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SA's second - and world's third - penis transplant recipient is one 'happy patient'

This is the third ever penis transplant conducted with the second one conducted in Boston at the Massachusetts General Hospital.

The recipient‚ a 40 year old man‚ has been without a penis for 17 years after a botched traditional circumcision. His name is being kept anonymous for ethical reasons.

“He is certainly one of the happiest patients we have seen in our ward. He is doing remarkably well. There are no signs of rejection and all the reconnected structures seem to be healing well‚” said Professor Andre Van der Merwe‚ Head of the Division of Urology at Stellenbosch University s Faculty of Medicine and Health Sciences.

The patient is expected to regain full use of his penis within six months of the transplant‚ said the release.

Medical tattooing will be used to correct the colour discrepancy between the recipient and the donor organ in six to eight months after the operation.

“Patients describe a penis transplant as ‘receiving a new life’. For these men the penis defines manhood and the loss of this organ causes tremendous emotional and psychological distress‚” said Dr Amir Zarrabi of the FMHS’s Division of Urology‚ who was a member of the transplant team. “I usually see cases of partial or total amputations in July and December – the period when traditional circumcisions are performed.”

The team consisted of Van der Merwe‚ Dr Alexander Zühlke‚ who heads the FMHS’ Division of Plastic and Reconstructive Surgery‚ Prof Rafique Moosa‚ head of the FMHS’ Department of Medicine‚ Zarrabi and Dr Zamira Keyser of Tygerberg Hospital. They were assisted by transplant coordinators‚ anaesthetists‚ theatre nurses‚ a psychologist‚ an ethicist and other support staff.

The first ever penis transplant patient from December 2014 is using his penis as normal.

“The patient is doing extremely well‚ both physically and mentally”‚ says Van der Merwe. “He is living a normal life. His urinary and sexual functions have returned to normal‚ and he has virtually forgotten that he had a transplant."

The transplant procedure is very complicated as nerves‚ blood‚ vessels and muscle from the donor organ have to be connected to the recipient.

“The diverse presentation of the blood vessels and nerves makes the operation very challenging and means each case is unique. All these structures need to be treated with the utmost delicacy and respect in order to be connected perfectly to ensure good circulation and function in the long term‚” said Zühlke.

Micro-surgery was used to connect small blood vessels and nerves.

It is thought that up 250 partial or complete penile amputations take place a year in South Africa due to botched traditional circumcisions. “At Stellenbosch University and Tygerberg Hospital we are committed to finding cost-effective solutions to help these men‚” says Van der Merwe. The procedure was part of a proof of concept study to develop a cost-effective penile transplant procedure that could be performed in a typical theatre setting in a South African public sector hospital‚ he said.

The costs of the second procedure was much less than the first.

The biggest challenge to rolling out this procedure is the shortage of organs. “I think the lack of penis transplants across the world since we performed the first one in 2014‚ is mostly due to a lack of donors. It might be easier to donate organs that you cannot see‚ like a kidney‚ than something like a hand or a penis‚” said Van der Merwe.

“We are extremely grateful to the donor’s family who so generously donated not only the penis‚ but also the kidneys‚ skin and corneas of their beloved son. Through this donation they are changing the lives of many patients.

The patient had counselling over two years to explain and ensure he understood the operation is not a tried and tested treatment‚ but is still an experimental procedure with many risks.

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"Verschärfte Vernehmung"

The phrase "Verschärfte Vernehmung" is German for "enhanced interrogation". Other translations include "intensified interrogation" or "sharpened interrogation". It's a phrase that appears to have been concocted in 1937, to describe a form of torture that would leave no marks, and hence save the embarrassment pre-war Nazi officials were experiencing as their wounded torture victims ended up in court. The methods, as you can see above, are indistinguishable from those described as "enhanced interrogation techniques" by the president. As you can see from the Gestapo memo, moreover, the Nazis were adamant that their "enhanced interrogation techniques" would be carefully restricted and controlled, monitored by an elite professional staff, of the kind recommended by Charles Krauthammer, and strictly reserved for certain categories of prisoner. At least, that was the original plan.

