Should Surgeons Perform Irreversible Genital Surgery on Children?

2017-09-05 18:33:39 | 日記

 

The arrest of a Michigan emergency room physician accused of performing illegal genital surgery on children hit my Facebook feed at 2 p.m. Hours later, it had generated hundreds of horrified comments by doctors condemning the practice of female genital mutilation (FGM), viewed by many in this country as a human rights violation.  

I sympathized with the outrage felt by my fellow medical practitioners, even as I was aware of the complex cultural significance of FGM to some. The notion of performing an irreversible procedure on a child—one that will likely render her incapable of achieving sexual pleasure in the future —is utterly abhorrent to me, as an insult on the body autonomy of a minor who is, by definition, incapable of giving informed consent.

Yet this is what some surgeons in the U.S. do every year. And so far, law enforcement has turned a blind eye.

Related: ‘Religious’ claim by doctor accused of female genital mutilation

There is an old saying that 50 percent of what you learn in medical school is going to be wrong by the time you actually practice; you just don’t know which 50 percent. Nowhere is this more true than in the treatment of people born with intersex traits—biological conditions where people have sex characteristics that fall outside of traditional conceptions of “male” or “female” bodies.

Since the 1950s, some surgeons have tried to “fix” intersex, projecting their assumptions about sex onto the bodies of children to justify surgical interventions that were often harmful and medically unnecessary.

Eight years ago, I did irrevocable damage to the first intersex person I ever met, taking out the gonads of a 17-year-old girl who found out after she never got her period that she had XY chromosomes, with internal testicles instead of ovaries and a uterus.

Now I would do things differently and not rush her into an elective surgery that rendered her menopausal and dependent upon a lifetime of hormonal manipulation. Yet this is poor consolation, because the chilling fact is that I may know but many of my colleagues do not.  

Every surgeon knows that the complications of surgery can be devastating, but for decades intersex patients’ stories went unheard. I know intersex women who have never experienced orgasm because clitoral surgery destroyed their sensation; men who underwent a dozen penile surgeries before they even hit puberty; people who had false vaginas created that scarred and led to a lifetime of pain during intercourse.

While some would argue that surgical practice has improved in the past decades, the fact remains that few attempts have been made to assess the long-term outcomes of these interventions.  

The psychological damage caused by intervention is just as staggering, as evidenced by generations of intersex adults dealing with post-traumatic stress disorder, problems with intimacy and severe depression. Some were even surgically assigned a gender at birth, only to grow up identifying with the opposite gender.

Compounding the stigma and shame was the common practice of telling patients that they are rare and isolated cases and would never meet another person like them.

In 2015, when I published None of the Above, my novel featuring an intersex main character inspired by my first patient, intersex people were largely invisible, even though up to 2 percent of people can have intersex traits.

Related: Trump on ‘campaign to erase LGBTQ people,’ groups say

However, in the past two years, as I’ve traveled to high schools, universities and book festivals from New York to Tennessee to San Francisco, I’ve seen a notable increase in intersex awareness, largely due to the nonprofit InterACT: Advocates for Intersex Youth, whose mission is to empower intersex voices to reverse years of erasure.

Under the umbrella of InterACT’s remarkable efforts, I spoke last year at the Society for Pediatric Urology to discuss the role of clinicians in patient advocacy. Joining me in the spotlight were two intersex women and one parent. It was the largest group of pediatric urologists to ever hear their intersex patients’ stories in a scientific setting.

In the following two months, InterACT was contacted by two separate physicians who opted to defer surgery on an intersex child as a result of seeing our presentation. In doing so, these stalwart doctors proved that old chestnut that we all learned from watching G.I. Joe: knowing is half the battle.

Intersex rights are human rights. Only we can help spread that awareness.

I.W. Gregorio is a surgeon and author.

 inhand networks, inhandnetworks, InHand Networks - Global Leader in Industrial IoT, Global Leader in Industrial IoTn>, 


Scientists May Have Solved Mystery Behind Extinction of Ice Age Giants

2017-09-04 19:33:18 | 日記

 

Updated | The extinction of megafauna across the globe at the end of the last Ice Age appears to have been driven, in part, by moisture from thawing glaciers and permafrost. As moisture in the air increased, grasslands turned to bog and ecosystems collapsed, eventually causing species like the woolly mammoth, giant sloth and sabre-toothed cat to die out.

Between 15,000 and 11,000 years ago, large animals—known as megafauna—across the globe disappeared. Extinctions were most pronounced across Eurasia and the Americas, in what is now Europe, Siberia and North and South America.

