Comparison of ChatGPT and Traditional Patient Education Materials for Men's Health.

INTRODUCTION: ChatGPT is an artificial intelligence platform available to patients seeking medical advice. Traditionally, urology patients consulted official provider-created materials, particularly the Urology Care Foundation™ (UCF). Today, men increasingly go online due to the rising costs of health care and the stigma surrounding sexual health. Online health information is largely inaccessible to laypersons as it exceeds the recommended American sixth to eighth grade reading level. We conducted a comparative assessment of patient education materials generated by ChatGPT vs UCF regarding men's health conditions. METHODS: All 6 UCF men's health resources were identified. ChatGPT responses were generated using patient questions obtained from UCF. Adjusted ChatGPT responses were generated by prompting, "Explain it to me like I am in sixth grade." Textual analysis was performed using sentence, word, syllable, and complex word count. Six validated formulae were used for readability analysis. Two physicians independently scored responses for accuracy, comprehensiveness, and understandability. Statistical analysis involved Wilcoxon matched-pairs test. RESULTS: ChatGPT responses were longer and more complex. Both UCF and ChatGPT failed official readability standards, although ChatGPT performed significantly worse across all 6 topics (all P < .001). Conversely, adjusted ChatGPT readability typically surpassed UCF, even meeting the recommended level for 2 topics. Qualitatively, UCF and ChatGPT had comparable accuracy, although ChatGPT had better comprehensiveness and worse understandability. CONCLUSIONS: When comparing readability, ChatGPT-generated education is less accessible than provider-written content, although neither meets the recommended level. Our analysis indicates that specific artificial intelligence prompts can simplify educational materials to meet national standards and accommodate individual literacy.

Analysis of patient education materials on TikTok for erectile dysfunction treatment.

Erectile dysfunction (ED) is widely prevalent and has diverse management options which are poorly understood and accessed by patients. This cross-sectional TikTok study aimed to evaluate the quality of ED educational materials and define trends in healthcare provider content development. Three reviewers independently analyzed 50 videos. Variables of interest included author characteristics, viewer engagement, content accuracy, and video quality, understandability, and actionability. Quantitative analysis was performed using the validated PEMAT and DISCERN screening tools. A wide range of treatment options were presented among the 26 healthcare and 24 non-healthcare videos, including behavioral techniques, herbs/ supplements, dietary modifications, pharmacology, and interventions. Healthcare authors tended to focus on pharmacology and intervention, and when they did discuss behavioral, herbal, or dietary options, accuracy significantly exceeded non-healthcare authors (96.2% vs. 12.5%, p < 0.001). Although healthcare-authored videos were superior in accuracy and understandability scores (p < 0.001), they had low actionability and reduced user engagement including likes (1195 vs. 4723, p = 0.050) and bookmarks (114 vs. 839, p = 0.010). Our findings indicate that despite the availability of high-quality ED treatment resources created by healthcare professionals on TikTok, engagement and actionability remain alarmingly low. Furthermore, there is substantial, readily accessible misinformation produced by non-healthcare entities. Modernized medical education paradigms, communications research, and awareness may optimize social media as a public health tool.

Exact analytic solution for a chaotic hybrid dynamical system and its electronic realization.

A novel hybrid dynamical system comprising a continuous and a discrete state is introduced and shown to exhibit chaotic dynamics. The system includes an unstable first-order filter subject to asynchronous switching of a set point according to a feedback rule. Regular samples of the continuous state yield a one-dimensional return map that is a tent function. An exact analytic solution is derived using a nonlinear transformation of a previously solved chaotic oscillator. Conjugacy to a symbolic dynamics is shown, and a practical realization of the system in an electronic circuit is demonstrated.

Generating and Detecting Solvable Chaos at Radio Frequencies with Consideration to Multi-User Ranging.

High entropy waveforms exhibit desirable correlation properties in radar and sonar applications when multiple systems are used in close proximity. Unfortunately, the information content of these signals can impose high sampling requirements for digital detection techniques. Solvable chaotic oscillators have been proposed to address such issues due to their simple, matched filters, where hardware has been demonstrated with a bandwidth of 10-20 kHz. To extend applications of these systems, we present theory, design, and experimental verification of solvable chaos at 1 MHz using simple off-the-shelf components. The waveforms produced by this system were propagated over a 2.45 GHz RF link and detected with an RLC-based, purely analog matched filter. Further, we show that properties of this special class of chaotic systems can be exploited to yield RF noise sources that are generally advantageous for multi-user ranging applications when compared to conventional techniques. The result is a simple, low-cost, and potentially low-power RF ranging system that requires very little digital signal processing.

