Is “Unconsummated Marriage” still an appropriate term? A snapshot of reality

The most shared definition of Unconsummated Marriage (UM) refers to “the failure to perform successful sexual intercourse at the beginning of the marriage. UM usually occurs in the first few nights of marriage and so it is frequently referred to as “honeymoon impotence” or “wedding night impotence”. In the Middle-Eastern (MES) and Western (WS) societies, sexuality follows different patterns in terms of meaning and rules. Moreover the evolution of societies all around the world created new contexts and kinds of relationship. This could hamper a correct taxonomy of such sexual dysfunction where a social variable seems crucial. Aim: To analyze and review data on UM all around the world, to understand if in different societies it refers to the same situation. Method: A review of published literature on UM from 1970 to date, was conducted. Results: Substantial difference emerged from MES to WS. In MES, sexuality is allowable only in marriage, while in WS sexuality and relationship are not strongly linked. This could suggest that the term “marriage” is unable to cover the phenomenon in such different countries. Moreover, the average time before the consultation, causal attribution and prevalence are very different in Western and Middle Eastern countries. Conclusion: We found that the term “first attempts dysfunction” could be better used to describe male, female or both difficulties related to ignorance about sexuality or state/performance anxiety. On the other hand over the individual category of sexual dysfunctions, we suggest a new term as “Unconsummated relationship”, where individual difficulties toward sexuality are involved creating a couple’s dysfunction. Keywords: Unconsummated marriage; Honeymoon impotence; White marriage; Vaginismus; Infertilit

Geological Criteria for Evaluating Seismicity Revisited: Forty Years of Paleoseismic Investigations and the Natural Record of Past Earthquakes

The identification of individual past earthquakes and their characterization in time and space, as well as in magnitude, can be approached in many different ways with a large variety of methods and techniques, using a wide spectrum of objects and features. We revise the stratigraphic and geomorphic evidence currently used in the study of paleoseismicity, after more than three decades since the work by Allen (1975), which was arguably the first critical overview in the field of earthquake geology. Natural objects or geomarkers suitable for paleoseismic analyses are essentially preserved in the sediments, and in a broader sense, in the geologic record. Therefore, the study of these features requires the involvement of geoscientists, but very frequently it is a multidisciplinary effort. The constructed environment and heritage, which typically are the focus of archaeoseismology and macroseismology, here are left aside. The geomarkers suitable to paleoseismic assessment can be grouped based on their physical relation to the earthquake\u2019s causative fault. If directly associated with the fault surface rupture, these objects are known as direct or on-fault features (primary effects in the Environmental Seismic Intensity [ESI] 2007 scale). Conversely, those indicators not in direct contact with the fault plane are known as indirect or off-fault evidence (secondary effects in the ESI 2007 scale). This second class of evidence can be subdivided into three types or subclasses: type A, which encompasses seismically induced effects, including soft-sediment deformation (soil liquefaction, mud diapirism), mass movements (including slumps), broken (disturbed) speleothems, fallen precarious rocks, shattered basement rocks, and marks of degassing (pockmarks, mud volcanoes); type B, which consists of remobilized and redeposited sediments (turbidites, homogenites, and tsunamites) and transported rock fragments (erratic blocks); and type C, entailing regional markers of uplift or subsidence (such as reef tracts, microatolls, terrace risers, river channels, and in some cases progressive unconformities). The first subclass of objects (type A) is generated by seismic shaking. The second subclass (type B) relates either to water bodies set in motion by the earthquake (for the sediments and erratic blocks) or to earthquake shaking; in a general way, they all relate to wave propagation through different materials. The third subclass (type C) is mostly related to the tectonic deformation itself and can range from local (next to the causative fault) to regional scale. The natural exposure of the paleoseismic objects\u2014which necessarily conditions the paleoseismic approach employed\u2014is largely controlled by the geodynamic setting. For instance, oceanic subduction zones are mostly submarine, while collisional settings tend to occur in continental environments. Divergent and wrenching margins may occur anywhere, in any marine, transitional, or continental environment. Despite the fact that most past subduction earthquakes have to be assessed through indirect evidence, paleoseismic analyses of this category of events have made dramatic progress recently, owing to the increasingly catastrophic impact that they have on human society

Simulation of hydrogenated graphene Field-Effect Transistors through a multiscale approach

In this work, we present a performance analysis of Field Effect Transistors based on recently fabricated 100% hydrogenated graphene (the so-called graphane) and theoretically predicted semi-hydrogenated graphene (i.e. graphone). The approach is based on accurate calculations of the energy bands by means of GW approximation, subsequently fitted with a three-nearest neighbor (3NN) sp3 tight-binding Hamiltonian, and finally used to compute ballistic transport in transistors based on functionalized graphene. Due to the large energy gap, the proposed devices have many of the advantages provided by one-dimensional graphene nanoribbon FETs, such as large Ion and Ion/Ioff ratios, reduced band-to-band tunneling, without the corresponding disadvantages in terms of prohibitive lithography and patterning requirements for circuit integration