Also: the use of hypothermia, authorized by Bush and Rumsfeld, was initially forbidden. 'Waterboarding" was forbidden too, unlike that authorized by Bush. As time went on, historians have found that all the bureaucratic restrictions were eventually broken or abridged. Once you start torturing, it has a life of its own. The "cold bath" technique - the same as that used by Bush against al-Qahtani in Guantanamo - was, according to professor Darius Rejali of Reed College,

pioneered by a member of the French Gestapo by the pseudonym Masuy about 1943. The Belgian resistance referred to it as the Paris method, and the Gestapo authorized its extension from France to at least two places late in the war, Norway and Czechoslovakia. That is where people report experiencing it.

In Norway, we actually have a 1948 court case that weighs whether "enhanced interrogation" using the methods approved by president Bush amounted to torture. The proceedings are fascinating, with specific reference to the hypothermia used in Gitmo, and throughout interrogation centers across the field of conflict. The Nazi defense of the techniques is almost verbatim that of the Bush administration...

Here's a document from Norway's 1948 war-crimes trials detailing the prosecution of Nazis convicted of "enhanced interrogation techniques" in the Second World War. Money quote from the cases of three Germans convicted of war crimes for "enhanced interrogation":

Between 1942 and 1945, Bruns used the method of "verschärfte Vernehmung" on 11 Norwegian citizens. This method involved the use of various implements of torture, cold baths and blows and kicks in the face and all over the body. Most of the prisoners suffered for a considerable time from the injuries received during those interrogations.

Between 1942 and 1945, Schubert gave 14 Norwegian prisoners "verschärfte Vernehmung," using various instruments of torture and hitting them in the face and over the body. Many of the prisoners suffered for a considerable time from the effects of injuries they received.

On 1st February, 1945, Clemens shot a second Norwegian prisoner from a distance of 1.5 metres while he was trying to escape. Between 1943 and 1945, Clemens employed the method of " verschäfte Vernehmung " on 23 Norwegian prisoners. He used various instruments of torture and cold baths. Some of the prisoners continued for a considerable time to suffer from injuries received at his hands.

Freezing prisoners to near-death, repeated beatings, long forced-standing, waterboarding, cold showers in air-conditioned rooms, stress positions [Arrest mit Verschaerfung], withholding of medicine and leaving wounded or sick prisoners alone in cells for days on end - all these have occurred at US detention camps under the command of president George W. Bush. Over a hundred documented deaths have occurred in these interrogation sessions. The Pentagon itself has conceded homocide by torture in multiple cases. Notice the classic, universal and simple criterion used to define torture in 1948 (my italics):

In deciding the degree of punishment, the Court found it decisive that the defendants had inflicted serious physical and mental suffering on their victims, and did not find sufficient reason for a mitigation of the punishment in accordance with the provisions laid down in Art. 5 of the Provisional Decree of 4th May, 1945. The Court came to the conclusion that such acts, even though they were committed with the connivance of superiors in rank or even on their orders, must be regarded and punished as serious war crimes.

The victims, by the way, were not in uniform. And the Nazis tried to argue, just as John Yoo did, that this made torturing them legit. The victims were paramilitary Norwegians, operating as an insurgency, against an occupying force. And the torturers had also interrogated some prisoners humanely. But the argument, deployed by Dick Cheney, Donald Rumsfeld, and the Nazis before them, didn't wash with the court. Money quote:

As extenuating circumstances, Bruns had pleaded various incidents in which he had helped Norwegians, Schubert had pleaded difficulties at home, and Clemens had pointed to several hundred interrogations during which he had treated prisoners humanely.

The Court did not regard any of the above-mentioned circumstances as a sufficient reason for mitigating the punishment and found it necessary to act with the utmost severity. Each of the defendants was responsible for a series of incidents of torture, every one of which could, according to Art. 3 (a), (c) and (d) of the Provisional Decree of 4th May, 1945, be punished by the death sentence.

So using "enhanced interrogation techniques" against insurgent prisoners out of uniform was punishable by death. Here's the Nazi defense argument:

(c) That the acts of torture in no case resulted in death. Most of the injuries inflicted were slight and did not result in permanent disablement.