Rationale for Haze Formation after Carboxymethyl Cellulose (CMC) Addition to Red Wine.

The aim of this study was to identify the source of haze formation in red wine after the addition of carboxymethyl cellulose (CMC) and to characterize the dynamics of precipitation. Ninety commercial wines representing eight grape varieties were collected, tested with two commercial CMC products, and analyzed for susceptibility to haze formation. Seventy-four of these wines showed a precipitation within 14 days independent of the CMC product used. The precipitates of four representative samples were further analyzed for elemental composition (CHNS analysis) and solubility under different conditions to determine the nature of the solids. All of the precipitates were composed of approximately 50% proteins and 50% CMC and polyphenols. It was determined that the interactions between CMC and bovine serum albumin are pH dependent in wine-like model solution. Furthermore, it was found that the color loss associated with CMC additions required the presence of proteins and cannot be observed with CMC and anthocyanins alone.

The Challenge of Erectile Dysfunction Management in the Young Man.

Erectile dysfunction (ED) in a young man is an important health problem that significantly impacts the patient's quality of life and can have a detrimental effect on his well-being and relationship with his partner. Erectile dysfunction or impotence is one of the few disorders that will bring a young man into the doctor's office. This review article focuses on the epidemiology, etiology, presentation, work-up, and treatment of young men (age ~20-40 years old) presenting with complaints of ED. It is important to identify the precise etiology of the ED before proceeding with further evaluation and treatment because the work-up can be invasive and costly. ED is estimated to affect 20 % of men above 40 years of age, with the incidence increasing with increasing age. Erectile dysfunction has traditionally been seen as an age-dependent problem; however, approximately 2 % of men are affected at 40 years of age but this may be a gross underestimation secondary to reporting bias. Because ED is traditionally seen in the aging male population, studies regarding ED tend to be more frequently carried out among middle-aged and elderly men rather than in young men. These studies underline how comorbidities such as diabetes mellitus, cardiovascular or neurological pathologies, and medication use are strongly linked with ED. In addition, ED has been described to be associated with obesity or physical inactivity. This review article summarizes the important information that all sexual medicine providers should be familiar with when diagnosing, counseling, and treating young men with erectile dysfunction.

Structured scale dependence in the Lyapunov exponent of a Boolean chaotic map.

We report on structures in a scale-dependent Lyapunov exponent of an experimental chaotic map that arise due to discontinuities in the map. The chaos is realized in an autonomous Boolean network, which is constructed using asynchronous logic gates to form a map operator that outputs an unclocked pulse-train of varying widths. The map operator executes pulse-width stretching and folding and the operator's output is fed back to its input to continuously iterate the map. Using a simple model, we show that the structured scale-dependence in the system's Lyapunov exponent is the result of the discrete logic elements in the map operator's stretching function.

Development of penile hydrocele following placement of inflatable penile prosthesis: a rare entity.

INTRODUCTION: The development of a penile hydrocele following the placement of an inflatable penile prosthesis (IPP) for erectile dysfunction has never been documented. We herein report an unusual complication of penile hydrocele formation that developed following placement of an IPP for erectile dysfunction. METHODS: The penile hydrocele was successfully repaired by excision of the hydrocele sac. RESULTS: Successful surgical repair of a penile hydrocele was accomplished following placement of an IPP without removal of any implant components. The penile implant was functional at the end of the procedure as well as at all scheduled follow-up appointments. CONCLUSIONS: With advances in both surgical techniques and improved devise technology, high volume penile implanters encounter fewer IPP-related complications such as infectious or mechanical complications. We herein report for the first time a rare complication of penile hydrocele development after IPP placement that was treated successfully with surgical excision of the hydrocele sac. Urologists who perform these types of procedures should be aware of this unusual complication and know that it is curable with prompt diagnosis and meticulous surgical repair.

Multidimensional subwavelength position sensing using a semiconductor laser with optical feedback.

