision superior to the umbilicus, and an additional 12 mm assistant port was placed in the Right Lower Quadrant (RLQ). The peritoneum was incised anteriorly lateral to the medial umbilical ligament, and the space of Retzius was developed by sharp and blunt dissection through densely adherent tissue planes. The pseudocapsule surrounding the eroded reservoir was incised, and the exposed reservoir was removed. Two fistulous tracts identified between the pseudocapsule and bladder were circumferentially excised, and the resultant bladder wall defect was repaired in a single layer with running 3-0 V-Loc suture. A drain was placed alongside the bladder repair and externalized through the RLQ assistant port.

Results

The patient tolerated these procedures well and without complications. He was admitted for routine postoperative observation overnight after surgery. On postoperative day one, the drain was removed, and the patient was discharged home with the Foley catheter remaining in place. At 2-week follow-up, the patient was recovering well and a cystogram was obtained showing no leaks, and the Foley catheter was removed.

Conclusions

This surgical case report demonstrates the feasibility and safety of performing removal of an eroded IPP reservoir through a minimally invasive approach with the da Vinci SP surgical system. The accompanying video provides a step-by-step demonstration of our technique.

Disclosure

No
244 Penile Entrapment by Metal Ring: A Video Guide to Surgical Removal
Authors: Glaser Z , Selph JP
Published: April 2022

Introduction

Penile rings may be used to enhance sexual function. Prolonged constriction greater than 30 minutes may lead to pain, edema and ultimately ischemic end organ damage. Failure to remove the ring warrants prompt evaluation and can be a surgical emergency.

Objective

The purpose of this video abstract is to review and demonstrate the management strategies to remove a constricting penile ring.

Methods

Conservative interventions which can be attempted at the bedside are reviewed. These include but are not limited to sliding the penile ring off of the penis using available lubrication as well as cutting the rings using pliers or bolt cutters. Interventions performed under general anesthesia include repeated attempts at sliding off or cutting the ring, and when these maneuvers fail, utilization of mechanical drills or saws may be indicated.

Results

The case presented is a 41 year old gentleman who presented with a thick silver metallic ring placed on the base of his penis. The penis had been entrapped for greater than 24 hours. Conservative measures at the bedside were not successful and the ring was ultimately removed in the operating room using a microsurgical saw. The patient experienced a complete cosmetic recovery and did not experience any long-term detriment to his voiding habits.

Conclusions

Prolonged penile entrapment by placement of a constricting ring risks ischemic end organ damage and is a rare surgical emergency. The conservative and more invasive management approaches are demonstrated in this video.

Disclosure

No
101 Penile Prosthesis Utilization After Radical Cystoprostatectomy for Bladder Cancer
Authors: Prunty M , Rhodes S , OBrian D , Jesse E , Callegari M , Arenas-Gallo C , Halpern J , Calaway A , Loeb A , Shoag J , Thirumavalavan N
Published: April 2022

Introduction

Radical cystoprostatectomy for bladder cancer may adversely affects sexual function in up to 80% of men. Penile prosthesis implantation can restore erectile function in these men, but the extent to which penile prosthesis is utilized in this patient population is unknown.

Objective

We aimed to determine the rate of and time to penile prosthesis implantation for men who have previously undergone radical cystectomy for bladder cancer.

Methods

Using the Premier Healthcare Database, we investigated all male patients undergoing radical cystectomy between 2000 and 2020 and identified the subgroup of patients undergoing penile prosthesis implantation. We compared sociodemographic characteristics in men who did and did not undergo implantation. Categorical variables were analyzed with Chi-squared tests and continuous variables were analyzed with Kolmogorov-Smirnov tests.

Results

We identified 142 men who underwent cystoprostatectomy and subsequently underwent penile prosthesis implantation. Among these 142 patients, 16 (11.27%) had a penile prosthesis placed on the day of cystectomy and 106 (74.65%) had a subsequent penile prosthesis placed at a median of 503.5 days (IQR 214-821 days) following cystectomy. Patients who underwent penile implant were statistically younger (64 years vs 68 years, p<0.001) and more likely to have private insurance (39% vs 25%, p<0.001), as compared to patients who did not have a follow up for penile prosthesis.

Conclusions

Sexual function is an important aspect of cancer survivorship and treatment of post-cystectomy erectile dysfunction should be considered a critical component of care. When penile prosthetics were utilized, this occurred with significant delay (median 503.5 days). Efforts to increase education about available treatment options, inclusion of sexual medicine urologists in post-cystectomy care pathways, and decreasing time to penile implantation may all improve quality of life for bladder cancer survivors.