This is the Yoo position. It's what Glenn Reynolds calls the "sensible" position on torture. It was the camp slogan at Camp Nama in Iraq: "No Blood, No Foul." Now take the issue of "stress positions", photographed at Abu Ghraib and used at Bagram to murder an innocent detainee. Here's a good description of how stress positions operate:

The hands were tied together closely with a cord on the back of the prisoner, raised then the body and hung the cord to a hook, which was attached into two meters height in a tree, so that the feet in air hung. The whole body weight rested thus at the joints bent to the rear. The minimum period of hanging up was a half hour. To remain there three hours hung up, was pretty often. This punishment was carried out at least twice weekly.

This is how one detainee at Abu Ghraib died (combined with beating) as in the photograph above. The experience of enduring these stress positions has been described by Rush Limbaugh as no worse than frat-house hazings. Those who have gone through them disagree. They describe:

Dreadful pain in the shoulders and wrists were the results of this treatment. Only laboriously the lung could be supplied with the necessary oxygen. The heart worked in a racing speed. From all pores the sweat penetrated.

Yes, this is an account of someone who went through the "enhanced interrogation techniques" at Dachau. (Google translation here.)

Critics will no doubt say I am accusing the Bush administration of being Hitler. I'm not. There is no comparison between the political system in Germany in 1937 and the U.S. in 2007. What I am reporting is a simple empirical fact: the interrogation methods approved and defended by this president are not new. Many have been used in the past. The very phrase used by the president to describe torture-that-isn't-somehow-torture - "enhanced interrogation techniques" - is a term originally coined by the Nazis. The techniques are indistinguishable. The methods were clearly understood in 1948 as war-crimes. The punishment for them was death.

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Men risk their lives in wars so women can enjoy societies where they can pursue feminist goals, such as punishing men for sexist language.

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Pro-rape' US pick-up artist posts personal details and pictures of female journalists online in revenge for negative coverage

Mail Online

A controversial 'pro-rape pick-up artist' is posting the personal details of journalists who have criticised him online.

Daryush Valizadeh - also known as Roosh V - is infamous for arguing that raping women should be legal on private property.

Labelled 'Operation Bullhorn', Roosh has asked his online supporters to 'adopt' a journalist and post their details on his forum. They have been instructed to gather photos, Facebook profiles and have even been told to save addresses for possible future use.

One forum user said the backlash was 'because women are scared that they won't be able to get a free lunch anymore by virtue of having a vagina.'

The backlash follows criticism of international meetups which included eight UK cities, including Manchester, London, Leeds, and Glasgow.

The meet-ups, set to take place today, were cancelled after Roosh claimed he feared for the safety of his supporters.

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Awake during surgery: 'I'm in hell'

CNN

May 17, 2010

(CNN) -- When Carol Weiher was having her right eye surgically removed in 1998, she woke up hearing disco music. The next thing she heard was "Cut deeper, pull harder."

She desperately wanted to scream or even move a finger to signal to doctors that she was awake, but the muscle relaxant she'd received prevented her from controlling her movements.

"I was doing a combination of praying and pleading and cursing and screaming, and trying anything I could do but I knew that there was nothing that was working," said Weiher, of Reston, Virginia. Weiher is one of few people who have experienced anesthesia awareness. Although normally a patient does not remember anything about surgery that involves general anesthesia, about one or two people in every 1,000 may wake up during general anesthesia, according to the Mayo Clinic. Most of these cases involve the person being aware of the surrounding environment, but some experience severe pain and go on to have psychological problems.

The surgical tools didn't cause Weiher pain -- only pressure -- but the injections of a paralytic drug during the operation "felt like ignited fuel," she said. "I thought, well, maybe I've been wrong about my life, and I'm in hell," she said. The entire surgery lasted five-and-a-half hours. Sometime during it she either passed out or fell unconscious under the anesthetic. When she awoke, she began to scream.

"All I could say to anyone was, 'I was awake! I was awake!' " she said.