What caused this mass trend is unclear. These species were in contact with early humans and Neanderthals and fossil evidence shows they were killed for their meat. Some scientists believe that as humans became more successful, they hunted megafauna to extinction. However, most agree that this alone could not have led to such widespread species extinction. Rather, they believe a combination of climate change and hunting was responsible.

In a study published in Nature Ecology & Evolution, a team of scientists led by Alan Cooper of the University of Adelaide, analyzed the teeth and bones of herbivorous megafauna to understand the impact of environmental change.

They took megafauna samples from across the globe, allowing the team to understand environmental changes on a continental scale. Findings showed thawing permafrost and melting glaciers led to a dramatic increase in landscape moisture. This, they found, caused grasslands to turn into bogs and peatlands and megafauna populations were forced to fragment. Effects were particularly prominent in Eurasia and the Americas, but less so in Africa.

"We didn't expect to find such clear signals of moisture increases occurring so widely across all of Europe, Siberia and the Americas," Cooper says in a statement. "The timing varied between regions, but matches the collapse of glaciers and permafrost and occurs just before most species go extinct.” Because herbivore megafauna were critical to the food chain, any decline in their populations would have a ricochet effect on the rest of the ecosystem and any species within it.

Scientists also say moisture levels can help explain why megafauna extinctions in Africa were far less pronounced. Environmental changes to moisture here were far less pronounced: “The stable presence of grasslands surrounding the central forested belt of Africa during this period helps to explain why proportionally fewer African megafauna became extinct during the late Pleistocene,” the scientists write.

Cooper adds: "The idea of moisture-driven extinctions is really exciting because it can also explain why Africa is so different, with a much lower rate of megafaunal extinctions and many species surviving to this day. Africa's position across the equator means that grassland zones have always surrounded the central monsoon region. The stable grasslands are what has allowed large herbivores to persist—rather than any special wariness of hunters learned from humans evolving there."

Adrian M Lister, from the Vertebrates and Anthropology division of London’s Natural History Museum, says the research adds to our understanding of megafauna extinctions. In an email interview with Newsweek, he says: “The idea that the grazing megafauna depended on a dry grassland habitat (the 'mammoth steppe'), that died away as the climate warmed and moisture increased, has been around for a long time (associated especially with Andrei Sher and Dale Guthrie, who termed it 'mammoth steppe'). Mainly it was based on the evidence of fossil pollen and insects, so it's very nice to have completely independent evidence from another source—stable isotopes—in this study.”

However, Gifford H Miller, Professor of Geological Sciences at the University of Colorado, disagrees. He says that while the study uses an “impressive data set,” there is no comparative study from previous ice ages to show widespread extinctions as a result of an abrupt shift in climate.

“Climate change associated with glacial/interglacial mode switches no doubt caused major ecosystem reorganization as the balance between temperature and precipitation underwent major shifts,” he tells Newsweek in an email interview. “Herbivores dependent on specific ecosystems—and no doubt partially responsible for the perpetuation of those ecosystems, as the authors point out—would have experienced stress. But there is no evidence that the most recent glacial/interglacial transition was in some fundamental way different than previous transitions during which megafauna remained intact.

“In the Americas the only real difference was that modern humans were also present, and in Eurasia, it was the first transition with Homo sapiens on the landscape.  Without evidence indicating the effective moisture changes of the most recent glacial/interglacial transition were unprecedented, I think the case for effective moisture change being the major driver of megafaunal extinction is weak.”

This story has been updated to include Adrian Lister's and Gifford H. Miller's comments.


ISE Series Unmanaged Industrial Ethernet Switch

2017-09-04 19:31:21 | 日記

 
ISE Series Unmanaged Industrial Ethernet Switch
Build simple, rugged and highly reliable communication systems

Built  with industrial design and easy management functions, the ISE series allow customers to build simple and reliable communication systems under harsh industrial environments.

 

Rugged Communications

The ISE series is built with high levels of ruggedness, featuring solid and durable metal shell, wide operating temperature, high EM compatibility, industrial redundant power supply, and an MTBF over35 years.   

 

 Aluminum alloy shell with protective coating, compression and corrosion resistant 

 IP40, resistant to dust, dirt and chips 

 Wide operating temperature: -40°C ~+85°C 

 EMC level 3 

 UL, CE, FCC, RCM certified

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Rich Selections of Ports

The ISE series consists ISE1000-100MB, ISE2000-100MB, ISE3000-1000MB and ISE5000-full 1000MB sub-series, offering a rich selection of models with different port combinations and transmission distances.

