bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Prevalence of Erectile Dysfunction in Diabetic Men With Depressive Symptoms: A Meta-Analysis
Authors: Wang Xu , Yang Xiaohua , Cai Yihong , Wang Shengmei , Weng Weiqun 
Published: June 2018

Abstract

Background
Erectile dysfunction (ED) may be common among diabetic men with depressive symptoms (DS), but its prevalence is still debated.

Aim
To conduct a meta-analysis of the prevalence of ED in diabetic men with DS compared to those without DS, calculating the relative odds ratios (ORs) and 95% CIs.

Methods
PubMed, MEDLINE, Embase, and Web of Science were searched up to January 2018. All the studies assessing the risk of ED among diabetic men having DS were reviewed. 2 Authors independently assessed literature and extracted information eligibility. Any disagreement was resolved by a third reviewer. Newcastle-Ottawa quality assessment scale was used to evaluate study quality in meta-analyses. We calculated the ORs with 95% CIs using software Stata, Version 12.0; StataCorp, College Station, TX). Data were pooled using a fixed or random effects model according to heterogeneity. Sensitivity analyses were conducted to assess potential bias. This study was conducted according to the guidelines for Meta-Analyses and Systematic Reviews of Observational Studies.

Outcomes
The strength of the association between DS and the prevalence of ED was evaluated using ORs and 95% CIs.

Results
5 Studies were eligible for the present analysis, reporting on a total of 2525 diabetic men. Mean age of patients ranged from 42.37–61.65 years in the included studies. The overall prevalence of ED in diabetic men with DS was 74.2% (95% CI 59.0–89.4). The overall prevalence of ED in diabetic men without DS was 37.4% (95% CI 16.2–58.6). The pooled crude OR for these 5 studies was 6.40 (95% CI 2.11–19.38, P &lt; .05, I2 = 94.6%). The pooled OR of 4 multi-variate analyses was 3.08 (95% CI 1.32–4.85, P &lt; .001, I2 = 83.5%).

Clinical Implications
Diabetic men with DS had a significantly increased prevalence of ED, suggesting that ED should be of concern to clinicians when managing diabetic men with DS.

Strengths & Limitations
A strength of this study is that it is the first meta-analysis to assess the prevalence of ED in diabetic men with DS and quantitatively analyze the association between DS and ED risk among diabetic men. A limitation is that all included studies were cross-sectional studies, which may generate bias.

Conclusion
The present meta-analysis of 5 cross-sectional studies suggests that diabetic men showing DS, compared to the diabetic men without DS, have more risk of ED. Further larger prospective cohorts with more power or meta-analysis based on individual patient data need to be conducted to confirm this association.
The Hemodynamic Effects of Intracavernosal Phenylephrine for the Treatment of Ischemic Priapism
Authors: Sidhu Ajaydeep S. , Wayne George F. , Kim Bu J. , Anderson Alexander G.S. , Cordon Billy H. , Caso Jorge R. , Polackwich A. Scott 
Published: June 2018

Abstract

Aim
We sought to evaluate whether the administration of phenylephrine (PE) at concentrations higher than those described in guidelines resulted in any significant changes in vital signs or impacted outcomes.

Methods
After receiving institutional review board approval, we retrospectively reviewed the charts of patients presenting to our emergency department between May 1, 2014, and August 15, 2016, using International Classification of Diseases, Ninth Edition and Internation Classification of Disease, Tenth Edition diagnosis codes for priapism. Treatment was reviewed, including corporal aspiration/irrigation, injection of PE, and shunt procedures. Vital signs were compared before and after treatment with PE. Baseline variables were explored with categorical data analysis (chi-squared tests, t-tests, and Mann-Whitney nonparametric tests). Where feasible, linear regression was used to evaluate outcomes.

Main Outcome Measure
Detumescence and changes in blood pressure and heart rate.

