Purpose
The COVID-19 pandemic, caused by the SARS-CoV-2, represents an unprecedented challenge for healthcare. COVID-19 features a state of hyperinflammation resulting in a “cytokine storm”, which ...leads to severe complications, such as the development of micro-thrombosis and disseminated intravascular coagulation (DIC). Despite isolation measures, the number of affected patients is growing daily: as of June 12th, over 7.5 million cases have been confirmed worldwide, with more than 420,000 global deaths. Over 3.5 million patients have recovered from COVID-19; although this number is increasing by the day, great attention should be directed towards the possible long-term outcomes of the disease. Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients.
Methods
A literature research on the possible mechanisms involved in the development of ED in COVID-19 survivors was performed.
Results
Endothelial dysfunction, subclinical hypogonadism, psychological distress and impaired pulmonary hemodynamics all contribute to the potential onset of ED. Additionally, COVID-19 might exacerbate cardiovascular conditions; therefore, further increasing the risk of ED. Testicular function in COVID-19 patients requires careful investigation for the unclear association with testosterone deficiency and the possible consequences for reproductive health. Treatment with phosphodiesterase-5 (PDE5) inhibitors might be beneficial for both COVID-19 and ED.
Conclusion
COVID-19 survivors might develop sexual and reproductive health issues. Andrological assessment and tailored treatments should be considered in the follow-up.
In this work, we investigate how illuminant estimation techniques can be improved taking into account intrinsic, low level properties of the images. We show how these properties can be used to drive, ...given a set of illuminant estimation algorithms, the selection of the best algorithm for a given image. The algorithm selection is made by a decision forest composed of several trees on the basis of the values of a set of heterogeneous features. The features represent the image content in terms of low-level visual properties. The trees are trained to select the algorithm that minimizes the expected error in illuminant estimation. We also designed a combination strategy that estimates the illuminant as a weighted sum of the different algorithms’ estimations. Experimental results on the widely used Ciurea and Funt dataset demonstrate the effectiveness of our approach.
Introduction
Many forms of mental disorders, especially psychotic disorders are characterized also by a worsening of sexual functioning. Sexual dysfunction has been shown to significantly correlate ...with a longer duration of untreated psychosis and with heavier psychotic symptomatology.
Objectives
The aim of this study is to validate the Italian version of the Arizona Sexual Experience (ASEX), a very handy and reliable tool to assess sexual dysfunction, in a population of people suffering from psychotic spectrum disorders.
Methods
Seventy-three psychiatric patients were recruited and assessed for mental illness and sexual functioning. We administered the Italian version of ASEX, adequately translated by two expert bilinguals. After 15 days we administered once again the test for test-retest reliability.
Results
Validation of ASEX revealed Cronbach’s coefficients >0.70 in both single items as in the total score. In addition, the test-retest reliability revealed Pearson’s coefficients >0.50 in the various domains. Confirmatory factor analysis revealed good fit indexes for the two factors model of ASEX (SRMR=0.54; CFI=0.974; RMSEA=0.135).
Conclusions
This study represents the first validation in the Italian psychiatric context of a very useful specific tool for the sexual assessment in people suffering from mental illness. Our analysis revealed good psychometric characteristics in terms of confirmatory factor analysis, internal consistency, and test-retest reliability.
Disclosure
No significant relationships.
Purpose
To date, few studies have addressed attitudes toward transgender individuals. In addition, little is known about health care providers’ (HCP) attitudes toward sexual minorities. The aim of ...the present study is to compare attitudes toward homosexual and transgender individuals between gender dysphoric individuals (GDs), general population controls (C) and HCP.
Methods
A total of 310 subjects were considered, including 122 GDs (63 transwomen and 59 transmen), 53 heterosexual HCP (26 males and 27 females) and 135 C. Participants completed the Modern Homophobia Scale (MHS) and the Attitudes Toward Transgendered Individuals Scale (ATTI) in order to assess attitudes toward gay men and lesbian women and toward transgender individuals, respectively. In addition, GDs completed the Gender Identity/Gender Dysphoria Questionnaire (GIDYQ-AA) and ATTI to measure, respectively, gender dysphoria levels and internalized transphobia. Religious attitudes were evaluated by means of the Religious Fundamentalism Scale (RFS), and Discrimination and Stigma Scale (DISC-12) was used to measure perceived discrimination.
