Management of erectile dysfunction post-radical prostatectomy

© 2015 Saleh et al.Radical prostatectomy is a commonly performed procedure for the treatment of localized prostate cancer. One of the long-term complications is erectile dysfunction. There is little consensus on the optimal management; however, it is agreed that treatment must be prompt to prevent fibrosis and increase oxygenation of penile tissue. It is vital that patient expectations are discussed, a realistic time frame of treatment provided, and treatment started as close to the prostatectomy as possible. Current treatment regimens rely on phosphodiesterase 5 inhibitors as a first-line therapy, with vacuum erection devices and intraurethral suppositories of alprostadil as possible treatment combination options. With nonresponders to these therapies, intracavernosal injections are resorted to. As a final measure, patients undergo the highly invasive penile prosthesis implantation. There is no uniform, objective treatment program for erectile dysfunction post-radical prostatectomy. Management plans are based on poorly conducted and often underpowered studies in combination with physician and patient preferences. They involve the aforementioned drugs and treatment methods in different sequences and doses. Prospective treatments include dietary supplements and gene therapy, which have shown promise with there proposed mechanisms of improving erectile function but are yet to be applied successfully in human patients

On the Kinetic Energy Density Functional: The Limit of the Density Derivative Order

Within ``orbital-free'' density functional theory, it is essential to develop general kinetic energy density (KED), denoted as $t(\mathbf{r})$. This is usually done by empirical corrections and enhancements, gradient expansions, machine learning, or axiomatic approaches to find forms that satisfy physical necessities. In all cases, it is crucial to determine the largest spatial density derivative order, $m$ in, $t(\mathbf{r})$. There have been many efforts to do so, but none have proven general or conclusive and there is no clear guide on how to set $m$. In this work, we found that, by imposing KED finitude, $m=D+1$ for systems of dimension $D$. This is consistent with observations and provides a needed guide for systematically developing more accurate KEDs

EVALUASI TINGKAT KEPUASAN PENGGUNA SIM-RS MENGGUNAKAN METODE EUCS DI RSUD PROF. DR. H. ALOEI SABOE KOTA GORONTALO

Tujuan dari penelitian ini adalah untuk mengukur tingkat kepuasan pengguna Sistem Informasi Manajemen Rumah Sakit (SIM-RS) Prof. Dr. H. Aloei Saboe Kota Gorontalo dan memberikan rekomendasi agar sistem berjalan lebih baik. Metode yang digunakan dalam penelitian ini adalah End-User Computing Satisfaction (EUCS) dengan menggunakan pendekatan kuantitatif. Penelitian ini melibatkan sebanyak 34 orang sebagai responden yang merupakan pegawai administrasi dan programmer di rumah sakit. Hasil penelitian menunjukkan bahwa tingkat kepuasan pengguna untuk seluruh variabel EUCS berada pada kategori puas dan sangat puas yang menandakan bahwa pengguna sudah merasa puas sehingga perlu dipertahankan. Sehingga direkomendasikan untuk melihat dari segi hardware seperti pengecekan perangkat komputer apabila ada perangkat yang sudah usang dan perlu diganti, atau dari segi brainware seperti meninjau kemampuan operator dalam mengoperasikan sistem atau melakukan pelatihan penggunaan sistem kepada operato

Identifikasi Pola Sebaran Intrusi Batuan Bawah Permukaan Menggunakan Metode Geomagnet di Sungai Jenelata Kabupaten Gowa

This research has been conducted using geomagnetic method at Jenelata River, Gowa regency, South Sulawesi. The purpose of this study is to identify subsurface geological structure of the study area. The number of measurement points as much as 248 points with area 70 × 300 meters. The process of data acquisition using a magnetometer. Data processing was carried out with the diurnal correction and IGRF correction and using filter upward continuation. Modelling conducted using forward modeling using the software Mag2DC. The total magnetic field ranges from 42,456 to 43,111.6 nT. Based on a qualitative interpretation obtain local magnetic anomaly contour variations values between -320 to 240 nT. While the quantitative interpretation indicates basalt rocks with susceptibility values to SI, which breached pyroclastic rocks with susceptibility values to SI, in the form of dyke