Disclosure

No
118 Does Irrisept Dipping/Irrigation Adversely Affect the Hydrophilic Coating of Titan Implants?
Authors: Karpman E , Klous D , Zhang W , Taylor J , Henry G
Published: April 2022

Introduction

Prosthetic infections occur in 1-3% of virgin implants. Titan penile prostheses (PP) have a hydrophilic coating that can absorb any antibiotic/antifungal solution for infection prevention. The ideal solution for dipping non-coated implants is yet to be described, however, reports of various solutions exist. Chlorhexidine gluconate is a very broad spectrum antibacterial, antifungal and antiviral solution that has been used for skin preparation for surgery because of its excellent profile for known pathogens. Irrisept is the first and only chlorhexidine 0.05% solution that has been FDA cleared for intra-corporal wound lavage in humans. When considering a new dipping solution, we must always weigh the effectiveness of any dipping solution with the caustic properties of the solution on the device and tissue.

Objective

The purpose of this experiment is to determine the effects of Irrisept solution on Coloplast's hydrophilic coating incorporated on the Titan penile prosthesis (PP).

Methods

Pre-connected Titan PP product including both pumps and cylinders were tested. The Titan PP was soaked in Irrisept solution and normal saline for 1, 15, 30 and 60 minutes. After soaking, all parts were dried for 15 minutes in a 35°C oven, and then went through the Congo Red Dye Test. Congo Red dye testing was performed per the approved FDA test method for ensuring product reliability. (Coloplast’ internal Test Method.)

Results

All the PPs tested achieved satisfactory coating results. There was no noticeable effect or difference of coating adherence between the saline soaked control and Irrisept soaked devices. And there was no noticeable effect or difference of coating adherence between different soaking time. (Figure 1 Congo Red stain)

Conclusions

Soaking the Titan PP in Irrisept solution does not effect the hydrophilic coating of the implant when compared to saline. There was also no difference in hydrophilic coating compared to saline controls at various times of dipping (1, 15, 30 and 60 min).

Disclosure

Yes, this is sponsored by industry/sponsor: Coloplast

Clarification: Industry initiated, executed and funded study

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast
120 Does Partner Involvement Reduce Unanticipated Postop Visits Following Penile Prosthesis?
Authors: Swanton A , Munarriz R , Gross M
Published: April 2022

Introduction

The spouses and partners of patients undergoing implantation of an inflatable penile prosthesis (IPP) are often active participants in the perioperative process. Many urologists encourage partner involvement for penile implant patients, but there is little information on whether this influences their post-operative course.

Objective

This study seeks to determine whether preoperative partner attendance at clinic appointments is associated with deviation from a standard postoperative care pathway for patients undergoing primary IPP placement.

Methods

This is a retrospective study conducted using data obtained from primary IPPs performed by a single surgeon between October 2016 and January 2021. A standardized postoperative course was used, including planned follow-up visits at 2 weeks (for wound check and device deflation) and 6 weeks (for device teaching). Patient characteristics, including demographics, partner involvement, and the number of follow-up visits were obtained from the medical record. Logistic regression modeling was performed to determine the influence of partner involvement on planned postoperative scheduled visits.

Results

During the study period, n = 170 primary IPP patients were identified and 147 (67%) of these patients had partners. Partners were involved in all perioperative visits for 92 patients (54%). Unplanned follow up visits were seen for 58 patients (34%) between 0-6 weeks and for 28 patients (17%) after 6 weeks postoperatively. Partner involvement was associated with a reduced odds of additional follow up visits, both at 0-6 weeks (unadj: OR 0.43, 95% CI 0.23-0.83; adj: OR 0.40, 95% CI 0.20-0.79) and after 6 weeks (unadj: OR 0.32, 95% CI 0.13-0.76; adj: OR 0.33, 95% CI 0.13-0.81), both in unadjusted analysis and when adjusted for obesity and presence of complications. Clavien-Dindo complications were identified in 29 patients (17%) intraoperatively or postoperatively. Mean surgical time was 69 minutes (SD = 19). Mean patient age was 62 years (SD = 9). Comorbidities included obesity (52%), diabetes (37%), hyperlipidemia (72%), and hypertension (84%).

Conclusions

Partner involvement equated to a 2.5 fold decrease in the odds of unplanned postoperative visits among primary IPP patients. Though the mechanism of this reduction is unclear, having partners attend perioperative visits is easily implemented, low cost, and minimal risk. We would recommend that urologists routinely encourage patients considering insertion of a penile prosthesis involve their partners in perioperative visits.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast
127 Penile Prosthesis Now An In office Procedure: A Single Center Experience In The US
Authors: Hakky T , Alexander-Rodriguez A
Published: April 2022

Introduction

Inflatable penile prosthesis (IPP), an implantable device for treatment of ED, historically have always been done in a hospital setting or outpatient setting. These surgeries are now done more frequently around the world as an in-office procedures. With the increase risk of COVID infections and the improvement of IPP technique we began performing this procedure in the office under local and total intravenous anesthesia.