Geological Criteria for Evaluating seismicity revisited: Forty Years of Paleoseismic Investigations and the Natural Record of Past Earthquakes

The identifi cation of individual past earthquakes and their characterization in time and space, as well as in magnitude, can be approached in many different ways with a large variety of methods and techniques, using a wide spectrum of objects and features. We revise the stratigraphic and geomorphic evidence currently used in the study of paleoseismicity, after more than three decades since the work by Allen (1975), which was arguably the fi rst critical overview in the fi eld of earthquake geology. Natural objects or geomarkers suitable for paleoseismic analyses are essentially preserved in the sediments, and in a broader sense, in the geologic record. Therefore, the study of these features requires the involvement of geoscientists, but very frequently it is a multidisciplinary effort. The constructed environment and heritage, which typically are the focus of archaeoseismology and macroseismology, here are left aside. The geomarkers suitable to paleoseismic assessment can be grouped based on their physical relation to the earthquake\u2019s causative fault. If directly associated with the fault surface rupture, these objects are known as direct or on-fault features (primary effects in the Environmental Seismic Intensity [ESI] 2007 scale). Conversely, those indicators not in direct contact with the fault plane are known as indirect or off-fault evidence (secondary effects in the ESI 2007 scale). This second class of evidence can be subdivided into three types or subclasses: type A, which encompasses seismically induced effects, including soft-sediment deformation (soil liquefaction, mud diapirism), mass movements (including slumps), broken (disturbed) speleothems, fallen precarious rocks, shattered basement rocks, and marks of degassing (pockmarks, mud volcanoes); type B, which consists of remobilized and redeposited sediments (turbidites, homogenites, and tsunamites) and transported rock fragments (erratic blocks); and type C, entailing regional markers of uplift or subsidence (such as reef tracts, microatolls, terrace risers, river channels, and in some cases progressive unconformities). The fi rst subclass of objects (type A) is generated by seismic shaking. The second subclass (type B) relates either to water bodies set in motion by the earthquake (for the sediments and erratic blocks) or to earthquake shaking; in a general way, they all relate to wave propagation through different materials. The third subclass (type C) is mostly related to the tectonic deformation itself and can range from local (next to the causative fault) to regional scale. The natural exposure of the paleoseismic objects\u2014which necessarily conditions the paleoseismic approach employed\u2014is largely controlled by the geodynamic setting. For instance, oceanic subduction zones are mostly submarine, while collisional settings tend to occur in continental environments. Divergent and wrenching margins may occur anywhere, in any marine, transitional, or continental environment. Despite the fact that most past subduction earthquakes have to be assessed through indirect evidence, paleoseismic analyses of this category of events have made dramatic progress recently, owing to the increasingly catastrophic impact that they have on human society

A dynamically consistent discretization method for Goodwin model

In economic theory the majority of macroeconomic models describing economic growth employ differential equations or sets of differential equations (see, among all, Solow, 1956 and Haavelmo, 1954). Nevertheless, economic data are usually available in discrete time. Therefore, when attempting to apply these models it is often necessary to use their discrete form, i.e. difference equations. To this aim, more and more often authors propose and analyse discrete versions of the models originally built with the assumption of time continuity. Despite many standard numeric techniques and ready-made software, obtained discrete models do not always maintain model characteristics in continuous time and the long run behaviours of the discretized model could differ from the original one. In this work, we present a modification of non-standard discretization method related to the methodology proposed by Mickens (2000), (2003) and its revisions (see Kwessi et al., 2018) for converting economic models from continuous time to discrete time. Such a discretization method preserves the original dynamic properties of the continuous model, in the sense of equilibria, their stability and bifurcation characteristics. Furthermore, the discretization produces solution trajectories in qualitative and quantitative agreement with those of the continuous model. An example of economic model described by a system of nonlinear differential equations is studied: we applied the discretization method to the Goodwin model (Goodwin, 1967) and provided a comparative analysis for qualitative and quantitative long run behaviour of the continuous and discrete version of the system

Trauma ICU Prevalence Project: the diversity of surgical critical care.