Penentuan Profil Ketebalan Sedimen Lintasan Kota Makassar Dengan Mikrotremor

Di kota metropolitan yang jauh dari fokus gempa besar misalnya Kota Makassar, getaran yang paling banyak mempengaruhi kontruksi bangunan adalah gempa mikro yang bersumber dari getaran mesin, angin, tumbuhan dan aktivitas manusia. Sumber getaran di permukaan bumi dapat menyebabkan tanah di sekitarnya beresonansi. Resonansi pada lapisan tanah yang terjadi secara periodik disebut gempa mikro atau mikrotremor. Hasil pengukuran mikrotremor dari arah Kabupaten Gowa ke Kota Makassar menjadi fokus analisis dalam penelitian ini. Studi mikrotremor ini bertujuan mengetahui berapa besar frekuensi resonansi, tingkat kerentanan seismik dan pendugaan ketebalan lapisan sedimen pada lintasan mikroteremor yang dibuat melewati daerah Gowa sampai kota Makassar. Frekuensi resonansi lintasan mikrotremor Gowa-Makassar sangat bervariasi mulai dari 0,647 – 11,698 Hz, dengan frekuensi resonansi rata-rata berada pada 6,29 Hz. Nilai indeks kerentanan seismik lintasan mikrotremor Gowa-Makassar berada pada interval nilai 0,15 – 30. Tingkat kerentanan seismik Gowa-Makassar cenderung semakin besar ke arah topografi yang lebih tinggi. Hasil perhitungan ketebalan sedimen lintasan mikrotremor Gowa-Makassar menggunakan teknik S/R adalah 6 – 66 m

VERTICAL SUBSURFACE FLOW AND FREE SURFACE FLOW CONSTRUCTED WETLANDS FOR SUSTAINABLE POWER GENERATION AND REAL WASTEWATER SELECTIVE POLLUTANTS REMOVAL

A vertical subsurface flow constructed wetland (VSSFCW) and a free surface flow constructed wetland (FSFCW) were set for the objective of comparison the performance of two systems in order to make a decision of the better one for future installation of wastewater treatment system and power generation. Both of the constructed wetlands were planted with Cyperus Alternifolius. During the observation period (19 days or 456 hours), environmental conditions such as pH, temperature, total chemical oxygen demand (COD), phosphate (PO4), nitrate (NO3), total suspended solids (TSS), total dissolved solids (TDS), Pb, Cu, and Cd removal efficiencies of the systems were determined. According to the results, final removal efficiencies for the VSSF and FWSF, respectively, were: COD (94.3% and 94.3%), PO4 (84.3% and 75.3%), NO3 (100% and 100%), TSS (96.8% and 85.6%), Pb (65.8% and 81.4%), Cu (more than 94.7% and 89.4%), Cd (85.7% and 88%). The treatment performances of the VSSF were better than that of the FWSF with regard to the removal of suspended solids and nutrients. In FWSF systems, electricity generation performed better than VSSF of 31.4 mV especially with batch system during one wastewater feed is loaded among all of the nineteen days with maximum voltage of 33.7 mV and decreased gradually as oxygen depletion in cathode chamber and less metabolism processes have occurred

E-Mobility -- Advancements and Challenges

Mobile platforms cover a broad range of applications from small portable electric devices, drones, and robots to electric transportation, which influence the quality of modern life. The end-to-end energy systems of these platforms are moving toward more electrification. Despite their wide range of power ratings and diverse applications, the electrification of these systems shares several technical requirements. Electrified mobile energy systems have minimal or no access to the power grid, and thus, to achieve long operating time, ultrafast charging or charging during motion as well as advanced battery technologies are needed. Mobile platforms are space-, shape-, and weight-constrained, and therefore, their onboard energy technologies such as the power electronic converters and magnetic components must be compact and lightweight. These systems should also demonstrate improved efficiency and cost-effectiveness compared to traditional designs. This paper discusses some technical challenges that the industry currently faces moving toward more electrification of energy conversion systems in mobile platforms, herein referred to as E-Mobility, and reviews the recent advancements reported in literature

Normal-tension glaucomatous optic neuropathy is related to blood pressure variability in the Maracaibo Aging Study

