bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-related medication nonadherence in the Mekong Delta, Vietnam
Authors: De Tran Van , Nguyen Minh Cuong , Nguyen Thi Hai Yen , Tran Thi Thu , Dewey Rebecca Susan
Published: December 2024

Background

Cost-related nonadherence (CRN) to prescription medication has been shown to affect healthcare outcomes. While CRN has been reported in many countries globally, it has not been fully characterized in Vietnam.

Objectives

This study was conducted to determine CRN rates and factors associated with CRN among pharmacy customers in the Mekong Delta, Vietnam.

Methods

A cross-sectional research design used printed self-administered questionnaires in Vietnamese distributed to customers of private pharmacies and pharmacy chains in the Mekong Delta from January to March 2024.

Results

Of the 1546 respondents, 49.9% reported experiencing CRN, with the most commonly reported action being delaying filling a prescription (38.2%). Compared to participants aged ≥65 years, those aged 18–44 years were 2.5 times more likely to report CRN, with an adjusted odds ratio (aOR) of 2.51 (95% confidence interval [CI]: 1.55–4.06). Poorer self-reported health status was a strong predictor of CRN (aOR = 3.72; 95% CI: 2.32–5.95) compared to better self-reported health status. Having more prescriptions was a strong predictor of CRN (aOR = 2.25; 95% CI: 1.70–2.98) compared to having fewer prescriptions. The presence of chronic conditions was associated with being 2.5 times more likely to report CRN (aOR = 2.46; 95% CI: 1.71–3.55) compared to those without chronic conditions.

Conclusions

Nearly half of the participants experienced CRN. The findings of this study showed that implementing public health initiatives, such as routine care, in-person and telephone counseling, and educational programs by pharmacists, is necessary to reduce CRN among the population of the Mekong Delta. More studies are needed to help inform policymakers on how to reduce CRN and improve access to medications.
Non-tempered Ext Branching Laws for the p-adic General Linear Group
Authors: Qadri Mohammed Saad
Published: December 2024

Let $F$ be a non-Archimedean local field. Let $\pi _{1}$ and $\pi _{2}$ be irreducible Arthur-type representations of $\operatorname{GL}_{n}(F)$ and $\operatorname{GL}_{n-1}(F),$ respectively. We study Ext branching laws when $\pi _{1}$ and $\pi _{2}$ are products of discrete series representations and their Aubert–Zelevinsky duals. We obtain an Ext analogue of the local non-tempered Gan–Gross–Prasad conjecture in this case.
On the Burde–de Rham Theorem for Finitely Presented Pro-p Groups
Authors: Mizusawa Yasushi , Tange Ryoto , Terashima Yuji
Published: December 2024

We consider the Burde–de Rham theorem for finitely presented pro-$p$ groups under the assumption that the total degrees of all relators are $0$. We also give some concrete examples including higher-dimensional cases under Iwasawa theoretic conditions, and consider some cohomological interpretations.
Replicating the Resource Curse: A Qualitative Replication of Ross 2004
Authors: Becker Megan , Markowitz Jonathan , Orsborn Sarah , Nazha Isabelle , Dasaraju Srividya , Lauder Lindsay
Published: December 2024

What are the causal pathways through which natural resources are linked to civil conflict? Ross evaluates ten causal pathways across thirteen conflicts to offer the most comprehensive answer to date. However, nearly 20 years later, all thirteen conflicts have ended, and more sources are available, motivating the question: Would the findings hold if replicated today? We employ a new explicit standards approach to replicate Ross’ thirteen cases twice: First, using his original seventy-eight sources and second, employing a more up-to-date set of conflict end-dates and over 500 sources. Most findings (75 percent) hold, while 25 percent do not. We find stronger evidence for Ross’ claim that looting resources is linked to longer conflicts and that resources motivate government repression. However, we also overturn some of his key claims, by demonstrating that resources do, in fact, affect conflict onset by funding rebel start-up costs and generating grievances amongst the population.
Development of a novel patient-reported outcome measure for disseminated coccidioidomycosis (valley fever)
Authors: Harvey Emma , Clegg Jennifer , Bresnik Mark , Blatt Elliott , Hughes Sophie , Umanzor-Figueroa Cindy , Purdie Rob , Thompson George R , Symonds Tara
Published: December 2024

Background

Coccidioidomycosis (Valley Fever) is a dimorphic fungal infection endemic to the southwest United States, Mexico, Central and South America, which can lead to chronic debilitating illness and death.