Results
(1) Men showed significantly higher levels of homophobia and transphobia when compared to women (
p
< 0.001); (2) perceived discrimination was higher in lesbian women compared to gay men and in transwomen compared to transmen (
p
< 0.001 and
p
< 0.05, respectively); and (3) religious fundamentalism was associated with both homophobia and transphobia (both
p
< 0.001).
Conclusions
Our results underline the need to promote awareness and acceptance of the sexual minorities, who are more at risk of discriminatory attitudes, which are strongly dependent on religious precepts and dogma.
In this work, we investigate how illuminant estimation techniques can be improved, taking into account automatically extracted information about the content of the images. We considered ...indoor/outdoor classification because the images of these classes present different content and are usually taken under different illumination conditions. We have designed different strategies for the selection and the tuning of the most appropriate algorithm (or combination of algorithms) for each class. We also considered the adoption of an uncertainty class which corresponds to the images where the indoor/outdoor classifier is not confident enough. The illuminant estimation algorithms considered here are derived from the framework recently proposed by Van de Weijer and Gevers. We present a procedure to automatically tune the algorithms' parameters. We have tested the proposed strategies on a suitable subset of the widely used Funt and Ciurea dataset. Experimental results clearly demonstrate that classification based strategies outperform general purpose algorithms.
Purpose
To investigate the impact of infertility in gender differences on psycho-traumatological, sexological, relational and emotional aspects and gender differences in couples requiring assisted ...reproductive treatment.
Methods
151 couples were recruited with a mean age of 36.7 ± 4.8 years for women and 39.8 ± 6.6f or men. 43% of women and 34% of men had already received the diagnosis of infertility. To recruited subjects was administered the following psychometric tests: Sexological and Emotional in Infertility questionnaire (SEIq), Arizona Sexual Experience Scale (ASEX), the Orgasmomether and the International Trauma Questionnaire (ITQ).
Results
There was a significant difference in traumatic symptoms between men and women (t = 5,859, p < 0.05). Gender differences were found in the sexological dimension of the SEIq (t = 7,858, p < .001) and in the total ASEX score (t = 3,979, p < .001). Specifically, significant correlations emerged between the ASEX domains and the emotional and sexological aspects related to infertility only in women. The reaction to the diagnosis was negatively correlated with the emotional area of the couple (r = -0.683, p < .001) and positively with the couple relationship (r = 0.815, p < .001). Multiple regression revealed that the overall functioning of the couple, rather than the single scales, is the main predictor of sexuality (R
2
= 0.77).
Conclusion
A clear impact of infertility on the couple’s psycho-traumatological, psycho-sexological and relational aspects emerged. It could be useful to promote targeted support interventions on the most compromised areas of couple functioning in assisted reproductive centers.
In the last years, hypersexual behavior has been broadly scientifically studied. The interest in this topic, belonging to psycho-sexology and sexual medicine, has been due to its still unclear ...aetiology, nature, and its manifestation in relationship with several organic and psychopathological conditions. So, the specialist (the psychologist, psychiatrist, endocrinologist, neurologist) may encounter some difficulties in diagnosing and managing this symptom. The first main objective of this position statement, which has been developed in collaboration between the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Psychopathology (SOPSI) is to give to the reader evidence about the necessity to consider hypersexuality as a symptom related to another underlying condition. Following this consideration, the second main objective is to give specific statements, for the biopsychosocial assessment and the diagnosis of hypersexual behavior, developed on the basis of the most recent literature evidence. To develop a psycho-pharmacological treatment tailored on patients’ needs, our suggestion is to assess the presence of specific comorbid psychopathological and organic conditions, and the impact of pharmacological treatments on the presence of an excess of sexual behavior. Finally, a suggestion of a standardized psychometric evaluation of hypersexuality will be given.