The use of general anesthesia is normally safe and produces a state of sedation that doesn't break in the middle of a procedure, doctors say. The patient and anesthesiologist collect as much medical history as possible beforehand, including alcohol and drug habits, to help determine the most appropriate anesthetic.

You may think of it as "going to sleep," but in terms of what your body is doing, general anesthesia has very little in common with taking a nap.

During sleep, the brain is in its most active state; anesthesia, on the other hand, depresses central nervous system activity. On the operating table, your brain is less active and consumes less oxygen -- a state of unconsciousness nothing like normal sleep.

Doctors do not know exactly how general anesthesia produces this effect. It is clear that anesthetic drugs interfere with the transmission of chemicals in the brain across the membranes, or walls, of cells. But the mechanism is the subject of ongoing research, Dr. Alexander Hannenberg, anesthesiologist in Newton, Massachusetts, and president of the American Society of Anesthesiologists.

Patients who remember falling unconscious under the anesthesia generally have a pleasant experience of it, Hannenberg said, and the period of "waking up" is also a relaxed state, Hannenberg said. Anesthesia awareness may relate to human error or equipment failure in delivering the anesthetic, Hannenberg said.

There are patients for whom doctors err on the side of a lower dose because of the nature of their condition, Hannenberg said. Someone who is severely injured and has lost a lot of blood, a patient with compromised cardiac function, or a woman who needs an emergency Caesarean section would all be at risk for serious side effects of high doses of anesthetic.

Heart or lung problems, daily alcohol consumption, and long-term use of opiates and other drugs may put patients at higher risk for anesthesia awareness, according to the Mayo Clinic.

Weiher started a campaign called the Anesthesia Awareness Campaign that seeks to educate people about the perils of waking up during surgery. She has spoken with about 4,000 people worldwide who have also had anesthesia awareness experiences.

The American Society of Anesthesiologists is engaged in an Anesthesia Awareness Registry, a research project through the University of Washington to examine cases of the phenomenon. One of the goals of the Anesthesia Awareness Campaign is to make brain activity monitoring a standard of care.

There has been controversy about the use of brain function monitors in general anesthesia. Advocates such as Dr. Barry Friedberg, anesthesiologist and founder of the nonprofit Goldilocks Anesthesia Foundation, say brain monitoring is essential for ensuring the patient achieves the appropriate sedation so as to not wake up. The monitors use a scale of 0 to 100 to reflect what's going on in the brain: 0 is a total absence of brain activity, 98 to 100 is wide awake, and 45 to 60 is about where general anesthesia puts the patient, Friedberg said.

But a 2008 study in the New England Journal of Medicine found no benefit in using brain function monitoring to prevent anesthesia awareness. The American Society of Anesthesiology has said the monitoring is not routinely indicated for general anesthesia, but may have some value and be appropriate for specific patients. The downsides are that they are expensive, and should not be used in place of heart rate and breathing signals when regulating the anesthesia.

Research does not consistently demonstrate a benefit from using brain function monitors, and the decision to use them should be made on an individual basis, Hannenberg said.

The anesthesiologist carefully monitors the patient's breathing and blood pressure, which can rise and fall, while the person is under the anesthetic, Hannenberg said. The treatment is tailored to the patient -- a young, healthy athlete will tolerate fluctuations in blood pressure better than someone with a serious condition, Hannenberg said.

As with surgical procedures themselves, anesthesia can result in stroke, heart attack and death. Such complications are more likely in people who have serious medical problems, and elderly people. Over the last two decades, anesthesiologists have made significant strides in reducing those risks, Hannenberg said.

A 6-year-old boy in Richmond, Virginia, recently died after going into cardiac arrest during a routine dental procedure that involved general anesthesia, CNN affiliate WTVR reported. Weiher had to have subsequent surgeries, including an operation on her other eye and a hysterectomy, and the experiences were terrifying. She is still taking medication for post-traumatic stress disorder as a result of her anesthesia awareness experience.

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Company Releases 'Child Love Dolls' to Stop Pedophiles Rumor: A company has released 'child love dolls' to provide a safe sexual outlet for pedophiles.