Results
We identified 74 different patient encounters of acute priapism. The median age was 36.5 years (interquartile range [IQR] = 27–47), and the median time to presentation was 5.4 hours (IQR = 4.0–9.6). 62 percent of cases were due to drug-induced priapism. In 58 (74%) encounters, patients received PE. The median dose of PE given was 1000 μg (IQR 500–2,000). Univariate regression found no association between PE dose and change in patient heart rate or blood pressure. A statistically significant decrease in heart rate (HR) (−4.2 BPM), systolic blood pressure (BP) (−1.8 mm Hg), and diastolic BP (−5.4 mm Hg) was noted. Fifty-three of 58 (91%) patients receiving PE experienced detumescence at the bedside, 2 required shunting in operating room, and 3 refused treatment and left against medical advice. No adverse events occurred.

Conclusion
We frequently treat patients with high doses of PE and seldom notice adverse effects, typically resulting in resolution of priapism without any additional procedures. Careful administration of high doses of intracavernosal PE in patients presenting with priapism does not appear to significantly affect heart rate or blood pressure and may help prevent further ischemic damage and achieve detumescence effectively and efficiently.
The Significance of the Female Orgasm: A Nationally Representative, Dyadic Study of Newlyweds' Orgasm Experience
Authors: Leonhardt Nathan D. , Willoughby Brian J. , Busby Dean M. , Yorgason Jeremy B. , Holmes Erin K. 
Published: June 2018

AbstractBackgroundSelf-reported orgasm, perception of partner's orgasm, and misperception of partner's orgasm have each been correlated with individual sexual and relationship satisfaction, but these associations have rarely included dyadic data, have not fully accounted for potentially confounding variables such as sexual communication, and have never been simultaneously studied with a nationally representative sample.AimTo provide a more complete picture of how the orgasmic experience within the heterosexual couple influences individual and partner sexual and relationship satisfaction.MethodsUsing a nationally representative dyadic sample of 1,683 newlywed heterosexual couples, a structural equation model was estimated to test associations between husband and wife self-reported orgasm frequency, husband and wife report of the other partner's orgasm frequency, and husband and wife misperception of their partner's orgasm frequency, as correlates of relationship and sexual satisfaction.OutcomesBoth husband and wife completed the Couples Satisfaction Index to assess their own relationship satisfaction, and completed a sexual satisfaction instrument designed for the CREATE study.Results87% of husbands and 49% of wives reported consistently experiencing orgasm. 43% of husbands misperceived how often their wives experienced orgasm. The final structural equation model, including sexual communication, explained moderate amounts of variance in wives' and husbands' relationship satisfaction, and a high level of variance for wives' and husbands' sexual satisfaction. Wives' relationship satisfaction was positively associated with wives' and husbands' sexual communication. Wives' sexual satisfaction was positively associated with self-reported orgasm frequency, and both wives' and husbands' sexual communication. Husbands' relationship satisfaction was positively associated with husbands' and wives' sexual communication. Husbands' sexual satisfaction was positively associated with husbands' perception of wives' orgasm frequency, and both husbands' and wives' sexual communication.Clinical TranslationWhen counseling couples, clinicians should give particular attention to the wife's orgasm experiences, to potentially help both husbands and wives have higher sexual satisfaction.Strengths & LimitationsStrengths of this study include the use of a nationally representative sample and dyadic data. Limitations include cross-sectional data, and the assessment of sexual experiences only in newlywed couples.ConclusionWives' orgasm (wives' self-report of frequency and husbands' perception of frequency) has a unique positive association with sexual satisfaction, even after taking into account other aspects of the orgasm experience and sexual communication.
Ex vivo ovine model for teaching open laryngotracheal surgery
Authors: Soliman Ahmed M.S. , Ianacone David C. , Isaacson Glenn C. 
Published: June 2018

ObjectiveTo develop an animal model for teaching open laryngotracheal surgical procedures.MethodsThe heads and necks from 5 pre‐pubescent sheep were harvested after humane anesthesia. After 2–5 days to allow for rigor mortis to resolve, a specimen was supported with sandbags on an operating table. Operative procedures including tracheotomy, medialization laryngoplasty, anterior cartilage grafting, tracheal resection with primary anastomosis, and laryngectomy with closure of the pharynx were attempted.ResultsThe ovine head and neck provided an accurate model for simulation of all attempted procedures. Ovine tissue resembled that of humans in mechanical properties and handling. Postsurgical endoscopy confirmed graft alignment.ConclusionsThe sheep head and neck provides an inexpensive, realistic, and safe model for surgical training for a variety of open laryngotracheal procedures. This is particularly relevant given the recent emphasis on surgical simulation and the relative rarity of some of these procedures in residency training.
Poro on Trial: The 1913 Special Commission Court case ofRex v. Fino, Bofio and Kalfalla
Authors: Keefer Katrina H.B. 
Published: June 2018