Objective

To present the nuances of office based 3 piece penile prosthesis and the outcome data for the feasibility of in-office implants while minimizing complications.

Methods

A retrospective chart review was performed on the 10 IPP patients who had surgery in the office based setting in our clinic. The age ranges varied from 34-58 years of age. All pateints who opted for IPP in the office were screened for any and history of pelvic surgery, renal failure, cardiac stents or heart failure. Preoperatively, Antibiotics used were Vancomycin, Amikacin and oral Fluconazole and oral Neurontin for analgesia. All patients had a preoperative COVID nasal swab or had the vaccine prior to surgery. Intraoperatively Vancomycin, Amikacin and Fluconazole were used for irrigation and implant prep. Smaller table sets with stacking sterile field was used with headlights and loupes. IV sedation was used with the assistance of an anesthesiologist who used Propofol for sedation. A propofol bolus was given prior to entering the space of retzius. The patients also received a penile and pudendal block with a mixture of 1% Lidocaine, 0.5% Marcaine and 1mg Solumedrol for post-op pain management. Postoperatively, Neurontin and Tylenol were given PO and Toradol was given IV.

Results

Of the 10 patients selected, 0 patients had infections we had even with a drain being in place 2 patients suffered a hematoma. 1 patient suffered urinary retention, resolving after 24 hours. Patients were cleared for device use between 5 to 8 weeks. 1 patient's implant was recalled; however, the patient did not have a desire for re-operation and has the device and works around the valve. The average procedure time was 53.5 minutes. Incision size range was 1.7 cm to 2.5 cm in length.Drains were placed in all patients for 24 to 48 hours with out puts of 90-160cc. Patients were discharged after 90 minutes in recovery phase.

Conclusions

Office based penile prosthesis is safe and feasible in the post COVID world. Nuances such was headlights, loupes and adequate block-aid and sterile field efficiency with preloading and stacking are a necessity. With careful patient selection, in-office implantable penile prosthesis implant can be a safe feasible alternative for patients that have severe ED, have gone through alternative therapies, but either cannot afford and or insurance does not cover this procedure.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast
129 Anal Sex and Sexual Function Satisfaction: A Comprehensive (and Critical) Review of Current Medical Literature
Authors: Walton A , Garcia M
Published: April 2022

Introduction

Anal sex is practiced by people of all sexualities, genders and bodies. Despite common practice, there is relatively little in the clinical literature about anal sex from a more sex-positive “sexual health” perspective.

Objective

To review the medical literature related to anal intercourse, with attention to the fraction that focuses on the sex positive aspects of anal sex to address and support the sex-based questions and concerns of adults who practice it.

Methods

A comprehensive literature review was conducted in accordance with PRISMA guidelines, using PubMed. For our search, we generated a comprehensive list of synonyms for anal intercourse and combined them with synonyms for sex positivity (sexual satisfaction, erogenous, pleasure, and orgasm).

Results

We identified a total of 149 articles from the search terms. Of these articles, 59 abstracts were relevant to include and were reviewed. Among these abstracts, 23 manuscripts were reviewed in full and only 20 of these were acceptable for inclusion in this review. Twelve of the twenty papers included in our review were primarily sexual health focused, while the other eight primarily pathology focused. Men who have sex with men (MSM) is the population most considered within the discussion of anal sex. There was a trend towards identifying the influence of external factors on the sexual outcomes of anal sex in MSM, such as condom use, lubricant use, prostate cancer, and drug use. Among women who have sex with men (WSM), 28.4% described the first experience as pleasant and 62.3% continued to practice anal sex. However, almost half of WSM found their first experience to be too painful to continue. Women who have sex with women (WSW) were missing from the discussion of anal sex and sexual health.

Conclusions

Though the medical literature contains an abundance of studies of “sexual pleasure” and “sexual function” these are commonly hetero-normative and focus on penile-vaginal intercourse, and very rarely include anal stimulation/sex. Given that anal sex is widely practiced, the dearth of sex-positive literature focused on anal sex suggests both that patient's practices of anal sex is less commonly queried by providers, and, that there is a need for medical literature to help inform providers and patients about how to make anal sex safer and more satisfactory. Second to the general U.S. population, other small but important subgroups for whom this is relevant include cancer survivors working to recover their sexual health, and transgender women awaiting gender affirming genital surgery. There is a need for more investigation into the sex positive nature of anal sex.