Objectives

This qualitative study was conducted to develop a bespoke patient-reported outcome measure for patients with chronic disseminated coccidioidomycosis to assess health-related quality of life (HRQoL) impacts.

Patients and methods

Online, first-person narratives of patient experiences of disseminated coccidioidomycosis were used to create a patient-centred conceptual model of symptoms and impacts of the condition. Interviews were conducted with expert clinicians, followed by concept elicitation interviews with patients, to generate key symptom and impact concepts from which an initial patient-reported outcome measure was developed. The draft measure was reviewed with clinicians for clinical relevance and further assessed in cognitive debriefing interviews with patients to refine the measure and establish content validity.

Results

A total of 25 patients were interviewed, which identified impacts relating to physical function, activities of daily living, cognitive function, social/role function and emotional function of disseminated coccidioidomycosis. Twenty items were developed simultaneously in English and Spanish to capture the main impacts across these 5 areas. In general, items were clear and well understood by patients, and clinicians found the measure clinically relevant and appropriate for assessing the burden of disseminated coccidioidomycosis on HRQoL.

Conclusions

Once fully validated, the Valley Fever—Patient Reported Outcome measure may be used in interventional studies to assess HRQoL outcomes, and in clinical practice to monitor patients’ HRQoL.
The effect of feeding order of forage and oats on metabolic and digestive responses related to gastric emptying in horses
Authors: Jensen Rasmus Bovbjerg , Walslag Ingrid Hornnes , Marcussen Caroline , Thorringer Nana Wentzel , Junghans Peter , Nyquist Nicole Frost
Published: December 2024

Feeding order of forage and concentrate might affect gastric emptying and subsequently digestion in horses. The objective of this study was to measure gastric emptying in combination with metabolic and digestive responses in the plasma and cecum, respectively, when changing the feeding order of oats (O) and hay (H) (oats first, then hay: O–H vs. hay first, then oats: H–O). Four cecum cannulated horses were used in a 2 × 2 crossover design, with two 12-d periods consisting of 10 d of diet adaptation and 2 d of data collection. Hay was fed at 0600, 1400, and 2000 hours, while oats were fed in the morning either 15 min before or 1 h after feeding hay. On days of data collection, baseline samples were collected before feeding 1.4 kg dry matter (DM) hay and 474 g DM oats (0.4 g starch/kg body weight), and data were collected until 8 h after feeding. Gastric emptying of oats was estimated using the 13C acetic acid breath test, where breath samples were analyzed for a 12C:13C ratio after administration of 13C acetic acid mixed with oats. Gastric emptying coefficient (GEC), time where half of the total cumulative recovery of 13C was excreted (t1/2), and time where the maximal amount of 13C was excreted (Tmax) were calculated. Samples of blood and cecal fluid were collected at hourly intervals. Blood plasma was analyzed for glucose and insulin, and baseline concentrations, peak concentrations, time of peaks, and area under the curves were calculated. A pH probe was placed in the cecum measuring pH every minute to find minimum pH and time to reach minimum pH. Hourly cecal samples were analyzed for pH and short-chained fatty acid (SCFA) concentrations. Results from the 13C acetic acid breath test indicated that feeding order affected gastric emptying, as Tmax was longer (P = 0.004) when feeding H–O (2.18 h) than O–H (1.09 h), but there was no effect on the GEC and T1/2. No effect of feeding order was found for plasma glucose and insulin measures. Feeding order had no effect on minimum pH, but the time to reach minimum pH increased (P = 0.014) from 170 min for O–H to 280 min for H–O, and average pH was lower in the intervals 0–170 min (P = 0.006) and 170–280 min (P = 0.006) for O–H than H–O. In general, the time of sampling had a larger effect on SCFA concentrations than feeding order. In conclusion, this study indicates that feeding order affected gastric emptying, and the digestive and metabolic responses were more clearly reflected in cecum pH than in plasma glucose and insulin.
Effect of second iron injection on growth performance, hematological parameters, and fecal microbiome of piglets fed different dietary iron levels
Authors: Johnson Alaina J , Li Wenli , Dittrich Barbara I , Cole Aleah C , Prodell Marie K , Lyons J Wesley , Fritz Scott A , Fregulia Priscila , Chen Chi , Kwon Chan Ho , Jang Young Dal
Published: December 2024

