Resolution Phase Research Articles

22. SEXUAL PROBLEMS AMONG OLDER ADULTS IN ASIA AND AFRICA: A REVIEW

The aim of this review was to explore the prevalence of sexual problems among older adults in Asia and Africa; and to analyze how difficult it was for them to seek help. Sexual problems are characterized by diminished or absent of sexual interests and by disturbances in the physiological or psychosocial patterns associated with sexual response cycle. Male sexual dysfunction (ED) and female sexual dysfunction increase with age. Studies show that about 33% of the elderly population has at least one complaint with their sexual functioning. Old people face shame and hesitancy when consulting health-care professionals for sexual problems due to the taboos surrounding sex, compounded by a lack of knowledge of older sexuality and ageism in healthcare. The General Practitioners (GP) on the other hand, tend to ignore older adult’s complaints due to lack of training, or just perceiving sexual problems is a norm at old age. However, GP should always give their clients’ opportunity to voice out their concerns with sexual function and offer them various health care regimen and alternatives for evaluation and treatments.

Psychological and sociodemographic factors associated with hypoactive sexual desire in Ecuadorian women

IntroductionHuman sexuality is a multifaceted process, and sexual desire plays a central role in the triphasic model of the sexual response cycle, as proposed by Helen Singer Kaplan.MethodsIn this cross-sectional correlational study, we examined the relationship between various sociodemographic factors, such as age and motherhood, and sexual variables, including erotophobia, erotophilia, homophobia, and unconventional sex, with hypoactive sexual desire in women from Quito, Ecuador. The study sample comprised 421 women between the ages of 18 and 50, who were administered the Revised Sexual Opinion Survey and the Inhibited Sexual Desire Scale to assess their sexual attitudes and levels of desire.ResultsThe findings revealed that age (F = 7.13, p < 0.001) and motherhood (F = 13.72, p < 0.001) had a significant impact on inhibited sexual desire. Furthermore, significant correlations were observed between inhibited sexual desire and age (r = 0.16, p < 0.001), motherhood (r = 0.18, p < 0.001), erotophobia (r = 0.19, p < 0.001), erotophilia (r = −0.21, p < 0.001), and homophobia (r = −0.18, p < 0.001).DiscussionThese results suggest that women who are older, mothers, or have higher levels of erotophobia are more likely to experience hypoactive sexual desire. In contrast, higher levels of erotophilia and homophobia were inversely related to hypoactive sexual desire. This contributes to a deeper understanding of how different personal and sexual attitudes influence sexual desire in Ecuadorian women.

A potent proresolving mediator 17R-resolvin D2 from human macrophages, monocytes, and saliva.

Production of specialized proresolving mediators (SPMs) during the resolution phase in the acute inflammatory response is key to orchestrating complete resolution. Here, we uncovered a trihydroxy resolvin in fresh human saliva. We identified and determined its complete stereochemistry as 7S,16R,17R-trihydroxy-4Z,8E,10Z,12E,14E,19Z-docosahexaenoic acid (17R-RvD2) using total organic synthesis and matching of physical properties. The 17R-RvD2 was produced by activated human M2-like macrophages, M1-like macrophages, and human peripheral blood monocytes. 17R-RvD2 displayed potent proresolving functions (picomolar to nanomolar). Topical application of 17R-RvD2 on mouse ear skin reduced neutrophilic infiltration (~50%). 17R-RvD2 increased M2 markers CD206 and CD163 on human monocyte-derived macrophages and enhanced efferocytosis of senescent red blood cells by M2-like macrophages (EC50 ~ 2.6 × 10-14 M). In addition, 17R-RvD2 activated the RvD2 receptor and was equipotent to its epimer RvD2. 17R-RvD2 also significantly increased phagocytosis of Escherichia coli by human neutrophils. Together, these results establish the complete stereochemistry and potent proresolving functions of the previously unknown 17R-RvD2.