Disclosure

No
131 Ejaculation Profiles in Men after Irreversible Electroporation for Prostate Cancer
Authors: Martinez J Flores , Benfante N , Chen L , Ehdaie B , Mulhall JP
Published: April 2022

Introduction

Irreversible Electroporation (IRE) is an evolving strategy for the management of localized prostate cancer. Little data exists on sexual function, in particular ejaculation, in such patients.

Objective

We aimed to report the ejaculatory function in patients undergoing IRE.

Methods

Patients undergoing IRE with ≥1-year follow-up were evaluated. These patients were selected for focal therapy and consented to participate in a prospective registry. Eligibility criteria: Gleason score 3+4, PSA <20, no evidence of extracapsular extension, seminal vesicle invasion or lymph node involvement on standard imaging. The Gleason score 3+4 prostate cancer was allowed up to a maximum of two adjacent sextants within the prostate gland. Concomitant Gleason score 6 was untreated and monitored on active surveillance. They completed the Male Sexual Health Questionnaire ejaculation domain short form (MSHQ-EFD-SF) at 6 weeks, 3 months, 6 months, and 12 months post-IRE. This questionnaire has 4 questions: 3 questions sum scores (range 1-15), where lower scores indicate worse ejaculatory function, and the MSHQ-Bother question score (ranges 0-5), with higher scores indicating higher bother associated with ejaculatory difficulties. Comorbidities, demographics, and pathology parameters were recorded.

Results

20 men have been evaluated to date with a mean age of 64.3 ± 4.8 years. Baseline testosterone and PSA were 536.3 ± 267.6 ng/dL and 6.2 ± 2.7 ng/mL. Mean prostate volume was 45.6 ± 11.9 cc. Median baseline score of MSHQ-EJD-SF was 13.5 (IQR 10, 14), and post-procedure median scores were 11 at 6 weeks; 12.5 at 3 months; 12 at 6 months; and 11.5 at 12 months (p-value =0.036). Scores for ejaculation strength and seminal volume ejaculated decreased significantly, and bother scores increased significantly between baseline and 1-year post-IRE. The ability to ejaculate during sexual activity did not change over time.

Conclusions

In our cohort of patients with prostate cancer who underwent IRE there was a significant difference in ejaculatory profiles between baseline and 1-year post-IRE.

Disclosure

No
141 Association of Poly-tobacco Use with Erectile Dysfunction: Findings from the Population Assessment of Tobacco and Health (PATH) Study
Authors: Raheem O , Shah T , Morenas R , El-Shahawy O
Published: April 2022

Introduction

The tobacco use landscape has shifted over time to include two or more tobacco products (i.e. "poly-tobacco" use). Tobacco smoking remains independently associated with erectile dysfunction (ED); however, data on the patterns of multiple tobacco products use on men's sexual health, including ED, are limited.

Objective

We sought to systematically evaluate the effects of poly-tobacco use on ED using nationally representative data.

Methods

Data from the Population Assessment of Tobacco and Health (PATH) survey wave 4 (December 2016- January 2018) was examined. Those who responded, “sometimes or never” to the question “Ability to get and keep an erection adequate for satisfactory intercourse?” were classified as having ED. Tobacco users were classified as mono-, poly- and non- users based on the past 30-day tobacco products use. Multivariate logistic regression models were used to identify association of tobacco use with ED among a restricted sample that included only men aged 20-65 who did not report any prior cardiovascular diagnosis. We adjusted for several covariates including sociodemographic characteristics, diabetes, body mass index, mental health status, and physical exercise.

Results

Included in the study were adult males, aged 20-65 years or older, who responded to the question assessing ED between December 2016 to January 2018 (N=8,651). Among the study population, 19.5% participants were mono-tobacco users and 16.1% were poly-tobacco users. The proportion of ED for the sample population was 8.2%; prevalence among mono-tobacco users was 1.7% and poly-tobacco users was 1.4%. Compared to non-users, current poly-tobacco users were more likely (adjusted OR (aOR)= 1.43; 95% CI=0.99, 2.07;p<0.05) to report having ED.

Conclusions

With the shift in the landscape of tobacco products that is associated with increasing prevalence of poly-tobacco products use, adult men and clinicians should be aware of its potential impact. Future studies should evaluate the longitudinal effect of multiple tobacco and tobacco use trajectories on the development of ED among adult men.

Disclosure

No
144 Analyzing the Impact of Diabetes on Erectile Function Recovery After Radical Prostatectomy
Authors: Martinez J Flores , Jenkins LC , Benfante N , Nelson CJ , Schofield E , Mulhall JP
Published: April 2022

Introduction

Diabetes (DM) is a known risk factor for ED. The impact of DM on erectile function recovery (EFR) after radical prostatectomy (RP) is poorly understood.