We demonstrate experimentally how to harness quasi-periodic dynamics in a semiconductor laser with dual optical feedback for measuring subwavelength changes in each arm of the cavity simultaneously. We exploit the multifrequency spectrum of quasi-periodic dynamics and show that independent frequency shifts are mapped uniquely to two-dimensional displacements of the arms in the external cavity. Considering a laser diode operating at telecommunication wavelength λ≈1550 nm, we achieve an average nanoscale resolution of approximately 9.8 nm (~λ/160).

A pseudo-matched filter for chaos.

A matched filter maximizes the signal-to-noise ratio of a signal. In the recent work of Corron et al. [Chaos 20, 023123 (2010)], a matched filter is derived for the chaotic waveforms produced by a piecewise-linear system. This system produces a readily available binary symbolic dynamics that can be used to perform correlations in the presence of large amounts of noise using the matched filter. Motivated by these results, we describe a pseudo-matched filter, which operates similarly to the original matched filter. It consists of a notch filter followed by a first-order, low-pass filter. We compare quantitatively the matched filter's performance to that of our pseudo-matched filter using correlation functions. On average, the pseudo-matched filter performs with a correlation signal-to-noise ratio that is 2.0 dB below that of the matched filter. Our pseudo-matched filter, though somewhat inferior in comparison to the matched filter, is easily realizable at high speed (>1 GHz) for potential radar applications.

Single-surgeon experience of 87 buccal mucosal graft harvests.

UNLABELLED: Although buccal mucosa has been the preferred graft material for use in the reconstruction of anterior urethral strictures for approximately 20 years, the plastic surgery literature is lacking in studies describing and evaluating this technique. The authors sought to report their experience with the technique of buccal mucosa graft harvest for use in urethral reconstruction. The authors identified 87 consecutive patients who underwent buccal mucosal graft harvesting during a 15-year period from 1995 to 2010. All donor sites were closed primarily. Preoperatively, a specialty-specific evaluation was performed by plastic surgeons and urologists. Postoperative donor-site morbidity was followed clinically. Eighty-seven patients underwent buccal harvesting. A single buccal graft was harvested in 75 patients (86.2 percent) and bilateral grafts were harvested in 12 patients (13.8 percent). The median patient age of the patients was 42 years (range, 16 to 78 years). There were no major intraoperative or postoperative complications. Minor complications included mild discomfort, numbness, cheek swelling, and restriction of oral movement, all of which resolved by the 3-month postoperative visit. The ability to eat and drink postoperatively was diminished during only the first 24 to 48 hours in all patients. Our series provides a 1-year follow-up in a substantial cohort looking at clinical outcomes after buccal harvesting. These results confirm the safety and efficacy of buccal mucosal harvesting to provide an effective and cosmetically superior option for urethral reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Impact of diurnal temperature variation on grape berry development, proanthocyanidin accumulation, and the expression of flavonoid pathway genes.

Little is known about the impact of temperature on proanthocyanidin (PA) accumulation in grape skins, despite its significance in berry composition and wine quality. Field-grown grapes (cv. Merlot) were cooled during the day or heated at night by +/-8 °C, from fruit set to véraison in three seasons, to determine the effect of temperature on PA accumulation. Total PA content per berry varied only in one year, when PA content was highest in heated berries (1.46 mg berry(-1)) and lowest in cooled berries (0.97 mg berry(-1)). In two years, cooling berries resulted in a significant increase in the proportion of (-)-epigallocatechin as an extension subunit. In the third year, rates of berry development, PA accumulation, and the expression levels of several genes involved in flavonoid biosynthesis were assessed. Heating and cooling berries altered the initial rates of PA accumulation, which was correlated strongly with the expression of core genes in the flavonoid pathway. Both heating and cooling altered the rate of berry growth and coloration, and the expression of several structural genes within the flavonoid pathway.

Ultra-high-frequency piecewise-linear chaos using delayed feedback loops.

We report on an ultra-high-frequency (>1 GHz), piecewise-linear chaotic system designed from low-cost, commercially available electronic components. The system is composed of two electronic time-delayed feedback loops: A primary analog loop with a variable gain that produces multi-mode oscillations centered around 2 GHz and a secondary loop that switches the variable gain between two different values by means of a digital-like signal. We demonstrate experimentally and numerically that such an approach allows for the simultaneous generation of analog and digital chaos, where the digital chaos can be used to partition the system's attractor, forming the foundation for a symbolic dynamics with potential applications in noise-resilient communications and radar.