This experiment was conducted to evaluate the effects of a second iron injection for suckling pigs fed diets with different dietary iron levels in the nursery period on growth performance, hematological parameters, serum and liver trace mineral content, fecal score, microbiome, and metabolites. A total of 70 newborn pigs from 7 litters were assigned to either 1 or 2 iron injections within the litter and received the first i.m. iron injection (200 mg) at 2 to 3 d of age. Pigs assigned to the second injection treatment received an additional iron injection 5 d after the first injection. At weaning (days 27 to 30 of age), pigs within iron injection treatments were divided into 2 nursery diet treatments for a 27-d growth period. Treatments were 1) no additional iron injection + nursery diets with 100 ppm iron (NC), 2) second i.m. iron injection (200 mg) + NC diets, 3) no additional iron injection + nursery diets with 200 ppm iron (PC), and 4) second i.m. iron injection (200 mg) + PC diets. The second iron injection increased liver iron content at weaning (P = 0.08, tendency), and serum iron, hemoglobin, and hematocrit levels until day 13 postweaning (P < 0.05). In the nursery period, pigs receiving the second iron injection had a greater final body weight (P = 0.08, tendency), overall growth rate (P = 0.08, tendency) and feed intake (P < 0.05), and lower fecal score (P < 0.05) indicating firmer feces compared to those receiving 1 iron injection. There was no major effect of dietary iron level or interaction with the iron injection treatment in any measurements except that the pigs fed the PC diets had greater hemoglobin and hematocrit levels (P < 0.05) at day 27 postweaning and a lower fecal score (P = 0.08, tendency) in the late nursery period than those fed the NC diets. The second iron injection reduced fecal bacterial alpha-diversity based on Faith’s phylogenetic diversity at weaning (P < 0.05), while the second iron injection and dietary iron levels resulted in dissimilarity in the fecal bacterial community based on Unweighted Unifrac analysis (P < 0.05; at weaning by iron injection and day 27 postweaning by dietary iron level). In conclusion, the second iron injection for suckling pigs improved postweaning growth performance and hemoglobin levels and affected the fecal microbiome, whereas an additional 100 ppm of dietary iron supplementation increased hemoglobin levels and altered the fecal microbiome in the late nursery period but did not affect postweaning growth.
In vitro investigation of monoglycerides and zinc glycinate: anti-inflammatory and epithelial barrier function
Authors: Park Sangwoo , Kovanda Lauren , Sokale Adebayo O , Barri Adriana , Liu Yanhong
Published: December 2024