Hypoperfusion of the optic nerve might be involved in the pathogenesis of normal-tension glaucomatous optic neuropathy (GON). Mean arterial pressure (MAP) drives ocular perfusion, but no previous studies have addressed the risk of GON in relation to blood pressure (BP) variability, independent of BP level. In a cross-sectional study, 93 residents of Maracaibo, Venezuela, underwent optical coherence tomography, visual field assessments and 24-h ambulatory BP monitoring between 2011 and 2016. We investigated the association of normal-tension GON with or without visual field defects with reading-to reading variability of 24-h MAP, as captured by variability independent of the MAP level (VIMmap). Odds ratios (ORs) were adjusted for 24-h MAP level and for a propensity score of up to five risk factors. Among the 93 participants (87.1% women; mean age, 61.9 years), 26 had open-angle normal-tension GON at both eyes; 14 had visual field defects; and 19 did not have visual field defects. The OR ratios for normal-tension GON, expressed per 1-SD increment in VIMmap (2 mm Hg), were 2.17 (95% confidence interval, 1.33–3.53) unadjusted; 2.20 (1.35–3.61) adjusted for 24-h MAP level only; 1.93 (1.10–3.41) with additional adjustment for age, educational attainment, high-density lipoprotein (HDL) cholesterol and office hypertension; and 1.95 (1.10–3.45) in models including intraocular pressure. We confirmed our a priori hypothesis that BP variability, most likely operating via hypoperfusion of the optic nerve, is associated with normal-tension GON. 24-H ambulatory BP monitoring might therefore help stratify the risk of normal-tension GON

Evolutionary history of endogenous Human Herpesvirus 6 reflects human migration out of Africa

Human herpesvirus 6A and 6B (HHV-6) can integrate into the germline, and as a result, ∼70 million people harbor the genome of one of these viruses in every cell of their body. Until now, it has been largely unknown if 1) these integrations are ancient, 2) if they still occur, and 3) whether circulating virus strains differ from integrated ones. Here, we used next-generation sequencing and mining of public human genome data sets to generate the largest and most diverse collection of circulating and integrated HHV-6 genomes studied to date. In genomes of geographically dispersed, only distantly related people, we identified clades of integrated viruses that originated from a single ancestral event, confirming this with fluorescent in situ hybridization to directly observe the integration locus. In contrast to HHV-6B, circulating and integrated HHV-6A sequences form distinct clades, arguing against ongoing integration of circulating HHV-6A or “reactivation” of integrated HHV-6A. Taken together, our study provides the first comprehensive picture of the evolution of HHV-6, and reveals that integration of heritable HHV-6 has occurred since the time of, if not before, human migrations out of Africa

Research on aging during the Venezuelan humanitarian crisis: the experience of the Maracaibo aging study

Background Venezuela is in the throes of a complex humanitarian crisis that is one of the worst in decades to impact any country outside of wartime. This case analysis describes the challenges faced by the ongoing Maracaibo Aging Study (MAS) during the deteriorating conditions in Venezuela. When the MAS began in 1997, it focused on memory-related disorders. Since then, strategic planning and proactive community participation allowed us to anticipate and address logistical, funding, and ethical challenges, and facilitated the enrollment and retention of more than 2500 subjects over 55 years of age. All participants, who are residents of the city of Maracaibo, Venezuela, underwent various assessments on several occasions. Here, we discuss how our approach to implementing a longitudinal, population-based study of age-related conditions has allowed our research program to continue throughout this period of political, economic, and social upheaval. Discussion As the social context in Venezuela became more complicated, new challenges emerged, and strategies to sustain the study and participation were refined. We identified five main mechanisms through which the evolving humanitarian crisis has affected implementation of the MAS: 1) community dynamics; 2) morale of researchers, staff, and participants; 3) financial feasibility; 4) components of the research process; and 5) impact on the health of staff, participants, and their families. Strategies to compensate for the impact on these components were implemented, based on inputs from community members and staff. Improved communication, greater involvement of stakeholders, broadening the scope of the project, and strengthening international collaboration have been the most useful strategies. Particular demands emerged, related to the increased mortality and comorbidities of participants and staff, and deterioration of basic services and safety. Conclusion Although the MAS has faced numerous obstacles, it has been possible to continue a longitudinal research project throughout the humanitarian crisis, because our research team has engaged the community deeply and developed a sense of mutual commitment, and also because our project has provided funding to help keep researchers employed, somewhat attenuating the brain drain