Photoinduced hydrogen dissociation in thymine predicted by coupled cluster theory

The fate of thymine upon excitation by ultraviolet radiation has been the subject of intense debate. Today, it is widely believed that its ultrafast excited state gas phase decay stems from a radiationless transition from the bright ππ* state to a dark nπ* state. However, conflicting theoretical predictions have made the experimental data difficult to interpret. Here we simulate the early gas phase ultrafast dynamics in thymine at the highest level of theory to date. This is made possible by performing wavepacket dynamics with a recently developed coupled cluster method. Our simulation confirms an ultrafast ππ* to nπ* transition (τ = 41 ± 14 fs). Furthermore, the predicted oxygen-edge X-ray absorption spectra agree quantitatively with experiment. We also predict an as-yet uncharacterized πσ* channel that leads to hydrogen dissociation at one of the two N-H bonds. Similar behavior has been identified in other heteroaromatic compounds, including adenine, and several authors have speculated that a similar pathway may exist in thymine. However, this was never confirmed theoretically or experimentally. This prediction calls for renewed efforts to experimentally identify or exclude the presence of this channel.

Development and Validation of a Measure of the Resolution Phase of the Sexual Response Cycle: The Sexual Resolution Scale (SRS)

ABSTRACT We developed and validated a measure of the depth of the resolution experience – the Sexual Resolution Scale (SRS). Portuguese-speaking participants responded to an online survey including the SRS whose eight items were derived from the literature on post-sex states: 1) deeply relaxed, 2) with elevated heart rate, 3) with intensified emotions, 4) more aware of body, 5) in a profound peace, 6) more imaginative, 7) more predisposed to talk about emotionally charged topics, 8) more predisposed to listen to emotionally charged topics. They also reported the intensity of satisfaction, desire, arousal, and orgasm, during the last sexual activity, and completed the Perceived Relationship Quality Components Inventory, and the Female Sexual Function Index or the International Index of Erectile Function. Principal Component Analysis and Confirmatory Factor Analysis revealed two dimensions: Internal Experience (items 1 to 6) and Openness to Communication (items 7 and 8). The two dimensions had good reliability. Invariance was confirmed between women and men. Nomological validity evidence was demonstrated: the two dimensions correlated with better sexual function during the last sexual activity and over the past 4 weeks. The SRS appears to be usable to measure the enjoyable aspects of the resolution phase of sexual intercourse.

O NÍVEL DE CONHECIMENTO DAS ACADÊMICAS EM RELAÇÃo AS DISFUNÇÕES SEXUAIS FEMININAS E A ATUAÇÃO DA FISIOTERAPIA

Female sexual dysfunction is defined as any change or pain in one or more stages of the sexual response cycle, such as any disorder related to sexual desire, excitability, orgasm, sexual pain, dyspareunia and vaginismus. It is considered a public health problem that significantly affects the lives of women and their partners. The causes of sexual dysfunction in women are multifactorial, involving physical, psychological, social aspects or even being of unknown cause, physiotherapeutic treatment is not yet as widespread. Thus, the objective of the study is to evaluate the perception of knowledge of academics about the role of physiotherapy in female sexual dysfunctions in the city of Porto Velho- RO. The present study is cross-sectional in nature, with a sample of 104 academic women, aged between 20 and 30 years, who meet the criteria of the online questionnaire reporting having some sexual dysfunction, and about their knowledge of Physiotherapy. The results showed that in relation to knowledge of the role of physiotherapeutics in this field, 23.4% of participants reported having no knowledge of the role of physiotherapy in sexual dysfunctions. These data corroborate the literature and provide more evidence on the subject.