The objectives of this study were to investigate the in vitro immune-modulatory effects of monoglycerides and zinc glycinate with porcine alveolar macrophages (PAM) and their impact on epithelial barrier integrity using the intestinal porcine enterocyte cell line (IPEC-J2). Cell viability was assessed using a Vybrant MTT assay to determine the appropriate dose range of monoglyceride blend (C4, C8, and C10) and zinc glycinate. In experiment 1, IPEC-J2 cells (5 × 105 cells/mL) were seeded and treated with each compound (monoglycerides: 0, 25, 100, 250, 500, and 1,000 µg/mL; zinc glycinate: 0, 2, 5, 12.5, 25, and 50 µg/mL). Transepithelial electrical resistance (TEER) was measured by Ohm’s law method at 0 h (before treatment) and at 24, 48, and 72 h posttreatment. In experiment 2, PAM were collected from 6 clinically healthy piglets (7 wk of age) and seeded at 106 cells/mL. After incubation, the cells were treated with each compound and/or lipopolysaccharide (LPS). The experimental design was a 2 × 6 factorial arrangement with 2 doses of LPS (0 or 1 μg/mL) and 6 doses of each compound (monoglycerides: 0, 50, 100, 250, 500, and 1,000 µg/mL; zinc glycinate: 0, 25, 50, 100, 250, and 500 µg/mL). Cell supernatants were collected to analyze the concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) by enzyme-linked immunosorbent assay kits. Data were analyzed by ANOVA using PROC MIXED of SAS with a randomized complete block design. IPEC-J2 cells treated with 250 or 1,000 μg/mL of monoglycerides, or 5 μg/mL of zinc glycinate had increased (P < 0.05) TEER values at 48 or 72 h posttreatment, compared with control. The LPS challenge increased (P < 0.05) the production of TNF-α and IL-1β from PAM. In the non-challenge group, 50 or 100 μg/mL of monoglycerides stimulated (P < 0.05) TNF-α and IL-1β production from PAMs. Treatment with 25 or 100 μg/mL of zinc glycinate also enhanced (P < 0.05) TNF-α production from PAM. In LPS-treated PAM, 1,000 μg/mL of monoglycerides increased (P < 0.05) IL-1β production, while zinc glycinate suppressed (P < 0.0001) the secretion of TNF-α and IL-1β at the doses of 100, 250, and 500 μg/mL. In conclusion, the results of this in vitro study indicate that monoglycerides positively affect the barrier function of the epithelium, while zinc glycinate may have strong immune regulatory benefits. Future animal studies will be required to verify their impacts on animal gut health, systemic immunity, and growth performance.
Romosozumab improves microarchitecture as assessed by tissue thickness–adjusted trabecular bone score in postmenopausal women with osteoporosis
Authors: McClung Michael R , Betah Donald , Leder Benjamin Z , Kendler David L , Oates Mary , Timoshanko Jen , Wang Zhenxun
Published: December 2024

Bone mineral density (BMD) is only one of several bone strength determinants affected by osteoporosis therapies. Trabecular Bone Score (TBS), a gray-level texture index determined from lumbar spine (LS) dual-X-ray absorptiometry scans, is an indirect measure of bone microarchitecture independent of and complementary to BMD and clinical risk factors. In the Active-Controlled Fracture Study in Postmenopausal Women with Osteoporosis at High Risk (ARCH), monthly subcutaneous romosozumab 210 mg for 12 mo followed by 24-mo open-label weekly oral alendronate 70 mg (romosozumab-to-alendronate) significantly reduced fracture risk compared to 36-mo alendronate alone in postmenopausal women with osteoporosis and prior fracture. This analysis evaluated tissue thickness–adjusted TBS (TBSTT) in a subgroup of patients from ARCH who had post-hoc TBS measurements at baseline and at least one post-baseline visit at months 12, 24, and 36. Baseline characteristics were similar between romosozumab-to-alendronate (n = 190) and alendronate alone (n = 188). Romosozumab led to significantly greater gains in TBSTT vs alendronate at month 12 (least squares mean difference, 3.6%), with greater gains maintained after transition to alendronate and persisting at months 24 (2.9%) and 36 (2.3%; all p<.001). Romosozumab-to-alendronate increased the percentage of individual patients with “normal” TBSTT from 28.9% at baseline to 48.1%, 43.9%, and 45.4% at months 12, 24, and 36, respectively, and decreased the percentage of individual patients with degraded TBSTT from 52.6% to 33.3%, 36.0%, and 33.5%, respectively (all p<.001). A similar but smaller trend was observed with alendronate alone from baseline through month 36 (p ≤.012). Changes in TBSTT and LS BMD were largely unrelated from baseline to month 12 (romosozumab-to-alendronate, r2 = 0.065; alendronate alone, r2 = 0.021) and month 36 (r2 = 0.058; r2 = 0.057, respectively). In postmenopausal women with osteoporosis and prior fracture, 12-mo romosozumab followed by 24-mo alendronate significantly improved bone microarchitecture estimated by TBSTT more than 36-mo alendronate alone.
King Francis I’s dracunculus: further solutions to the mystery of an infamous museum piece
Authors: Senter Philip J
Published: December 2024