Objective

We aimed to assess the impact of DM on the EFR after RP.

Methods

Men who had RP with ≥2 years follow-up constituted the study population. EFR was assessed using International Index of Erectile Function, Erectile Function Domain (EFD) score pre-RP and at 2 years post RP. ADT and radiation therapy before or after RP were exclusions. Demographics, comorbidities, pathological parameters were recorded. We performed univariate and multivariate logistic regression assessments to evaluate predictive factors, including DM, patient age, nerve sparing status (NSS) scored between 1 (preserved) to 4 (resected) for each side, and comorbidity profile, associated with poor EFR post-RP.

Results

2024 men were included. Mean age at RP was 61.3±7.1 years. Median baseline and 2-year EFD scores were 27 (IQR = 19-30), and 13 (IQR = 5-25). 10% had DM with a mean pre-RP hemoglobin A1c of 6.6±1.3%. 44% had hypertension, 51% dyslipidemia, 14.5% obstructive sleep apnea, 5% history of coronary artery disease, 8% were current and 34% former smokers. 38% reported two or more comorbidities pre-RP. Median Gleason sum was 7. Nerves were preserved bilaterally in 77% and unilaterally in 16%. Median NS score was 3 (IQR 2-4). Median EFD scores at 2 years with and without DM were 7 (IQR 3-16), and 14 (IQR 5-25), respectively (p<0.001). At 2 years, in men with and without DM, the proportion with EFD ≥24 was 14% and 32% and EFD ≤10 was 63% and 42% respectively.

Conclusions

In our cohort, DM was a significant predictor of lower EFR at 2 years post-RP.

Disclosure

No
147 Critical Underdiagnosis and Undertreatment of Sexual Health Issues in Male Kidney Transplant Recipients
Authors: Santamaria A , Modiri N , Yoffe DA , Shahinyan R , Jayadevan R , Islam M , Eleswarapu S , Mills J
Published: April 2022

Introduction

Patients with end stage renal disease (ESRD) often endure a worse quality of life (QOL) than the general population. As a result of improved outcomes with kidney transplants, it has become increasingly important to address QOL. Sexual function is one such QOL domain in which kidney transplant (KT) patients are particularly affected by.

Objective

This study aims to elucidate the underdiagnosis and undertreatment of sexual health issues in male KT recipients, as well as the treatment profile for erectile dysfunction (ED) in these patients.

Methods

With IRB approval we retrospectively reviewed the charts of men age 18 and older who received a KT between January 2016 and February 2020 at an academic institute. We sought to identify those with a diagnosis of ED, low or decreased libido, hypogonadism, ejaculatory dysfunction, Peyronie's disease (PD), or male factor subfertility. Next, for those with a diagnosis of ED, information regarding time of initial diagnosis of ED, time when treatment was started, treatment profile and adverse events were documented. Causes of ESRD were obtained, but not controlled for.

Results

A total of 35 men were diagnosed with some form of sexual dysfunction, which represents 4.2% of the 833 men aged 18+ years who received a KT during this time. Seventy-one percent of men had a diagnosis of ED, 17.1% had ED and hypogonadism, 2.9% had ED and low libido, 8.6% had hypogonadism alone, and there were no diagnosis of ejaculatory dysfunction, PD, or infertility. Seventy-five percent of men with a diagnosis of ED were treated with phosphodiesterase-5 inhibitors (PDE5i), 25% with intracavernosal injections (ICI), 3.1% with intraurethral (IU) suppositories, and 9.4% with a penile prosthesis (PP). No severe medical or surgical adverse events were noted. Of those with ED, 87.5% were diagnosed prior to their transplant surgery and only 62.5% received any treatment prior to it.

Conclusions

In this study we show that a small fraction of men who received a KT had a diagnosis of a sexual health issue. This is in spite of the known high prevalence of ED in ESRD patients that can be as high as 75%, with up to a 10-20% improvement of ED with transplant alone. Furthermore, we note that KT recipients with ED are treated similarly to the general population and have a similar side effect profile, however, a significant number of patients do not receive treatment until after their transplant.