Abstract:In 1913, a Special Commission Court in Sierra Leone saw a series of trials concerning members of the Human Leopard Society, and conflated this society with the regional Poro Society. This article examines one of those trials and unearths motivations for murder and questions of bias. With the reinvention of identity in the shadow of slavery, a nuanced and complicated picture emerges of the situation. Though more questions than answers are offered by the details of the case, this article problematizes Sierra Leone under British authority, and shows a nuanced snapshot of power struggles playing out in a murder trial.
Bougie-assisted cricothyroidotomy: Delphi-derived essential steps for the novice learner
Authors: Dharamsi Alia , Gray Sara , Hicks Christopher , Sherbino Jonathan , McGowan Melissa , Petrosoniak Andrew 
Published: June 2018

AbstractObjectiveA cricothyroidotomy is a life-saving procedure, performed as a final option to emergency airway algorithms, and is essential for all clinicians who perform emergency airway management. The bougie-assisted cricothyroidotomy (BAC) is a novel technique that may be performed faster and with fewer complications than other traditional approaches. There is no established standard set of steps to guide the instruction of BAC performance. This study sought to systematically develop a BAC checklist for novice instruction using a modified Delphi methodology and international airway experts.MethodsA literature review informed the creation of a preliminary BAC checklist. A three round, modified Delphi method was used to establish a BAC checklist intended for novice-level instruction. The consensus level for each step and the final checklist were predefined at 80%. Participants were international airway experts identified by study personnel and snowball sampling.ResultsFourteen international airway experts across six acute care specialities participated in the study. The checklist was refined using a seven-point rating scale for each item and participant comments. A 17-item checklist was developed with expert consensus achieved after three rounds. Internal consistency, measured with Cronbach’s α, was 0.855 (95% confidence interval 0.73-0.94).ConclusionThis modified Delphi-derived checklist is the first systematically developed list of essential steps for guiding BAC instruction for novice learners. This tool serves to standardize BAC skill instruction and provide learners with a structured and consistent set of steps for deliberate practice.
Improved rates of antimicrobial stewardship interventions following implementation of the Epic antimicrobial stewardship module
Authors: Pettit Natasha N. , Han Zhe , Choksi Anish R. , Charnot-Katsikas Angella , Beavis Kathleen G. , Tesic Vera , Bhagat Palak , Nguyen Cynthia T. , Bartlett Allison H. , Pisano Jennifer 
Published: June 2018

AbstractWe evaluated the impact of the Epic antimicrobial stewardship module (EAM) on the number of interventions, antimicrobial usage, and clinical outcomes. Use of the EAM allowed us to significantly increase the number of ASP antimicrobial reviews and interventions while maintaining a sustained impact on antimicrobial utilization.
Successful and unsuccessful weight-loss maintainers: strategies to counteract metabolic compensation following weight loss
Authors: Clamp Louise D. , Hume David J. , Lambert Estelle V. , Kroff Jacolene 
Published: June 2018

