Venous Leak Embolization in Patients with Venogenic Erectile Dysfunction via Deep Dorsal Penile Vein Access: Safety and Early Efficacy.

PURPOSE This all-comers registry aimed to assess safety and early efficacy of venous embolization in patients with venogenic erectile dysfunction due to venous leak in an unselected cohort. METHODS Between October 2019 and September 2022, patients with venogenic erectile dysfunction resistant to phosphodiesterase-5-inhibitors were treated with venous embolization using ultrasound-guided anterograde access via a deep dorsal penile vein in a single center. A mix of ethiodized oil and modified cyanoacrylate-based glue n-butyl 2 cyanoacrylate (NBCA) monomer plus methacryloxy-sulpholane monomer (Glubran-2, GEM, Italy) was used as liquid embolic agent. Prior to embolization, venous leak had been verified based on penile duplex sonography and computed tomography cavernosography. Procedural success was defined as technically successful and complete target vein embolization. The primary safety outcome measure was any major adverse event 6 weeks after the procedure. The primary feasibility outcome measure was IIEF-15 (International Index of Erectile Function-15) score improvement ≥ 4 points in ≥ 50% of subjects on 6 weeks follow-up post intervention. RESULTS Fifty consecutive patients (mean age 61.8 ± 10.0 years) with severe erectile dysfunction due to venous leak underwent venous embolization. Procedural success was achieved in 49/50 (98%) of patients with no major adverse events on follow-up. The primary feasibility outcome measure at 6 weeks was reached by 34/50 (68%) of patients. CONCLUSION Venous leak embolization via deep dorsal penile vein access using a liquid embolic agent was safe for all and efficacious in the majority of patients with severe venogenic erectile dysfunction on 6 weeks follow-up

Female Perpetrators in Internal Child Trafficking in China: An empirical study

Through an empirical study, this article explores the overall profile of female traffickers of children in China and their role and performance in the trafficking processes. Its contribution to the human-trafficking literature lies in its focus on female perpetrators in particular. The article provides an overview of the international literature on female traffickers as well as contemporary knowledge about internal child trafficking in China. Empirical data from incarcerated traffickers suggest that portraying female traffickers as active players of criminal networks obscures the structural problems affecting female child traffickers. The short-term result is that the problems of female offenders are ignored, and the long-term impact is policy making that is disconnected from the lived experiences of an important population. From a gender perspective, this study suggests that female child traffickers are offenders as well as victims of social and gender inequalities in China’s reform era. This study also proposes that internal child trafficking in China should be brought in the international and Anglo-American debates surrounding human trafficking

CW Performance of an InGaAs-GaAs-AlGaAs Laterally-Coupled Distributed Feedback (LC-DFB) Ridge Laser Diode

Single-mode distributed feedback (DFB) laser diodes typically require a two-step epitaxial growth or use of a corrugated substrate. We demonstrate InGaAs-GaAs-AlGaAs DFB lasers fabricated from a single epitaxial growth using lateral evanescent coupling of the optical field to a surface grating etehed along the sides of the ridge. A CW threshold current of 25 mA and external quantum efficiency of 0.48 mW/mA per facet were measured for a 1 mm cavity length device with anti-reflection coated facets. Single-mode output powers as high as 11 mW per facet at 935 nm wavelength were attained. A coupling coefficient of at least 5.8/cm was calculated from the subthreshold spectrum taking into account the 2% residual facet reflectivity