Abstract 4134531: BST2 induces vascular smooth muscle cell plasticity and phenotype switching during cancer progression

Rationale: Smooth muscle cell (SMC) plasticity and phenotypic switching play prominent roles in the pathogenesis of multiple diseases like atherosclerosis and pulmonary hypertension, but their role in tumorigenesis is unknown. Objective: To investigate SMC diversity and plasticity in tumor angiogenesis and its underlying molecular drivers. Methods and Results: Here we use SMC-specific lineage-tracing mouse models and single cell RNA sequencing (scRNA-seq) to observe the phenotypic diversity of SMCs participating in tumor vascularization. We find that around 10% of SMCs adopt a phenotype which includes features traditionally associated with macrophage-like cells, suggesting they may contribute to the immune profile of the tumor microenvironment (TME). These cells are transcriptionally similar to ‘resolution phase’ M2b macrophages, which have been described to have a role in inflammation resolution. Signaling from bone marrow stromal antigen 2 (BST2) on the surface of tumor cells to PIRA2 on SMC promotes this phenotypic transition, leading to a SMC phenotype that is more proliferative, migratory, and phagocytic. Knockdown of BST2 in the tumor significantly decreases the transition towards a macrophage-like phenotype, and the cells that were able to transition had a comparatively higher inflammatory signal typically associated with anti-tumor effect. Conclusions: As BST2 is known to be a poor prognostic marker in multiple cancers where it is associated with an M2 macrophage-skewed TME, these studies suggest that phenotypically switched SMCs may have a previously unidentified role in this immunosuppressive milieu. The novel concept of SMC contribution to the immune landscape suggests manipulation of SMC phenotypic switching as an approach to altering cancer pathogenesis. Further translational work is needed to understand how this phenotypic switch could influence response to anti-cancer agents and if targeted inhibition of SMC plasticity would be therapeutically beneficial.

A beam-reconfigurable probe-fed mm-wave SIW slot array antenna using cavity-backed U-slot SIW switch

ABSTRACT A beam-reconfigurable millimeter-wave (mm-wave) antenna is proposed, constructed with a dodecagonal substrate integrated waveguide (SIW) structure and a cavity-backed U-slot SIW switch. The SIW switch consists of a U-shaped slot in the ground plane, a p-i-n diode, and a pair of metallic vias, primarily operated by controlling the impedance of the U-shaped slot. Six SIW switches are employed to enable six-beam switchable reconfiguration. Correspondingly, six 4 × 4 SIW slot subarrays are equiangularly arranged along the periphery of the dodecagonal substrate, acting as the main radiators. By carefully controlling the excitation phase and magnitude of the slot elements in the subarrays, a tilted beam of approximately θ = 19° can be produced in measurement with switchable reconfigurable beams 1‒6 steering along the azimuth plane at discrete angles of approximately ϕ = 90°, 150°, 210°, 270°, 330°, and 30°, respectively. The measured results indicate that the overlapped impedance bandwidth (|S11|<-10 dB) of the proposed antenna is across 25.63‒26.08 GHz with a relative bandwidth of 3.7%. The measured antenna peak gains for beams 1‒6 can reach up to 8.0 dBi.

Epigenetic Mechanisms of the Anti-inflammatory Action of the Opioid Peptide Leutragin: Role of Sirtuin 1

Sirtuin 1 (SIRT1) is a class III histone deacetylase that plays a key role in resolving inflammation through known epigenetic mechanisms involving histone and nuclear factor κB (NF-κB) deacetylation. Deacetylation reduces the transcriptional activity of NF-κB and the associated production of pro-inflammatory cytokines such as interleukin 1β (IL-1β), tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6). In the present study, we show for the first time that biomodeling of acute lung inflammation by a single injection of lipopolysaccharide (LPS) induces synchronous oscillations of mRNA levels of cytokines IL-1β, TNF-α, IL-6 and SIRT1 deacetylase in the lungs, the maximum amplitudes of cytokine mRNA oscillations are observed between 1.5 and 5 hours, whereas high levels of SIRT1 mRNA are observed up to 24 hours, when cytokine mRNA oscillations have already faded, which is consistent with the hypothesis about the role of SIRT1 as a factor acting in the phase of inflammation resolution. The study shows that the mechanism of anti-inflammatory action of inhaled hexapeptide Leutragin, a δ-opioid receptor agonist, is related to its ability to increase SIRT1 mRNA expression and decrease the amplitudes of IL-1β, TNF-α, and IL-6 mRNA oscillations in the lungs, which generally leads to the resolution of inflammation in the conditions of biomodeling of acute lung inflammation.