AbstractAdaptive thermogenesis and reduced fat oxidative capacity may accompany weight loss, continuing in weight maintenance. The present study aimed (1) to determine whether weight-reduced and weight-loss relapsed women are at greater metabolic risk for weight gain compared with BMI-matched controls with no weight-loss history, and (2) to identify protective strategies that might attenuate weight loss-associated adaptive thermogenesis and support successful weight-loss maintenance. Four groups of women were recruited: reduced-overweight/obese (RED,n15), controls (low-weight stable weight; LSW,n19) BMI <27 kg/m2; relapsed-overweight/obese (REL,n11), controls (overweight/obese stable weight; OSW,n11) BMI >27 kg/m2. Body composition (bioelectrical impedance), 75 g oral glucose tolerance test, fasting and postprandial metabolic rate (MR) and substrate utilisation (RER) and physical activity (accelerometer (7 d)) were measured. Sociobehavioural questionnaires and 3 × 24 h diet recalls were completed. Fasting and postprandial MR, RER and total daily energy intake (TDEI) were not different between RED and RELv.controls (P> 0·05). RED consumed less carbohydrate (44·8 (sd10·3)v.53·4 (sd10·0) % TDEI,P= 0·020), more protein (19·2 (sd6·0)v.15·6 (sd4·2) % TDEI,P= 0·049) and increased physical activity, but behaviourally reported greater dietary restraint (P= 0·002) compared with controls. TDEI, macronutrient intake and physical activity were similar between OSW and REL. REL reported higher subjective fasting and lower postprandial ratings of prospective food consumption compared with OSW. Weight-reduced women had similar RMR (adjusted for fat-free mass) compared with controls with no weight-loss history. Increased physical activity, higher protein intake and greater lean muscle mass may have counteracted weight loss-associated metabolic compensation and highlights their importance in weight-maintenance programmes.
Sex in the laboratory: the Family Planning Association and contraceptive science in Britain, 1929–1959
Authors: SZUHAN NATASHA 
Published: June 2018

AbstractScientific and medical contraceptive standards are commonly believed to have begun with the advent of the oral contraceptive pill in the late 1950s. This article explains that in Britain contraceptive standards were imagined and implemented at least two decades earlier by the Family Planning Association, which sought to legitimize contraceptive methods, practice and provision through the foundation of the field of contraceptive science. This article charts the origins of the field, investigating the three methods the association devised and employed to achieve its goal of effecting contraceptive regulation. This was through the development of standardized methods to assess spermicidal efficacy; the establishment of quality, strength and manufacturing standards for rubber prophylactics; and the institution of animal trials to ensure the safety of specific contraceptives. The association publicized the results of its scientific testing on proprietary contraceptives in its annual Approved List of contraceptives. This provided doctors and chemists with a definitive register of safe and effective methods to prescribe.
Paleoeskimo Occupations of Central and High Arctic Canada
Authors: McGhee Robert 
Published: June 2018

Most of our knowledge regarding the Paleoeskimos of Arctic Canada is derived from the “core area” of Paleoeskimo occupation, a rough circle of some 1,000 km diameter including the coasts of Fury and Hecla Strait, Hudson Bay, and Hudson Strait. This is the area in which Dorset culture was first recognized, the source of most of our larger collections, and the area where continuity of development throughout the Paleoeskimo sequence has been demonstrated (Meldgaard 1962; Taylor 1968a; Maxwell 1973). The number and size of archaeological collections from this area suggest that it supported a larger Paleoeskimo population than did other regions of Arctic Canada, while the temporal distribution of components and continuities of style suggests that the region was occupied continuously throughout the Paleoeskimo period.In the fringe areas surrounding this central core, continuous occupation has not yet been demonstrated through any major segment of the Paleoeskimo sequence. Work in these fringe areas has rapidly progressed during the past decade, and it now seems certain that most of the temporal gaps and cultural discontinuities are not the result of poor archaeological sampling but reflect a situation of sporadic occupation occurring at different times in different regions. One of the striking features of the Paleoeskimo population was its propensity for expanding and retracting its geographical range, and this is the phenomenon which this paper will attempt to document. The primary aim of the paper is to sort out who lived where and when; a secondary aim is to suggest how they may have got there and what happened to them.
Radiocarbon Dates on Samples from New York State
Authors: Ritchie William A. 
Published: June 2018

Radiocarbon dates on charcoal samples from New York State have added significant new data to our knowledge of previously little known factors of chronology and continuity in the area. The dates have provided the lower portions of an apparently valid time scale upon which may be reared a more realistic three-dimensional picture of the prehistoric events of this portion of the United States.Sample 191 was excavated by the writer from a hearth situated in the deepest refuse level in trench 4, section 4, of the Frontenac Island site, Cayuga County (Ritchie, 1945, pp. 6, 115, Plate 115). At Frontenac Island, an occupational component referable to the Lamoka focus appeared to precede the coming of Laurentian brachycephals with their specific cultural complex. The subsequent interaction of the two discrete peoples and cultures was evident in the physical remains, burial modes, and character of grave goods. The hearth, found on the lower level of the site, is presumed to pertain to the initial Lamoka- Laurentian contact. The radiocarbon dating yielded an antiquity of 4930 ± 260 years of elapsed time.
Radiocarbon Dating: A Summary
Authors: Johnson Frederick , Rainey Froelich , Collier Donald , Flint Richard F. 
Published: June 2018