   

● 5-18 ports optional, including optical ports, 100MB/1000MB Ethernet ports 

● Rich optical fiber connector types, SC/FC/ST optional, support short range and mid to long distance transmission

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Simple and Easy to Use

The ISE switch is very simple and easy to use. It is plug and play. The DIP switch of broadcast storm control, port flow control and interruption alarms*, and relay alarms* can help engineers manage the network effectively.   

 

 Support DIP switch on/off broadcast storm control, port flow control and abnormal interruption alarms* 

 Relay alarms of power failure and port down, for prompt fault detection* 

 Plug and play, enables fast deployment or quick device replacement 

 Standard DIN rail and wall mounting, compact-sized for easy fitting in racks and cabinets 

 (* Only supported on some of the ISE models.)

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Seismic Telemetry With 3G Cellular Routers

2017-09-02 19:42:22 | 日記

 

Background

 

Earthquake detection now relies more and more on wireless networks, especially cellular. Satellite communication is costly, requires a large power source and is limited by bandwidth and latency considerations. Satellite also is unsuitable for areas with dense foliage or high mountains blocking the signal between the satellite and the remote site. Cellular has become overwhelmingly the dominant choice for seismic telemetry.

 

Seismic monitoring requires a reliable network connection:

● Reliable in extreme climates: wide temperature range and humidity tolerance

● Low power consumption for battery usage

● Robust, with link auto-recovery and auto-reboot

 

A university choses InHand cellular technology for seismic equipment monitoring.


Solution

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In this project, the university targeted a large earthquake-prone area for monitoring. They built thousands of seismic stations to gather information and added a seismic monitor in each station. The sensor records very small vibrations into an event file. The event file contains information like intensity, a time-stamp, waveform data and other parameters. The seismic station then relays this event file back to an earthquake study center for analysis.

If the university chose to use satellite they would face problems with high expenses and low bandwidth, so they made a decision to choose the InHand cellular networking solution. In each station, an IR700 cellular router is connected to a seismic monitor with an RJ45 cable. The seismic monitor can then transmit data to the research center over a secured 3G cellular connection.

One of the biggest challenges faced by the university was the reliability of the cellular network. The sites were located in remote areas far removed from normal cellular coverage. The IR700 boasts excellent link detection and auto-recovery mechanisms, allowing it to reconnect to the internet within five minute whenever it loses signal.

 

Advantages

 

1. InHand cellular data transmission excels in field telemetry because of its advantages:

● Ruggedized for harsh conditions

● Low power consumption: 3.6 W maximum

● Wide Operating Temperature: -25~70 °C, -13~158 °C

● Power Inputs: 12~48 VDC, Industrial Terminal Block

● Immunity to EMI

2. Link auto-recovery and auto-reboot to ensure network devices are always online.

 Tags:  inhand networks, inhandnetworks, InHand Networks - Global Leader in Industrial IoT, Global Leader in Industrial IoT


InRouter611-S Series Industrial LTE Router

2017-09-01 09:06:24 | 日記

 

 

 
InRouter611-S Series Industrial LTE Router
Cost-effective, 3G/4G LTE, Wi-Fi, VPN

Integrating 3G/4G cellular routing and VPN technologies, the InRouter611-S is a cost-effective entry-level industrial IoT router that provides uninterrupted network access, easy deployment and comprehensive remote device management for light industrial and business applications.

Reliable High-speed Communications

The InRouter611-s provides uninterrupted access to 3G/4G with 100Mbps download and 50Mbps uplink; it is compatible with GPRS/CDMA2.5G and also support high speed Wi-Fi.  

 

The InRouter611-s supports backup between 3G/4G and Wi-Fi links; multi-layer auto link detection and recovery ensures stable network connection.

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VPN and Data Security

The InRouter611-S is designed with a comprehensive security solution to protect business data, including encrypted VPN transmission, firewall protections and multi-level authorization control.

 

● Data Transmission Security: support IPSec VPN, L2TP, PPTP, and SSL VPN.

● Firewall Protections: SPI (Stateful Packet Inspection), SSH (Secure Shell), intrusion protection (Ping blocking), DoS defense, attack defense, IP-MAC binding, etc.

 Multi-level user authorization for access security

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Compact Rugged Frame

The industrial-grade build of the product ensures it can withstand harsh operating conditions while maintaining continuous communications without impeding business operations. 

 

● Metal enclosure, IP30 protection 

● Wide operating temperature: -20°C~+70°C 

● Wide voltage input: DC9~26V EMC level 2 

● Compact easy-to-fit, hanger mounting

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Efficient Remote Device Monitoring & Configuration

The InRouter611-S supports InHand Device Manager cloud platform for remote monitoring and centralized management of large-scale devices. Batch configuration via Device Manager can greatly increase efficiency.

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