Snopes

Could you look into the validity of a supposed new company that will be marketing “love dolls” for pedophiles?

ORIGINS: On 13 April 2015, the entertainment web site Celebtricity published a hoax article reporting that a former sexual molestation victim had started a company to produce lifelike male and female “child love dolls” that pedophiles could have sexual relations with in place of molesting real children:

Buck Dobson knows what it is like to suffer at the hands of pedophile. He was repeatedly molested at age 10 by his 19-year-old-sister and says the scars have never healed. However, the abuse inspired Dobson to spend most of his adult life working to cure pedophilia. For years, Dobson tried to rehabilitate pedophiles within the Colorado prison system and through Christian outreach programs, but Dobson said his efforts failed.

“Look, you can’t change a pedophile’s sexual-orientation, and that’s what it is, an orientation, any more than you can a homo or heterosexual’s,# Dobson told Christian Family Daily. #You can try to get a pedophile to refrain from touching kids — and that sometimes works — but these people desire children and that desire is deep inside their genes. So why try to fix something unfixable?”

Instead, Dobson is starting a company that will create and market life-like male and female child and baby love dolls that pedophiles can molest and have sexual relations with.

“#These dolls will feel and smell just like real children and have all the naughty parts,”# Dobson said. “#Pedophiles are gonna love them.”

Unlike many “satire” sites operating on the Internet, Celebtricity occasionally posts real news stories in addition to its fake news pieces in an effort to confuse readers. That strategy seems to have worked, as many readers have shared this “news” about “love dolls” for pedophiles as if it were a factual account. Nonetheless, Celebtricity‘s disclaimer reveals the nature of that site:

Celebtricity.com is a combination of real shocking news and satirical entertainment to keep its visitors in a state of disbelief.

In January 2016, life appeared to imitate fake news, as stories emerged that a company is, indeed, producing dolls similar to the ones previously described. Shin Takagi owns Trottla, a company that produces anatomically-correct child sex dolls that he says are manufactured in order to help pedophiles control their urges. “I am helping people express their desires, legally and ethically,” Takagi told The Atlantic.

“We should accept that there is no way to change someone’s fetishes…. It’s not worth living if you have to live with repressed desire.”

However, the Celebtricity entry clearly falls into the category of “satire” rather than “real shocking news”: In addition to the fact that the article is missing key information (such as the name of the company putatively planning to release these “love dolls”), the image accompanying the article was swiped from the web site of French artist Lauren Curet, who creates detailed miniature child dolls from polymer clay as artworks rather than as sexual playmates for pedophiles.

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It is the secret dream of every Swedish or German woman to marry a black men, or at least have sex with a black man. Every smart young African man should migrate to Europe. Free money, nice house, good sex!

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How surgery restores pleasure for female cut victims

Whenever other women talked about their sexual escapades, Naomi* always wondered what an orgasm felt like. The possibility of getting one was robbed from her when she was put through female genital mutilation (FGM) at age 14.

Now at the entrance of the Karen Hospital in Nairobi, she stands at the door of opportunity that may restore what was violently taken away from her. Clitoraid, a non-profit organisation based in the US, has pitched tent at the hospital to offer clitoris restorative surgeries for free.

The Kenya Demographic Health Survey of 2014 shows that 21 per cent of women aged 15 to 49 have undergone FGM.

Nine per cent underwent the most severe form where the genital area is sewn shut after being cut off. To restore the clitoris which is normally 11 centimetres long, with only five per cent cut off even in the worst case of FGM, the remaining part of the clitoris which is buried in the body is brought to the surface.

The restoration of sexual pleasure is possible because the entire clitoris is sensory, not just the amputated portion. “Sensation is lost because the amputated portion retracts and gets covered by scar tissue. The clitoris is shortened but not removed. The restoration surgery exposes the clitoral stump.

Then, with plastic surgery, we are able to bring the exposed portion to the surface and even create new labia minora using the surrounding skin. The newly exposed portion is then able function,” said Dr Marci Bowers, Clitoraid’s gynaecological surgeon, who has operated on the women with the help of Kenyan plastic surgeon Dr Abdullahi Adan.