High-Speed Operation of Interband Cascade Lasers

Optical sources operating in the atmospheric window of 3-5 microns are of particular interest for the development of free-space optical communication link. It is more advantageous to operate the free-space optical communication link in 3-5-microns atmospheric transmission window than at the telecom wavelength of 1.5 m due to lower optical scattering, scintillation, and background radiation. However, the realization of optical communications at the longer wavelength has encountered significant difficulties due to lack of adequate optical sources and detectors operating in the desirable wavelength regions. Interband Cascade (IC) lasers are novel semiconductor lasers that have a great potential for the realization of high-power, room-temperature optical sources in the 3-5-microns wavelength region, yet no experimental work, until this one, was done on high-speed direct modulation of IC lasers. Here, highspeed interband cascade laser, operating at wavelength 3.0 m, has been developed and the first direct measurement of the laser modulation bandwidth has been performed using a unique, highspeed quantum well infrared photodetector (QWIP). The developed laser has modulation bandwidth exceeding 3 GHz. This constitutes a significant increase of the IC laser modulation bandwidth over currently existing devices. This result has demonstrated suitability of IC lasers as a mid-IR light source for multi-GHz free-space optical communications link

Characterization and observation of animals responsible for rabies post-exposure treatment in Phnom Penh, Cambodia

In order to provide relevant therapeutic answers to human patients exposed to risk of rabies infection who visit the lnstitut Pasteur du Cambodge for post-exposure treatment and to improve control of rabies in Cambodia, a pilot study was carried out in Phnom Penh Province in November and December 1997 with three objectives: characterization of the population of animals responsible for the exposure to rabies, observation of the animals concerned, and confirmation of the presence of rabies virus in the province. Between 18 November 1997 and 19 December 1997, 409 of the 741 patients treated at the lnstitut Pasteur du Cambodge because of an exposure to a known rabies vector were included in the study. The animals concerned were: 401 dogs (98 %), six monkeys (1 ,5 %) and two cats (0,5%). Three-hundred-and-seventy of the animals (90,5%) were owned, 4 (1 %) were unowned but were available for characterization and observation, and 35 (8,6 %) had an unknown ownership status and were not available for further study. The exposures occurred on private property in 84% of the cases, and 80 of the 370 owned animals (22 %) lived in the same home as had the patient. The 374 animals with known ownership status were examined. Five were already dead and two of these five dogs had presented clinical signs typical of those of rabies. The male:female sex ratio of the dogs was 2,1: 1. The 369 live animals were placed under observation for 10 d immediately after exposure of the humans had taken place. At the end of the period none of the animals had developed clinical signs of rabies, three had died of diseases other than rabies, and one was lost. Tests for the rabies nucleocapsid antigen were positive in two cases (the two suspected rabid dogs), confirming the presence of rabies in Phnom Penh Province. Consequently, we recommend measures to improve the control of rabies in Cambodia.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat v.9 was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.mn201

The Incidence and Health Economic Burden of Ischemic Amputation in Minnesota, 2005-2008

Critical limb ischemia (CLI) is the most severe manifestation of peripheral artery disease (PAD), is associated with high rates of myocardial infarction, stroke, and amputation, and has a high health economic cost. The objective of this study was to estimate the incidence of lower limb amputation, the most serious consequence of CLI, and to create a surveillance methodology for the incidence of ischemic amputation in Minnesota

The FReedom from Ischemic Events - New Dimensions for Survival (FRIENDS) registry: design of a prospective cohort study of patients with advanced peripheral artery disease

Background: Advanced lower extremity peripheral artery disease (PAD), whether presenting as acute limb ischemia (ALI) or chronic critical limb ischemia (CLI), is associated with high rates of cardiovascular ischemic events, amputation, and death. Past research has focused on strategies of revascularization, but few data are available that prospectively evaluate the impact of key process of care factors (spanning pre-admission, acute hospitalization, and post-discharge) that might contribute to improving short and long-term health outcomes. Methods/Design The FRIENDS registry is designed to prospectively evaluate a range of patient and health system care delivery factors that might serve as future targets for efforts to improve limb and systemic outcomes for patients with ALI or CLI. This hypothesis-driven registry was designed to evaluate the contributions of: (i) pre-hospital limb ischemia symptom duration, (ii) use of leg revascularization strategies, and (iii) use of risk-reduction pharmacotherapies, as pre-specified factors that may affect amputation-free survival. Sequential patients would be included at an index “vascular specialist-defined” ALI or CLI episode, and patients excluded only for non-vascular etiologies of limb threat. Data including baseline demographics, functional status, co-morbidities, pre-hospital time segments, and use of medical therapies; hospital-based use of revascularization strategies, time segments, and pharmacotherapies; and rates of systemic ischemic events (e.g., myocardial infarction, stroke, hospitalization, and death) and limb ischemic events (e.g., hospitalization for revascularization or amputation) will be recorded during a minimum of one year follow-up. Discussion The FRIENDS registry is designed to evaluate the potential impact of key factors that may contribute to adverse outcomes for patients with ALI or CLI. Definition of new “health system-based” therapeutic targets could then become the focus of future interventional clinical trials for individuals with advanced PAD