Seeking the optimal SPOC-based blended learning approach to enhance deep learning from the community of inquiry perspective

To equip students with 21&lt;sup&gt;st&lt;/sup&gt; century skills to be competent global citizens and succeed academically and professionally, information and communication technology tools are being utilized to facilitate deep learning in higher education. This study integrated a small private online course (SPOC) with face-to-face (F2F) classroom learning to design and implement a blended English as a foreign language (EFL) course for deep learning. A mixed-method design was employed to investigate the learning experiences and perceptions of EFL students in the SPOC-based blended learning (BL) environment. The primary objective was to examine whether and how the teaching, social and cognitive presences were established from the perspective of the community of inquiry (CoI) model. Participants were 60 students enrolled in an eight-week English communicative course in a Chinese college. Quantitative data was obtained from the CoI and BL surveys, while qualitative data was gathered through individual interviews with 10 students. The results showed that a CoI was established, and deep learning happened in both SPOC and F2F learning areas with a more salient teaching presence in the SPOC area, a stronger social presence and a higher frequency of resolution phase reached in the F2F area. Furthermore, learners expressed satisfaction with the BL course, perceiving it as effective for English language acquisition. Pedagogical implications were offered to assist educators and institutions in optimizing the use of SPOC-based BL to enhance deep learning.

Global shift symmetry on an ADM hypersurface: Toward emergent gravity

Generalized symmetries and their spontaneous breakdown serve as the fundamental concept to constrain the many-body entanglement structure, which allows us to characterize quantum phases of matter and emergent collective excitations. For example, emergent photons may be understood by spontaneous 1-form symmetry breaking, which results from a long-ranged entanglement structure between UV microscopic degrees of freedom. In this study, we show that emergent “gravity” may also arise in a similar fashion, where quotes have been used to emphasize that the symmetry-constrained gravitons show unconventional properties compared to usual gravitons. As the electric 1-form symmetry in Maxwell theory is realized as a global shift symmetry of the spatial component of the U(1) gauge field, generated by the electric field, we demonstrate that a constant shift of the Arnowitt-Deser-Misner (ADM) metric on the spatial hypersurface can be viewed as a global symmetry, generated by the ADM canonical momentum. Deriving a vector-type conserved charge from the variation of action, we construct a shift symmetry operator. Considering a Wick rotation, we demonstrate that a gravitational Wilson loop is charged under the action of this shift symmetry operator, which thus confirms the existence of a generalized global symmetry on the ADM hypersurface. Based on the Ward identity, we show that the spontaneous breaking of this global shift symmetry may give rise to a nonpropagating massless symmetric gauge field at the boundary of the hypersurface. Published by the American Physical Society 2024

Dynamic instabilities and turbulence of merged rotating Bose–Einstein condensates

We present the simulation results of merging harmonically confined rotating Bose–Einstein condensates in two dimensions. Merging of the condensate is triggered by positioning the rotation axis at the trap minima and moving both condensates toward each other while slowly ramping their rotation frequency. We analyze the dynamics of the merged condensate by letting them evolve under a single harmonic trap. We systematically investigate the formation of solitonic and vortex structures in the final, unified condensate, considering both nonrotating and rotating initial states. In both cases, merging leads to the formation of solitons that decay into vortex pairs through snake instability, and subsequently, these pairs annihilate. Soliton formation and decay-induced phase excitations generate sound waves, more pronounced when the merging time is short. We witness no sound wave generation at sufficiently longer merging times that finally leads to the condensate reaching its ground state. With rotation, we notice off-axis merging (where the rotation axes are not aligned), leading to the distortion and weakening of soliton formation. The incompressible kinetic energy spectrum exhibits a Kolmogorov-like cascade [E(k)∼k−5/3] in the initial stage for merging condensates rotating above a critical frequency and a Vinen-like cascade [E(k)∼k−1] at a later time for all cases. Our findings hold potential significance for atomic interferometry, continuous atomic lasers, and quantum sensing applications.