The Preceding discussions have considered the radiocarbon dates in relation to a number of archaeological, geological, and palynological problems. It remains to consider the endeavor as a whole, and to reach some conclusions concerning its present and future value and usefulness. Of primary importance is a consideration of what the dates mean. Basic to this is an understanding of the statistics involved. At the request of the Committee, Arnold, who has been intimately associated with the project, has kindly contributed the following explanatory paragraphs:It seems worth while to review briefly the physical scientist's notions about the errors inherent in such measurements, as they apply to radiocarbon dates.
The Significance of Recent Archaeological Discoveries in Inland Alaska
Authors: Rainey Froelich 
Published: June 2018

Inland Alaska is undoubtedly one of the most discouraging areas for archaeological research in North America. But the fascinating theory of human migrations via Bering Strait has led several of us to search this critical territory of boreal forest and tundra for material evidence of the theory. Sites and collections of implements discovered so far are ridiculously small and scattered considering the size of the territory, yet as a while they may be significant.” I shall present here my own conclusions on the present significance of these materials—conclusions which reflect discussions with Giddings and Larsen but which do not convict them.Reviewing what has been done in this field during the post-war years I cannot escape the conclusion that there is as yet no evidence whatever for the hypothetic migrations of men from Asia via the Bering Strait region during the Neolithic period, that is in the European sense of the term.
4 Description of the Farming Sites
Authors: Woodbury Richard B. 
Published: June 2018

Although there are many farming sites in the Point of Pines area, only ten are described here in detail. These ten sites are representative of the variety of topographic situations and types of farms, and provide an adequate sample for studying the prehistoric agricultural practices of the area. Summary data on the ten sites are presented at the end of this chapter (Table 4).About 8 miles west-northwest of the Point of Pines field school and about a mile south of Clover Well, on a small promontory overlooking Clover Basin, are the remains of a small village partly surrounded by farms or garden plots. The location today is in grass, with scattered juniper and ponderosa pine, and the surface is littered with basalt boulders (Fig. 4). At many places the boulders appear concentrated in lines and a little study reveals the pattern shown in the map (Fig. 3).
2 The Cemetery and Other Features
Authors: Greenwood Roberta S. 
Published: June 2018

A Well Defined cemetery was located at a distance approximately 75 feet west and 20 feet south of the geographical center of the site. It covers an area about 20 feet square, containing 14 burials and the fragments of undoubtedly many others, and 12 lithic features. Six other rock features were discovered elsewhere and will be described separately.Within the burial area, the features were dispersed rather more widely than the bone itself. Four discrete burials were found within one five-foot pit, and two each within four tangential squares. Almost all of the bone lay at a depth of 18 to 24 inches with the interments resting on large sandstone boulders on the occupation base of tan-colored sand with streaks of clay. At this depth the earth no longer shows the darker brown color typical of the deposit, but does exhibit small flecks of charcoal and bits of burned sandstone.
5 All Other Remains
Authors: Greenwood Roberta S. 
Published: June 2018

Perhaps the most remarkable discoveries at the Browne site are the two effigy-like sculptures in-the-round. The larger of these was found in situ in undisturbed soil at a depth of one foot. It lay dorsal aspect uppermost in a portion of the site which yielded many of the grinding tools, and was within 10 inches of a mano. It measures 16.5 cm. in length, 11.8 cm. in diameter at the mid-point, and 7.5 cm. in height. It weighs 2,834 gr.The figure is a thoroughly sophisticated work of art with masterly handling of the plane surfaces and a delicate balance from both front to back and side to side. Although at first glance it resembles a fish, the absence of fishing equipment and skeletal remains makes it improbable that fish were either economically or ritually important at the site and therefore would be unlikely subjects for the artist. It is more likely the representation of a toad or frog. The protuberant eyes, pointed jaw, and V-shaped mouth all suggest an amphibian or some intermediate evolutionary form.