Quasi 3D ECE imaging system for study of MHD instabilities in KSTAR

A second electron cyclotron emission imaging (ECEI) system has been installed on the KSTAR tokamak, toroidally separated by 1/16th of the torus from the first ECEI system. For the first time, the dynamical evolutions of MHD instabilities from the plasma core to the edge have been visualized in quasi-3D for a wide range of the KSTAR operation (B0 = 1.7???3.5 T). This flexible diagnostic capability has been realized by substantial improvements in large-aperture quasi-optical microwave components including the development of broad-band polarization rotators for imaging of the fundamental ordinary ECE as well as the usual 2nd harmonic extraordinary ECE.open1

Interdisciplinary Transgender Veteran Care: Development of a Core Curriculum for VHA Providers

Purpose: The Veteran\u27s Health Administration (VHA) has created a training program for interdisciplinary teams of providers on the unique treatment needs of transgender veterans. An overview of this program\u27s structure and content is described along with an evaluation of each session and the program overall. Methods: A specialty care team delivered 14 didactic courses supplemented with case consultation twice per month over the course of 7 months through video teleconferencing to 16 teams of learners. Each team, consisting of at least one mental health provider (e.g., social worker, psychologist, or psychiatrist) and one medical provider (e.g., physician, nurse, physician assistant, advanced practice nurse, or pharmacist), received training and consultation on transgender veteran care. Results: In the first three waves of learners, 111 providers across a variety of disciplines attended the sessions and received training. Didactic topics included hormone therapy initiation and adjustments, primary care issues, advocacy within the system, and psychotherapy issues. Responses were provided to 39 veteran-specific consult questions to augment learning. Learners reported an increase in knowledge plus an increase in team cohesion and functioning. As a result, learners anticipated treating more transgender veterans in the future. Conclusion: VHA providers are learning about the unique healthcare needs of transgender veterans and benefitting from the training opportunity offered through the Transgender Specialty Care Access Network-Extension of Community Healthcare Outcomes program. The success of this program in training interdisciplinary teams of providers suggests that it might serve as a model for other large healthcare systems. In addition, it provides a path forward for individual learners (both within VHA and in the community) who wish to increase their knowledge

Nonlinear Interaction of Edge-Localized Modes and Turbulent Eddies in Toroidal Plasma under n=1 Magnetic Perturbation

The effect of static n = 1 resonant magnetic perturbation (RMP) on the spatial structure and temporal dynamics of edge-localized modes (ELMs) and edge turbulence in tokamak plasma has been investigated. Two-dimensional images measured by a millimeter-wave camera on the KSTAR tokamak revealed that the coherent filamentary modes (i.e., ELMs) are still present in the edge region when the usual large scale collapse of the edge confinement, i.e., the ELM crash, is completely suppressed by n = 1 RMP. Cross-correlation analyses on the 2D images show that (1) the RMP enhances turbulent fluctuations in the edge toward the ELM-crash-suppression phase, (2) the induced turbulence has a clear dispersion relation for wide ranges of wave number and frequency, and (3) the turbulence involves a net radially outward energy transport. Nonlinear interactions of the turbulent eddies with the coexisting ELMs are clearly observed by bispectral analysis, which implies that the exchange of energy between them may be the key to the prevention of large scale crashes.clos