“Women orgasm for the first time in their lives after this,” she added. By Wednesday last week, more than 20 women had been operated on at Mama Lucy Hospital in Nairobi, and more women queued silently at the Karen Hospital waiting for surgery.

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An ornithologist argues for the evolution of beauty for beauty’s sake

Imagine a world created by the quest for beauty, filled with colorful dancing and governed by the principle of autonomous sexual freedom. To access this world, according to Richard Prum, you need only take a stroll outside and watch the avian rites of spring. The Evolution of Beauty represents the culmination of decades of Prum’s careful research on birds—he is the William Robertson Coe Professor of Ornithology at Yale University—including the evolution of feathers, courtship patterns, and social behavior.

Prum argues that evolutionary biologists, especially those who spend their time with mammals, have fundamentally underestimated the importance of female choice as a cause of beauty in the natural world. Throughout the book, he interweaves biological details with accounts of watching birds as a young man, field experiences, and even conversations with friends. The result reads like a memoir, argues like a manifesto, and shines with his passion for all things ornithological.

For decades, biologists have largely agreed that Darwin’s theory of mate choice works because females prefer to pair with colorful, athletic partners. Beauty, they maintained, acts as a proxy measure of evolutionary fitness; the more colorful the male’s plumage, the more resources are available on his territory, or perhaps he carries fewer parasites on his body. In other words, physiologically expensive courtship displays provide “honest” signals of a male’s quality. That they are also beautiful is beside the point.

Prum disagrees with this line of reasoning. He wants to return sexual selection theory to its roots. Prum follows Darwin’s explication in The Descent of Man (1), arguing that the spectacular courtship displays of birds such as manakins and bowerbirds cannot be explained by natural selection but rather evolved for the sake of their beauty alone—that is, beauty as perceived by the desires of females in the species.

Prum sees mate choice, and the beauty it has created, as an important—even central—mechanism of evolutionary change at almost every stage of bird evolution. For example, he suggests that the planar structure of bird feathers may have evolved to display patterned colors and was secondarily co-opted for flight. Early feathers in the evolutionary record were downy, like those of young chicks, he notes. Although they likely came in many shades, the patterned colors found in modern birds are made possible by the two-dimensional flatness of their feathers, a feature that later facilitated flight. Because the only dinosaurs to survive the Cretaceous-Tertiary extinction event were those that could fly, from Prum’s perspective, this aesthetic innovation ultimately enabled their survival.

He argues, too, that female mating preferences for increased sexual autonomy were likely behind the loss of penises early in bird diversification and contributed to the origins of lekking behavior, in which a group of males compete for the attention of prospective partners. (Ducks, notoriously brutish and baroquely endowed, serve to prove his point and provide surprisingly successful fodder for dinner party repartee.)

Prum devotes the final third of the book to the evolution of sexuality in humans. Although it would be tempting to attend to differences between men and women, Prum argues that to understand our own nature, we would be better served by comparing ourselves with our ancestors and simian relatives. From this angle, human males are far less sexually aggressive than we should expect.

In comparison with male chimpanzees, human men have relatively smaller testicles, longer sex, dramatically reduced canine teeth, decreased rates of infanticide, and higher rates of homosexual interactions. These physiological and behavioral changes, Prum contends, might result from selection for female sexual autonomy and pleasure similar to that seen in birds. He hopes that other biologists will incorporate sexual selection for beauty into their own research programs on the mating (or more accurately, remating) preferences of humans.

In broad prospect, Prum’s The Evolution of Beauty argues that the aesthetic agency of individual animals lies at the heart of evolution and, over time, has created strong selection for female pleasure and desire. This represents a substantial shift from the economic metaphors of evolutionary theory that have dominated decades of evolutionary thought, in which female choice represented a mechanism devoid of desire, cold rationality without aesthetics or, indeed, true choice.

Most of all, Prum aims to reinsert idiosyncratic desires into scientific understandings of the evolution of beauty. This is not just an intellectual reformulation of biological theories of mate choice; he believes it could allow evolutionary theory to break, finally, with eugenically derived conceptions of “fitness.”

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