Disclosure

No
(In)Sights from Àwòrán: Yorùbá Epistemologies and the Limits of Cartesian Vision in Teju Cole’s Open City
Authors: Inyang Utitofon Ebong
Published: April 2022

Teju Cole’s Open City is often read as the quintessential Western cosmopolitan novel. But despite the protagonist’s fixation with European aestheticism, the presence of African antecedents looms almost as an unacknowledged shadow in the acclaimed cosmopolitan novel. This article traces how Yorùbá visual registers about perception, subjectivity, and representation provide interpretative cues for understanding the meta-text of Cole’s novel in ways that illuminate the conflicted, contradictory itineraries of the postcolonial African transnational figure. I argue that Yorùbá conceptual registers relating to visuality, especially the concept of Àwòrán and its insistence on intersubjective relations and the visual call of images, highlight a visual hermeneutics that inflect the construction of personhood in Open City. By tracing the centrality of Yorùbá optic codes to Cole’s project, the article concludes that the novel’s philosophically dense conversation with aspects of Yorùbá culture demonstrates how conceptual registers from African cultures might contour Afro-diasporic texts.
Absence of singularities in solutions for the compressible Euler equations with source terms in
Authors: Wu Xinglong
Published: April 2022

The present article is devoted to the study of global solution and large time behaviour of solution for the isentropic compressible Euler system with source terms in $\mathbb {R}^d$, $d\geq 1$, which extends and improves the results obtained by Sideris et al. in ‘T.C. Sideris, B. Thomases, D.H. Wang, Long time behavior of solutions to the 3D compressible Euler equations with damping, Comm. Partial Differential Equations 28 (2003) 795–816’. We first establish the existence and uniqueness of global smooth solution provided the initial datum is sufficiently small, which tells us that the damping terms can prevent the development of singularity in small amplitude. Next, under the additional smallness assumption, the large time behaviour of solution is investigated, we only obtain the algebra decay of solution besides the $L^2$-norm of $\nabla u$ is exponential decay.
The Labor-Intensive Path: Wages, Incomes, and the Work Year in Japan, 1610–1890
Authors: Kumon Yuzuru
Published: April 2022

I use new evidence from servant contracts, 1610–1890, to estimate male farm wages and the length of the work year in Japan. I show Japanese laborers were surprisingly poor and could only sustain 2–3 adults relative to 7 adults for the English. Japanese wages were the lowest among pre-industrial societies and this was driven by Malthusian population pressures. I also estimate the work year and find peasants worked 325 days a year by 1700, predating the “industrious” revolution in Europe. The findings imply Japan had a distinct labor-intensive path to industrialization, utilizing cheap labor over a long work year.
Shades of faith: the phenomenon of doubt in early Christianity
Authors: Schliesser Benjamin
Published: April 2022

‘Faith’ (pistis) is a key term in early Christianity. It not only describes the self-understanding of an individual Christ-follower, but also operates as the social marker of the Christ-groups. Rather than adding to the renaissance of studies on faith in recent years, this article seeks to illuminate what faith is by focusing on the phenomenon of doubt, broadly understood. After some linguistic reflections, the article identifies six basic types of doubt in early Christian writings and then compiles eighteen coping strategies and patterns of resilience reflected in the most prominent texts. The article is not an attempt at systematizing early Christian reflections on doubt but is rather a cornucopia of insights into how the first Christian theologians talked about doubt, dealt with it, and tried to overcome it.
An exploration of the views of staff on cultural aspects of end-of-life care in Japanese long-term care facilities: a qualitative study
Authors: Iida Kieko , Ryan Assumpta , Hasson Felicity , Payne Sheila , McIlfatrick Sonja
Published: April 2022

Long-term care facilities are increasingly important places for palliative and end-of-life care provision in Japan. While the importance of culture has been noted for palliative and end-of-life care, an exploration of its influence on care provision in long-term care settings has received little direct attention in Japan. Exploring staff views and beliefs in palliative and end-of-life care in these settings can potentially enhance our understanding of culturally oriented care and facilitate the development of tailored and more effective support practices. This study aimed to explore the cultural views and beliefs regarding palliative and end-of-life care among the staff in Japanese long-term care facilities. A qualitative exploratory study was conducted using focus groups with facility staff (N = 71) and semi-structured interviews with facility managers (N = 10) in the Kanto region of Japan. Thematic analysis was conducted according to Braun and Clarke's approach. The findings are presented in five key themes: ‘Changes in society's and family's end-of-life perspectives’, ‘Values and beliefs regarding death and dying’, ‘Anxiety and regret’, ‘Tensions in doing the right thing’ and ‘Ways of alleviating pressure’. The findings indicate that the provision of palliative and end-of-life care is underpinned by cultural nuances that influence care providers' approach and delivery. Recognising and understanding the cultural beliefs of staff around death, dying and end-of-life care are important in meeting the needs of residents. Palliative care education for staff in these settings should include cultural considerations that reflect changing societal views on death and dying.
A sectoral approach to measuring output gap: Evidence from 20 US Sectors over 1948−2020
Authors: Tercioglu Remzi Baris
Published: April 2022