Subwavelength position sensing using nonlinear feedback and wave chaos.

We demonstrate a position-sensing technique that relies on the inherent sensitivity of chaos, where we illuminate a subwavelength object with a complex structured radio-frequency field generated using wave chaos and nonlinear feedback. We operate the system in a quasiperiodic state and analyze changes in the frequency content of the scalar voltage signal in the feedback loop. This allows us to extract the object's position with a one-dimensional resolution of ~λ/10,000 and a two-dimensional resolution of ~λ/300, where λ is the shortest wavelength of the illuminating source.

Plant metabolism and the environment: implications for managing phenolics.

The presence of phenolic compounds in food has garnered much attention over the years. The diversity of these compounds and their contribution to nutritive and sensory qualities has been investigated in depth to elucidate benefits and modes of action. This review is intended to provide information on the impact of growing conditions on the accumulation of phenolics in plants. The aim is to provide knowledge of factors that influence phenolic biosynthesis in plants to help us manage them prior to harvest. Through improving our understanding of plant responses to the environment we may be able to manipulate growing parameters to suit the needs of the consumer. In this review, research regarding plant responses to climate, farming practices, biotic, and abiotic stresses is presented.

Assessing the impact of temperature on grape phenolic metabolism.

This study assessed the impact of fruit temperature on the phenolic metabolism of grape berries (Vitis vinifera L. cv. Merlot) grown under field conditions with controlled exposure to sunlight. Individual cluster temperatures were manipulated in situ. Diurnal temperature fluctuation was damped by daytime cooling and nighttime heating of clusters. Daytime-only and nighttime-only temperature controls were applied for comparison. Berry temperatures were recorded continuously to compare the chemical data. Samples collected at véraison indicated that damping the diurnal temperature fluctuation advanced the onset of ripening. Those berries were larger (double-damped: 0.753+/-0.015gberry(-1) vs control: 0.512+/-0.034gberry(-1)) and more colored than all others. Development of phenolic metabolites was followed by two reversed-phase high performance liquid chromatography methods and gel permeation chromatography. These methods provided information on anthocyanins, proanthocyanidins, flavonols, flavan-3-ol monomers, and polymeric material. Damping the diurnal temperature fluctuation reduced proanthocyanidin mean degree of polymerization (double-damped: 21.8+/-1.0 vs control: 28.0+/-1.7). Proanthocyanidin accumulation at véraison was linearly related to heat summation over the developmental period with nighttime heating yielding the highest concentration and daytime cooling yielding the lowest (night-heat: 1.46+/-0.13mgberry(-1) vs day-cool: 0.97+/-0.09mgberry(-1)). Damping the diurnal temperature fluctuation had a marked effect on the rate of fruit development whereas total heat summation had more of an effect on phenolic metabolism alone. The results provide insight on the direct effect of temperature on phenolic metabolism.

Effect of postharvest dehydration on the composition of pinot noir grapes (Vitis vinifera L.) and wine.

This study was conducted in order to improve our understanding of how phenolics and aroma compounds change in wine grapes during postharvest dehydration. Pinot noir grapes grown in the Willamette Valley of Oregon were harvested at 22.0 and 24.0°Brix. Grapes harvested at 22.0°Brix were divided into three equal lots with one lot immediately used for wine production, and the remaining two lots placed inside an air tunnel with an air speed of 1.0-1.8ms(-1), 38% relative humidity and a temperature of 22°C. The soluble solids content and weight loss were measured daily and wines were made from grapes when they reached 24.8 and 26.7°Brix. The soluble solids of grapes increased about 1°Brix per day; therefore, on the third and fourth day the berries reached the desired concentration; weight loss was 14 and 16%, respectively. Results from berry phenolic analysis indicated that per berry anthocyanin amount remained unchanged during dehydration. The composition of proanthocyanidins isolated from berries changed during dehydration. Volatile compounds in wines made from dehydrated grapes contained more terpenes and norisoprenoids (ß-ionone, ß-damascenone) when compared to wine made from the original fruit. Wines made from increasingly dehydrated grapes tended to resemble the composition and flavour profile of wines made from grapes left on the vine (i.e. with extended ripening). The results of this study suggest that postharvest flavour changes consistent with changes during fruit ripening can occur in grapes when harvested early and allowed to dehydrate under controlled conditions prior to fermentation.