Investigation of a Magnetic Levitation Architecture with a Ferrite Core for Energy Harvesting

This work presents the development of a magnetic levitation system with a ferrite core, designed for electromagnetic energy harvesting from mechanical vibrations. The system consists of a fixed enamel-coated copper coil and five neodymium-iron-boron permanent magnets housed within a PVC spool. To enhance magnetic flux concentration, a manganese-zinc ferrite (Mn-Zn) ring was employed within the spool. Experimental tests were conducted at frequencies up to 20 Hz, demonstrating the device’s potential for harvesting energy from small vibrations, such as those generated by human biomechanical movements, achieving operating voltages up to 3 V. Additionally, the architecture is scalable for larger systems and allows for the integration of multiple transducers without magnetic field interference, independent of the frequency or excitation phase of each transducer.

Impact of Various High Intensity Earthquake Characteristics on the Inelastic Seismic Response of Irregular Medium-Rise Buildings

In the twenty-first century, the seismic design of buildings seems to have become a fully recognized topic. There are guidelines and standards which should be taken into account by designers in seismic areas. Designers using modern international guidelines have ascertained that the behavior of structures is not as expected. New challenges in the construction industry result in the construction of structures with new, unusual shapes. These are structures that do not meet the assumptions of safe construction in seismic areas. Contemporary buildings are also characterized by their irregular distribution of structural elements. Such solutions are not beneficial from the point of view of seismic engineering and can lead to reduced dynamic resistance and damage in such structures. In this paper, a five-storey, irregular-shaped reinforced concrete (RC) building model was subjected to different earthquakes with varying magnitudes, PGA (peak ground acceleration) and PGV (peak ground velocity) values, and durations of the intense shock phase. Once the model was verified using previous in situ measurements, the building model was subjected to five earthquakes. A numerical nonlinear analysis of the building was performed using a verified FEA (finite element analysis) model in the time domain through non-linear time history analysis with the Broyden–Fletcher–Goldfarb–Shanno (BFGS) method. The building’s dynamic properties were measured using various methods of excitation. The model was influenced, among others, by two far-field representative events caused by the last earthquake in Turkey, which resulted in strong ground motion. The analysis results identified the locations of structural damage and allowed for the assessment of the structure’s dynamic resistance. The results of the calculations prove that the duration of the intensive phase of extortion is one of the reasons for building damage in earthquake-prone areas. Building damage occurs with earthquakes that are characterized by an intensive phase of excitation with a long duration and high values of velocity in the earthquake components. The article highlights the inadequate dynamic resistance of the building, leading to excessive displacements and unfavorable structural solutions. Damage to buildings at this earthquake intensity caused damage to the load-bearing structure, which was not designed for such intensities. This paper is a research report with a specific case study of medium-rise irregular RC buildings.

Inflammation and resolution in obesity.

Inflammation is an essential physiological defence mechanism, but prolonged or excessive inflammation can cause disease. Indeed, unresolved systemic and adipose tissue inflammation drives obesity-related cardiovascular diseaseand type 2 diabetes mellitus. Drugs targeting pro-inflammatory cytokine pathways or inflammasome activation have been approved for clinical use for the past two decades. However, potentially serious adverse effects, such as drug-induced weight gain and increased susceptibility to infections, prevented their wider clinical implementation. Furthermore, these drugs do not modulate the resolution phase of inflammation. This phase is an active process orchestrated by specialized pro-resolving mediators, such as lipoxins, and other endogenous resolution mechanisms. Pro-resolving mediators mitigate inflammation and development of obesity-related disease, for instance, alleviating insulin resistance and atherosclerosis in experimental disease models, so mechanisms to modulate their activity are, therefore, of great therapeutic interest. Here, we review current clinical attempts to either target pro-inflammatory mediators (IL-1β,NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3)inflammasome,tumour necrosis factor (TNF)and IL-6) or utilize endogenous resolution pathways to reduce obesity-related inflammation and improve cardiometabolic outcomes. A remaining challenge in the field is to establish more precise biomarkers that can differentiate between acute and chronic inflammation and to assess the functionality of individual leukocyte populations. Such advancements would improve the monitoring of drug effects and support personalized treatment strategies that battle obesity-related inflammation and cardiometabolic disease.