The existing output gap measures for the US economy rely on aggregate data and assume a constant output gap over sectors (see Coibion et al. [(2018) Brookings Papers on Economic Activity, 333–441] and Owyang et al. [(2018) Federal Reserve Bank of St. Louis Review, 297–316]); however, each sector has its cycle, which does not necessarily match the business cycle (Burns and Mitchell [(1946) National Bureau of Economic Research]). By modeling sectoral cycles based on their investment cycles with a nonparametric method, I estimate output gaps of 20 US sectors over 1948–2020. The weighted mean output gap indicates a persistent spare capacity in the last business cycle, pointing to insufficient stabilization policies behind secular stagnation. Phillips curve estimations with the weighted quartiles of sectoral output gaps show that the output gap of bottleneck sectors (weighted Q3) is correlated strongly with inflation over 1950–2020. Policymakers can track bottleneck sectors to mitigate inflationary pressures while supporting the sectors with negative output gaps to stabilize the output at its potential. My findings show that it is possible to produce more output by sector-level demand supporting policies without generating inflation.
Absence of Morphological Case and Gender Marking in Contemporary Hasidic Yiddish Worldwide
Authors: Belk Zoë , Kahn Lily , Szendrői Kriszta Eszter
Published: April 2022

This paper demonstrates that the language of the post-War generations of adult Haredi (that is, strictly Orthodox), primarily Hasidic, speakers of Yiddish in the major Hasidic centers worldwide lacks morphological case and gender. Elicited spoken and written data from native Haredi speakers of Yiddish from Israel and the United States, aged 18–87, and limited additional evidence from Canada and Belgium, reveal a complete absence of distinction between masculine, feminine, and neuter genders as well as between the nominative, accusative, and dative cases. While some speakers make use of a variety of morphological definite determiner and attributive adjective forms, their use is not determined by case or gender distinctions. Most of the speakers in our study have an invariable determiner pronounced as /dɛ/ or /di/, whereas the earlier case and gender suffixes on attributive adjectives have been reanalyzed as a single attributive marker, /ɛ/. These findings are consistent with our previous work on the loss of case and gender in the Hasidic Yiddish of London’s Stamford Hill and support our proposal that the Yiddish spoken in (primarily Hasidic) Haredi communities can be considered a distinct variety of the language known as Contemporary Hasidic Yiddish.*
Theorizing Trauma and Music in the Long Nineteenth Century
Authors: Meinhart Michelle , Rogers Jillian C.
Published: April 2022

Investigations of how people have used music to represent, perform, enact and cope with trauma have proliferated in the last decade, although these have often focused on post-World War II musicians and musical phenomena. This work has engaged various methodologies and drawn on myriad bodies of trauma theory in order to better understand the relationships between music and trauma for Holocaust survivors, Cold War- and glasnost-era Eastern European musicians and civilians and soldiers in Iraq. However, despite the growing interest in trauma within music scholarship, scant attention has been paid to relationships between musical phenomena and trauma prior to World War II. And yet, the wars, revolutions, forced displacement, slavery and imperialism of the late nineteenth and early twentieth centuries make these years some of the most violent in the histories of modern Europe and the Americas, and thus some of the most important to address when asking questions regarding relationships between music and trauma.

In this special issue's introductory essay, we consider why pre-twentieth century musicians and repertoires have historically not been addressed in scholarly literature. In so doing, we outline the aims of the issue; review relevant literature in musicology and trauma studies; discuss the benefits and challenges of applying trauma theory to nineteenth-century music and musicians and provide readers with information on this special issue's collaborative history. Although giving readers a fleshed-out overview of trauma studies from the nineteenth century to present is outside the scope of this article, this introduction nevertheless provides enough background on the status and main ideas of trauma research from the mid-nineteenth century to present day to facilitate comprehension of how the research showcased in this special issue relates to social, historical and political conceptions of trauma.
Modeling and electromagnetic analysis of typical environmental clutter based on SMCG
Authors: Li Zhenhua
Published: April 2022