Taxidermy, first practised in the sixteenth century, was often used to preserve animal remains in museums of the European Renaissance, and was soon deployed to create dragon hoaxes. Many such specimens were displayed in museums and were cited by naturalists as evidence that dragons were real animals. The dracunculus of King Francis I of France (r. 1515–47) was an internationally famous case. The specimen is now lost, but a previous investigation of contemporary drawings and a written description showed that the specimen had the skull of a weasel and the tail skeleton of an eel. This continuation of the investigation reveals that the limbs, skin and ribcage were those of an ocellated lizard (Timon lepidus), with the skin shifted over the lizard’s skeleton into an unnatural position. This study elucidates the materials and methods that were used to produce an astonishing category of biological fraud in which early museums unwittingly participated.
Real-world data of first-line treatment with pembrolizumab for NSCLC with high PD-L1 expression in elderly patients: a subgroup analysis of HOT/NJLCG2001
Authors: Tateishi Kazunari , Mizugaki Hidenori , Ikezawa Yasuyuki , Morita Ryo , Yokoo Keiki , Sumi Toshiyuki , Aso Mari , Kikuchi Hajime , Nakamura Atsushi , Sekikawa Motoki , Yoshiike Fumiaki , Kitamura Yasuo , Kimura Nozomu , Hachiya Tsutomu , Tsurumi Kyoji , Agatsuma Toshihiko , Megumi Furuta , Nakamura Keiichi , Jingu Daisuke , Yamamoto Hiroshi , Kosaka Makoto , Yokouchi Hiroshi
Published: December 2024

Background

In the first-line treatment of elderly patients with advanced-stage non-small cell lung cancer (NSCLC) with high programmed death-ligand 1 (PD-L1) expression (tumor proportion score ≥ 50%), this study aimed to determine whether pembrolizumab monotherapy (MONO) or pembrolizumab plus platinum-based chemotherapy (COMB) should be selected.

Methods

We performed a retrospective multicenter study (sub-analysis of the HOT/NJLCG2001 trial) of 299 patients with NSCLC with high PD-L1 expression who received MONO or COMB as the first-line treatment between December 2018 and January 2020. We selected patients aged 75 years and older and assessed the clinical efficacy and toxicity.

Results

In total, 81 (median age: 79 years) and 19 (median age: 76 years) patients received MONO and COMB, respectively. Twenty patients with a performance status (PS) score of 2–3 were enrolled in the MONO group. The median progression-free survival (PFS) was 7.8 and 8.9 months in the MONO and COMB groups, respectively. The median overall survival (OS) was 14.6 and 20.3 months, and the 2-year survival rates were 38.8 and 49.9%, respectively. Furthermore, 29.6% and 26.3% of patients discontinued treatment due to adverse events, respectively. In MONO, patients with PS 0–1 had a longer PFS (10.5 months) and OS (21.7 months) than those with PS 2–3 (0.7 and 1.6 months, respectively).

Conclusion

Some elderly patients with NSCLC and high PD-L1 expression might benefit from COMB; however, MONO is considered the preferred treatment. MONO may not be an effective or feasible treatment for patients with PS 2–3, even with high PD-L1 expression.
The Influence of affective and cognitive appeals on persuasion outcomes: a cross-cultural meta-analysis
Authors: Ng Wei Jie Reiner , See Ya Hui Michelle , Cheung Mike W -L
Published: December 2024

People are frequently exposed to different extents of affective and cognitive appeals, but it remains unclear whether appeals targeting emotions or beliefs are differentially effective across cultures. Hence, this meta-analysis investigates the relative influence of affective versus cognitive appeals for persuasion outcomes as a function of individualism-collectivism. Using 133 samples across 22 countries (N = 29,338), we found affective appeals to be relatively more effective than cognitive appeals in collectivistic societies, but both appeals were similarly effective in individualistic societies. These analyses demonstrate the fruitfulness of examining affective–cognitive appeals through a cultural lens, and suggest new directions for future research.
Stereotactic arrhythmia radioablation for ventricular tachycardia: a review of clinical trials and emerging roles of imaging
Authors: Kawamura Mariko , Shimojo Masafumi , Tatsugami Fuminari , Hirata Kenji , Fujita Shohei , Ueda Daiju , Matsui Yusuke , Fushimi Yasutaka , Fujioka Tomoyuki , Nozaki Taiki , Yamada Akira , Ito Rintaro , Fujima Noriyuki , Yanagawa Masahiro , Nakaura Takeshi , Tsuboyama Takahiro , Kamagata Koji , Naganawa Shinji
Published: December 2024