Non-uniformly Spaced Antenna Arrays with Overlapped Elements Constraint

In the literature, inter-element spacing antenna design methods have been widely discussed and presented as an alternative approach to element excitation amplitude and/or phase control methods that may be relied upon to achieve the required array pattern shapes. However, methods associated with non-uniformly distributed elements suffer from the element overlap problem, where some of the optimized element locations may overlap each other and cause changes in the overall array aperture length. Practically, these element overlaps cannot be implemented, due to the physical antenna element size, without omitting some of them. Consequently, the overall performance of the antenna array is degraded. Further, degradation may occur when considering phased arrays with scanned main beams. In this paper, we first illustrate the effect of the problem of overlapped element locations and then we propose two approaches based on the genetic algorithm to optimize non-uniformly spaced arrays with overlapped element locations, while simultaneously preserving the array's directivity. To solve the problem of overlapping and to determine the physical array element size, the minimum element-spacing constraints are incorporated in a simple way in the proposed approaches. Thus, the time required to perform optimization-related computations is greatly reduced. Simulation results confirm the effectiveness of the two proposed solutions, where the probability of the elements overlapping has been reduced to zero under specific conditions related to the locations of the some of the elements, while the peak sidelobe levels were always kept below -15 dB and directivity was maintained, to the extent possible, at the level of that of standard uniformly spaced arrays.

Development of a flexible phased array electromagnetic acoustic testing system with array pickups

The thermal barrier coatings (TBCs) used to protect blades of heavy-duty gas turbines is prone to debonding defects during fabrication and service. It is difficult to detect the debonding defects in the TBC system non-destructively and in situ due to the curved shape of blade and the narrow space between the blades setting in the gas turbine. In this paper, a flexible phased array electromagnetic acoustic (FPA-EMA) testing system with array pickups is developed, which is capable to drive a flexible phased array electromagnetic acoustic transducer (FPA-EMAT) to generate and receive ultrasonic wave directly in the metallic substrate of TBCs, and is potential to be applied to the inspection of debonding defects in the TBC system of gas turbine blades. A phased array excitation unit, a multi-channel signal receiving unit and a new signal post-processing algorithm are developed for the new EMA testing system to enhance the surface acoustic wave in the layered structure and to improve the low conversion efficiency of the conventional EMA testing system. In addition, a bias magnetic field coil fed with long pulse current of large amplitude is adopted to make the new EMAT thin and flexible in order to be applied in a narrow space. The interfering noise and geometric size problems brought by the multiple excitation and pickup channels are well addressed in the new system. The good performances of the developed FPA-EMA testing system were verified experimentally and show the system of good potential to be applied to NDT of practical curved structures.

Functionalized polyaniline nanofibrils on lamellar structured zirconium for effective bone mineralization