In the research of the natural ecological environment, environmental scattering is an important research content whose results are widely used. In order to fully study the relevant characteristics of the natural grassland environment, this paper established a grassland broadband clutter model, summarized the dominant and recessive laws of the grassland environment broadband clutter, and provided a new perspective for related environmental monitoring which would be helpful to solve the problem of target detection in complex environments. The main work of this paper is as follows: The dielectric constant model of the grass was established, and the curve of the dielectric constant with frequency was obtained. The Monte Carlo method combined with the Gaussian spectrum function was used to generate a two-dimensional Gaussian surface to simulate the actual grass surface. A broadband clutter model was established, and, considering the calculation efficiency and accuracy, the Sparse Matrix/Canonical Grid (SMCG) was used to calculate the surface scattering coefficient. Then, the environmental clutter amplitude with different radar bandwidth (10, 40, 80 MHz), surface roughness (h = 0.1 m, h = 0.2 m, h = 0.4 m) and grazing angle (30°, 60°) were calculated and the probability density function (PDF) was obtained. The results show that the higher the radar resolution, the larger the incident angle, and the rougher the interface, all of which will cause the tail of the PDF to become longer which will not only reduce the detection probability of the radar, but also the tracking accuracy. The research results can be used for civilian and military field.
Impact of Proxies and Prior Estimates on Data Assimilation Using Isotope Ratios for the Climate Reconstruction of the Last Millennium
Authors: Shoji Satoru , Okazaki Atsushi , Yoshimura Kei
Published: April 2022

Climate reconstructions by data assimilation need to accommodate for sensitivities to proxies and prior estimates because models are uncertain and proxies are spatiotemporally limited. This study examines these sensitivities using multiple climate model simulations and different combinations of proxies (i.e., corals, ice cores, and tree‐ring cellulose). Experiments were conducted using an offline data assimilation approach; the results showed annual variations in the global distribution of surface air temperature and precipitation amount from 850 to 2000. Standard deviations of surface air temperature and precipitation amount during the entire period differed by up to 36% due to prior estimates. Experiments with different types of proxies showed that the El Niño‐like distribution of positive anomalies in the central to eastern tropical Pacific may only be adequately reproduced in experiments with corals, and not experiments without corals. The correlation coefficient of the NINO.3 index from 1971 to 2000 between experiments with corals and the Japanese 55‐year Reanalysis (JRA‐55) was 0.81 at maximum. By contrast, the correlation coefficient between experiments without corals and JRA‐55 was a maximum of 0.19.
Increased Risk of Extreme Precipitation Over an Urban Agglomeration With Future Global Warming
Authors: Doan Quang‐Van , Chen Fei , Kusaka Hiroyuki , Dipankar Anurag , Khan Ansar , Hamdi Rafiq , Roth Matthias , Niyogi Dev
Published: April 2022

Understanding the response of extreme precipitation (EP) at a city scale to global warming is critical to reducing the respective risk of urban flooding. Yet, current knowledge on this issue is limited. Here, focusing on an urban agglomeration in the tropics, Singapore, we reveal that future global warming enhances both frequency and intensity of EP, based on simulations with a state‐of‐the‐art convection‐permitting regional climate model. EP intensification can reach maximum “super” Clausius‐Clapeyron rate (+7% per K warming) rate, implying a “new normal” of “extreme events get more extreme,” which is consistently for both Representative Concentration Pathways 8.5 and 4.5. The intensification is lower for moderate and light precipitation. Also, global warming was found to dampen the urban effect on EP events. The EP enhancement is attributed to the increased atmospheric moisture and convective inhibition due to enhanced low‐level stratification that delays a convection to develop until it becomes more intense.
Projecting the Suicide Burden of Climate Change in the United States
Authors: Belova Anna , Gould Caitlin A. , Munson Kate , Howell Madison , Trevisan Claire , Obradovich Nick , Martinich Jeremy
Published: April 2022

We quantify and monetize changes in suicide incidence across the conterminous United States (U.S.) in response to increasing levels of warming. We develop an integrated health impact assessment model using binned and linear specifications of temperature‐suicide relationship estimates from Mullins and White (2019), in combination with monthly age‐ and sex‐specific baseline suicide incidence rates, projections of six climate models, and population projections at the conterminous U.S. county scale. We evaluate the difference in the annual number of suicides in the U.S. corresponding to 1–6°C of warming compared to 1986–2005 average temperatures (mean U.S. temperatures) and compute 2015 population attributable fractions (PAFs). We use the U.S. Environmental Protection Agency’s Value of a Statistical Life to estimate the economic value of avoiding these mortality impacts. Assuming the 2015 population size, warming of 1–6°C could result in an annual increase of 283–1,660 additional suicide cases, corresponding to a PAF of 0.7%–4.1%. The annual economic value of avoiding these impacts is $2 billion–$3 billion (2015 U.S. dollars, 3% discount rate, and 2015 income level). Estimates based on linear temperature‐suicide relationship specifications are 7% larger than those based on binned temperature specifications. Accounting for displacement decreases estimates by 17%, while accounting for precipitation decreases estimates by 7%. Population growth between 2015 and the future warming degree arrival year increases estimates by 15%–38%. Further research is needed to quantify and monetize other climate‐related mental health outcomes (e.g., anxiety and depression) and to characterize these risks in socially vulnerable populations.