Ventricular tachycardia (VT) is a severe arrhythmia commonly treated with implantable cardioverter defibrillators, antiarrhythmic drugs and catheter ablation (CA). Although CA is effective in reducing recurrent VT, its impact on survival remains uncertain, especially in patients with extensive scarring. Stereotactic arrhythmia radioablation (STAR) has emerged as a novel treatment for VT in patients unresponsive to CA, leveraging techniques from stereotactic body radiation therapy used in cancer treatments. Recent clinical trials and case series have demonstrated the short-term efficacy and safety of STAR, although long-term outcomes remain unclear. Imaging techniques, such as electroanatomical mapping, contrast-enhanced magnetic resonance imaging and nuclear imaging, play a crucial role in treatment planning by identifying VT substrates and guiding target delineation. However, challenges persist owing to the complex anatomy and variability in target volume definitions. Advances in imaging and artificial intelligence are expected to improve the precision and efficacy of STAR. The exact mechanisms underlying the antiarrhythmic effects of STAR, including potential fibrosis and improvement in cardiac conduction, are still being explored. Despite its potential, STAR should be cautiously applied in prospective clinical trials, with a focus on optimizing dose delivery and understanding long-term outcomes. Collaborative efforts are necessary to standardize treatment strategies and enhance the quality of life for patients with refractory VT.
(013) DISSATISFACTION AFTER INFLATABLE PENILE PROSTHESIS: A LONGITUDINAL STUDY
Authors: Guillen A , Bonakdarhashemi M , Dumbrava M , Pinkhasov A , Sevann H , Ziegelmann M
Published: December 2024

Introduction

Penile prosthesis (PP) implantation is associated with high patient satisfaction and improved sexual quality of life in medically refractory erectile dysfunction (ED). While reported patient satisfaction with this surgery is high, there are a variety of factors that can influence patient satisfaction after PP surgery.

Objective

We aimed to identify factors responsible for patient dissatisfaction after PP surgery.

Methods

We initiated a registry of patients undergoing surgery for placement of a PP. After consent, Perioperative study assessments and follow-ups were conducted. After surgery, patients were directed to fulfill a survey at 6 months and 12 months. Patients who completed both surveys were included in the analysis.

Results

A total of 304 patients had a PP placement, of these 101completed at least the first survey. Patients reported using their PP a median of 4 (2-8) times per month at 6 months, and 5 (2-9) at 12 months (p = 0.651). Main reasons of lack of use of the PP can be seen in Fig. 1A. The most frequent reported reason was lack of interest from partner (20.3% at 6-months, 18.8% at 12-months). Patient reported reasons for dissatisfaction are seen in Fig. 1B. Examples include penile pain (19% at 6-months, 11% at 12-months), difficulty with orgasm (39% at 6-months, 37% at 12-months), unsatisfactory penile cosmesis (28% at 6-months, and 25% at 12-months), problems inflating of the prosthesis (14.9% at 6-months, and 21.5% at 12-months), and problems deflating of the prosthesis (33.7% at 6-months, and 31.6% at 12-months). Despite these concerns, most patients found PP easy to use (83.2% at 6-months, and 82.1% at 12-months) and a reported a very or somewhat natural sensation with their erections (66.4% at 6-months, and 62.8% at 12-months) Fig. 1C.

Conclusions

There was a higher than anticipated rate of penile pain, difficulty achieving climax, and unsatisfactory cosmesis that warrant further investigation. Despite this, the majority of patients found their PP easy to use and a reported natural sensation when having erections.

Disclosure

Yes, this is sponsored by industry/sponsor: Coloplast.