The surface physiology of certain implant material has the ability to promote implant–cell signalling process through which a stable environment is formed. The formation of this favourable environment hastens the process of biomineralization and regeneration. In this context, Zirconium (Zr) when treated with alkali undergoes a surface modification which results in the development of a lamellar structured Zirconium (ATZ). Further, encapsulation of polyaniline (PAni) on ATZ was achieved through the electropolymerization technique which results in an effective and homogeneous electrodeposition of PAni nanofibrils on ATZ surface. A high resolution scanning electron microscope analysis (HR-SEM), phase analysis and functional group analysis were carried out confirming the semi-crystalline PAni nanofibrils braided on the ATZ surface. Potentiodynamic polarization studies of the coated sample exhibited higher Ecorr (−0.060 V) and lower icorr (0.007 µA/cm2) values signifying its better corrosion resistance behaviour in higher potentials coupled with lower electrochemical activity in the SBF medium. The porosity of PAni/ATZ nanofibril was 0.007 % and it provides an effective platform for implant-tissue attachment. The In-vitro biomineralization studies proved the bioactivity of PAni/ATZ which forms well-matured HAp spherules over the surface. Further, hemocompatibility studies of PAni/ATZ expressed a hemolytic rate of ∼0.39 % which denotes it’s biocompatible and non-hemolytic behaviour with the blood cells. Further, the coated sample on gram-positive and gram-negative bacteria causes demise of bacterial cell wall and exhibits higher inhibition percentage. In addition, a standard MTT assay of PAni/ATZ provides an effective support in maintaining cell viability and aids in proliferation of MG-63 cells. Thus, the results demonstrate that the nanoscale surface architecture of PAni/ATZ could serve as a potential and conducive environment for bone-implant interaction on the implant material for better osseointegration.

High-efficient sample point transform algorithm for large-scale complex optimization

Decomposition algorithms and surrogate model methods are frequently employed to address large-scale, intricate optimization challenges. However, the iterative resolution phase inherent to decomposition algorithms can potentially alter the background vector, leading to the repetitive evaluation of samples across disparate iteration cycles. This phenomenon significantly diminishes the computational efficiency of optimization. Accordingly, a novel approach, designated the Sample Point Transformation Algorithm (SPTA), is put forth in this paper as a means of enhancing efficiency through a process of mathematical deduction. The mathematical deduction reveals that the difference between sample points in each iteration loop is a simple function related to the inter-group dependent variables. Consequently, the SPTA method achieves the comprehensive transformation of the sample set by establishing a surrogate model of the difference between the sample sets of two cycles with a limited number of sample points, as opposed to conducting a substantial number of repeated samplings. This SPTA is employed to substitute the most time-consuming step of direct calculation in the classical optimization process. To validate the calculation efficiency, a series of numerical examples were conducted, demonstrating an improvement of approximately 75 % while maintaining optimal accuracy. This illustrates the advantage of the SPTA in addressing large-scale and complex optimization problems.

What are future doctors learning about sex? An assessment of sexual health curricula across medical schools in the Northeastern United States.

Sexual health is an imperative area of study in medical school education, yet many medical schools do not offer a comprehensive curriculum nor is it standardized across the United States (US). This study aims to assess written curriculum materials from sexual health curricula in medical schools across the northeast region of the US and compare the current teachings to suggested standards. A compilation of academic resources including lecture materials and syllabi were systematically reviewed utilizing a standardized and validated rubric with variables assessed including: biological and psychological aspects of human sexual development, anatomy and physiology of the human sexual response cycle, sexual health in relation to human reproduction, and contraceptive options. We analyzed our data from the document analysis to look at the frequency of inclusion and exclusion of the sexual health topics included in our rubric. The outcomes of our data set were in line with our hypothesis that there is significant variance between sexual health curricula across institutions as well as an overall lack in material covering sexual health topics. The data show significant sex specific differences such that male-specific topics were covered more frequently than female-specific information. Additionally, only one of the 10 schools examined taught about vulvar conditions. There was also a paucity of information about sexuality in the post-partum period. The clinical implications of this study aim to highlight the discrepancy between an ideal sexual health curriculum and what is actually being taught in medical schools and help to guide future work of creating a comprehensive and standardized sexual medicine education in US. medical schools. The validity of this study was strengthened by analyzing direct curricula materials as opposed to previous use of subjective, self-reported questionnaires. However, the sample location being restricted to the Northeast was a limitation to generalize findings across the country. Future studies would aim to analyze medical school curricula across different regions in the US. This study shows that there is a lack of comprehensive and standardized sexual health curriculum in medical schools in the Northeastern US and serves as initial evidence for further investigation of this topic across American medical schools.