Introduction Since the early 1990s, many studies have shown lower mortality for abdominal aortic aneurysm (AAA) repair at high-volume centers compared with low-volume centers. The introduction of ...endovascular AAA repair (EVAR) also has changed the practice of AAA repair. The goal of this study was to determine if regionalization of AAA repair occurred in the United States. Etiologic factors were examined in addition to any reduction in operative mortality rates. Methods Patient discharges of nonruptured AAA repair were identified from the Nationwide Inpatient Sample between 1998 and 2004. Hospitals were stratified by yearly AAA surgical volume of low (≤17 cases), medium (18 to 50), and high (>50). Results A total of 46,901 patients underwent AAA repair (72.7% open vs 27.3% endovascular). The percentage of AAA repairs performed at both low-volume (36.2% to 24.3%) and medium-volume (51.0% to 44.8%) centers fell; whereas, the percentage performed at high-volume centers nearly tripled (12.9% vs 30.9%). In 1998 there were 10 high-volume centers; by 2004 this had increased to 26. The number of low-volume centers decreased, from 412 to 328. EVAR was more rapidly adopted by high-volume centers compared with low-volume centers. By 2004, 64.3% of AAA repairs at high-volume centers were done with endovascular techniques compared with 31.8% in low-volume centers. A concurrent reduction occurred in patient mortality, from 4.4% in 1998 to 2.5% in 2004 ( P < .0001). Conclusion Between 1998 and 2004, a trend towards the regionalization of AAA repair to high-volume centers occurred. Nearly one-third of all AAA repairs were performed at high-volume centers. There was a concurrent increase in the frequency of endovascular AAA repair, especially at high-volume centers. During this period of regionalization of AAA repair to high-volume centers, patient mortality after AAA repair decreased by 23%. Thus, the observed regionalization of AAA repair and the reduction in short-term patient mortality for this operation may be explained by increased utilization of endovascular technologies at high-volume centers.
Summary
The impact of phosphodiesterase type 5 inhibitor (PDE5I) treatment modality (on‐demand vs. daily), PDE5I half‐life and time from surgery to PDE5I prescription on the achievement of ...drug‐assisted erectile function (EF) recovery is uncertain. We systematically reviewed published randomized clinical trials (RCTs). We performed meta‐analyses of data on 2317 men treated with PDE5Is after nerve‐sparing radical prostatectomy (NSRP). A PubMed and SCOPUS search was performed for trials published from 1 January 1969 to 30 June 2016. PDE5Is are effective in achieving drug‐assisted recovery of erectile function (EF). From a statistical standpoint, these studies were subjected to Trial Sequential Analysis to determine whether the pooled data were adequately powered to verify the study outcomes. On‐demand treatment with PDE5Is was significantly better than daily treatment in recovering drug‐assisted EF. This effect was maintained even when the drugs were stratified according with half‐life. Although not based on head‐to‐head trials, Avanafil used on‐demand was the most effective PDE5I in recovering drug‐assisted EF. Whereas tadalafil was equally effective when used both on‐demand and daily, vardenafil significantly improved drug‐assisted EF recovery only when used on‐demand. The start of PDE5I treatment six months or more after surgery compared to treatment started earlier did not negatively affect the rate of drug‐assisted EF recovery or the possibility to have successful intercourse based on the Sexual Encounter Profile question‐3 (SEP‐3). Current trials do not support the hypothesis that PDE5I use recovers drug‐unassisted EF, although chronic low‐dose tadalafil administration may help to preserve erectile tissue integrity. Potential shortcomings in the trials design may partially explain these disappointing results and several questions concerning the recovery of drug‐unassisted EF remain unanswered. Thus, there is a need for well‐designed new RCTs requiring changes in the timing of PDE5I administration as well as in the dose and the treatment duration.
We propose a new self-adaptive image cropping algorithm where the processing steps are driven by the classification of the images into semantic classes. The algorithm exploits both visual and ...semantic information. Visual information is obtained from a visual attention model, while semantic information relates to the automatically assigned image genre and to the detection of face and skin regions.
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