Background:Surgical critical care is crucial to the care of trauma and surgical patients. This study was designed to provide a contemporary assessment of patient types, injuries, and conditions in intensive care units (ICU) caring for trauma patients. Methods:This was a multicenter prevalence study of the American Association for the Surgery of Trauma; data were collected on all patients present in participating centers' trauma ICU (TICU) on November 2, 2017 and April 10, 2018. Results:Forty-nine centers submitted data on 1416 patients. Median age was 58 years (IQR 41-70). Patient types included trauma (n=665, 46.9%), non-trauma surgical (n=536, 37.8%), medical (n=204, 14.4% overall), or unspecified (n=11). Surgical intensivists managed 73.1% of patients. Of ICU-specific diagnoses, 57% were pulmonary related. Multiple high-intensity diagnoses were represented (septic shock, 10.2%; multiple organ failure, 5.58%; adult respiratory distress syndrome, 4.38%). Hemorrhagic shock was seen in 11.6% of trauma patients and 6.55% of all patients. The most common traumatic injuries were rib fractures (41.6%), brain (38.8%), hemothorax/pneumothorax (30.8%), and facial fractures (23.7%). Forty-four percent were on mechanical ventilation, and 17.6% had a tracheostomy. One-third (33%) had an infection, and over half (54.3%) were on antibiotics. Operations were performed in 70.2%, with 23.7% having abdominal surgery. At 30 days, 5.4% were still in the ICU. Median ICU length of stay was 9 days (IQR 4-20). 30-day mortality was 11.2%. Conclusions:Patient acuity in TICUs in the USA is very high, as is the breadth of pathology and the interventions provided. Non-trauma patients constitute a significant proportion of TICU care. Further assessment of the global predictors of outcome is needed to inform the education, research, clinical practice, and staffing of surgical critical care providers. Level of evidence:IV, prospective observational study

Exact states and spectra of vibrationally dressed polaritons

Strong coupling between light and matter is possible with a variety of organic materials. In contrast to the simpler inorganic case, organic materials often have a complicated spectrum, with vibrationally dressed electronic transitions. Strong coupling to light competes with this vibrational dressing and, if strong enough, can suppress the entanglement between electronic and vibrational degrees of freedom. By exploiting symmetries, we can perform exact numerical diagonalization to find the polaritonic states for intermediate numbers of molecules and use these to define and validate accurate expressions for the lower polariton states and strong-coupling spectrum in the thermodynamic limit. Using this approach, we find that vibrational decoupling occurs as a sharp transition above a critical matter-light coupling strength. We also demonstrate how the polariton spectrum evolves with the number of molecules, recovering classical linear optics results only at large N

The footprint of a historical paleoearthquake: the sixth-century-CE event in the European western Southern Alps

Low-deformation regions are characterized by long earthquake recurrence intervals. Here, it is fundamental to extend back the record of past events as much as possible to properly assess seismic hazards. Evidence from single sites or proxies may be not compelling, whereas we obtain a more substantial picture from the integration of paleo- and archeoseismic evidence at multiple sites, eventually supplemented with historical chronicles. In the city of Como (N Italy), we perform stratigraphic and sedimentological analyses on the sedimentary sequences at Via Manzoni and we document earthquake archeological effects at the Roman baths by means of structure from motion and field surveys. Radiocarbon dating and chronological constraints from the archeological site allow us to bracket the time of occurrence of the deformations to the sixth century CE. We interpret the observed deformations as due to earthquake ground shaking and provide constraints on the lower threshold for the triggering of such evidence. We move toward a regional view to infer possible relevant seismic sources by exploiting a dataset of published paleoseismic evidence in Swiss and N Italy lakes. We perform an inverse grid search to identify the magnitude and location of an earthquake that can explain all the positive and negative evidence consistent with the time interval of the event dated at Como. Our results show that an earthquake (minimum Mw 6.32) with epicenter located at the border between Italy and Switzerland may account for all the observed effects; a similar event in the sixth century CE has not been documented so far by historical sources. Our study calls for the need to refine the characterization of the local seismic hazard, especially considering that this region seems unprepared to face the effects of an earthquake size similar to the one inferred for the sixth-century-CE event.</p

Induced sputum cellularity. Reference values and distribution in normal volunteers.

Abstract Sputum induction has recently been proposed as the only direct noninvasive method for measuring airway inflammatory indices. The reference values and the distribution of cells in induced sputum in a control population have not yet been well defined. We therefore evaluated data from a large number of healthy volunteers. One hundred fourteen healthy, nonatopic, nonsmoking volunteers without airway hyperreactivity were enrolled (age: 38 +/- 13 yr [mean +/- SD]; FEV(1): 105 +/- 10% predicted; provocative dose of methacholine inducing a 20% decrease FEV(1) > 3,200 microgram). Ninety-six subjects (84%) produced adequate analysis samples. The subjects had a normal age distribution. Their induced sputum was rich in macrophages (69.2 +/- 13%) and neutrophils (27.3 +/- 13%), and poor in eosinophils (0.6 +/- 0.8%), lymphocytes (1.0 +/- 1.2%), and epithelial cells (1.5 +/- 1.8%). Only macrophages and neutrophils showed a normal distribution; total and differential counts of other cells did not. We propose that these data be used in comparison of the induced sputum cells of normal subjects and those of patients with airway inflammation