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The use of various SSRIs, clomipramine, and topical anesthetics, along with the development of new ondemand drugs for the treatment of PE, has drawn new attention to this age-old and benignly ignored problem Drug combinations or single agents that target multiple 5-HT receptors may represent the next stage of PE drug development The resulting spate of recent research is providing greater understanding of the problem, and equally important, the negative psychosocial effects of this dysfunction However, until the neurobiologic, physiologic and psychologic mechanisms responsible for PE are better understood, treatment strategies for PE may fall short Because ejaculation depends upon the complex interplay of central and peripheral somatic and autonomic nervous systems, and various neurochemical regulatory pathways, a complete understanding of PE undoubtedly lies some distance down the road

When you introduce more than one eBGP-speaking router, you introduce the need to coordinate their activities This is done with iBGP connectivity The basic setup of iBGP is simple You need to declare neighbors inside your own AS (Figure 918) In small to medium ASs, all BGP speakers should be fully

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Due diligence prior to your purchase (something we discuss in 11) should provide a clear picture of the average annual expenses associated with the property This information, combined with a consultation with your accountant, should highlight areas where you may want to make changes Perhaps you ll decide to pass along some of the costs to your tenants, or a review of your expenses may flag areas where you re spending more money than necessary and need to economize

9

The challenge will be to nd ways to integrate drug treatment and behavioral psychotherapy into a multi-dimensional treatment plan Both drug treatment and psychotherapy are limited in that they represent symptomatic treatments for controlling and delaying ejaculation Furthermore, the irreversible nature of surgical procedures relegates them to lastresort strategies The goal of treatment should be to improve the level of sexual satisfaction of both sufferer and partner by offering a variety of tools and treatment options that afford greater self-ef cacy over their sexual response with their partner To this end, further investigation into the ways in which biomedical and psychologic strategies can combine to achieve optimal outcomes is greatly needed

meshed with iBGP Full meshing does not necessarily mean there is a physical link between them, but there must be a full mesh of BGP sessions among the BGP speakers iBGP full meshing, however, does not scale to large size, and only the smallest ISPs can run it As the iBGP topology becomes more complex, you are likely to need to reduce the number of sessions on any one router There are two basic techniques for doing so, both of which introduce hierarchy into iBGP These techniques, discussed in 10, are route reflection and confederations

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The interaction of BGP with general IGP routing is sufficiently complex that it is easiest to look first at the process of installing routes when there is only one BGP route to each destination Mechanisms for selecting among multiple BGP routes are discussed in 10 BGP does not replace IGPs BGP is primarily concerned with the reachability of destinations outside the AS, while IGPs deal with the reachability of internal destinations iBGP relies on IGPs to find the various BGP speakers in an AS An especially important aspect is the use of IGPs to discover the topology over which label-switched paths can be established in an intraprovider core (see 8) Once BGP is running, there will exist at least two routing tables in the router The BGP table shows the set of routes received via BGP that are accepted by the acceptance policy and whose next hops are reachable through the main routing table Some of the routes in the BGP table may indeed be the best to a particular destination, and may be installed as well in the main routing table (See Figure 919) In the BGP table, there may be multiple routes to the desti-