Clarification: Industry funding only - investigator initiated and executed study.
(046) SEXUAL OUTCOMES IN PATIENTS WHO UNDERWENT REZUM WITH TURP FOR MEDIAN LOBE
Authors: Bonakdar Hashemi M , Piraino J , Pinkhasov A , Guillen Lozoya A , Lybert D , Kohler T
Published: December 2024

Introduction

Treatment of patients with obstructive lower urinary tract symptoms has various side effects on their quality of sexual life.

Objective

This study aimed to compare the effects of Rezum and Rezurp (a combination of Rezum for lateral lobes and TURP for the median lobe) on erections, retrograde ejaculation, and subjective orgasm experience in patients with a significant median lobe.

Methods

This is a retrospective cohort study that includes patients who underwent Rezum and Rezurp between January 2021 and January 2024. Sexual outcomes were assessed at 3 months and a median follow up phone call was 33 months. Patients were queried: Any changes in erections (yes/no) and changes in ejaculation (yes/no). If yes to changes, patients were asked to further define and characterize their responses including specific effect on orgasm. The effect of surgery on sexual outcomes was explored by chi-square analysis with P ≤ 0.05 considered statistically significant.

Results

Sexual outcomes were obtained for 78/89 patients in the Rezurp and 97/107 patients in the Rezum group. There was no significant difference in baseline characteristics, including age, prostate volume, and medication regimens, between the two groups, as shown in Table 1. The results indicated that 78% (61/78) and 83% (86/97) of Rezurp and Rezum patients experienced no change in ejaculation. Total ejaculation loss was seen only in two Rezurp patients. Ejaculatory changes between the two groups were not significantly different, with 13.8% and 4.23% worsening for Rezurp and Rezum, respectively (P = 0.08). Changes in erections and orgasm satisfaction were not statistically significant between the two groups (P = 0.76 and 0.54, respectively). Subjective worsening in orgasm quality for Rezurp and Rezum was not different between groups (P = 0.54), with 6.4% and 4.1% worsening, respectively (Table 2).

Conclusions

Rezurp and Rezum have similar sexual function outcomes.

Disclosure

No.
(056) CHARACTERIZING CORPOROVENOCCLUSIVE DYSFUNCTION IN MEN AFTER RADIATION THERAPY FOR PROSTATE CANCER
Authors: Flores Martinez J , Ljubetic BM , Liso N , Elshafei A , Mulhall JP
Published: December 2024

Introduction

Radiation therapy (RT) for prostate cancer (PC) often leads to erectile dysfunction (ED).

Objective

We aimed to characterize corporvenocclusive dysfunction (CVOD) rates in men following RT for PC.

Methods

Study population consisted of (i) men after RT with or without androgen deprivation therapy (ADT) (ii) who developed ED (iii) with poor response to PDE5i and ICI, (iv) who had penile duplex Doppler ultrasound (DUS) (v) using a vasoactive agent redosing schedule. Arterial insufficiency (AI) was defined using a peak systolic velocity (PSV) <30 cm/sec bilaterally and CVOD using end diastolic velocity (EDV) values ≥5 cm/sec bilaterally. Demographics, comorbidity, endocrine profiles and DUS parameters were recorded. The erection hardness scale (EHS) was used to evaluate ED before RT (1-4, 4 hardest erection). We used univariate (UV) and multivariable analyses (MV) to define factors predictive of CVOD. Variables included in the UV model: age, comorbid conditions (diabetes (DM), hyperlipidemia (HLD), obstructive sleep apnea (OSA), coronary artery disease (CAD), hypertension (HTN)), RT type - brachy (BT) vs external beam (EBRT), RT dose, EHS, and ADT duration. Factors that were significant on UV analysis moved forward into the MV model.

Results

156 men were analyzed. Median age was 69 (62, 74) years. Median RT dose 7020 (4000,10 000) Gy with 57% of men receiving EBRT and 43% received BT. 54% received ADT, with a median exposure of 15 (6, 24) months. 33% received ADT for ≥12 months. 4% had ≥3 vascular comorbidities: DM 21%, OSA 25%, smoking 47%. Median pre-RT EHS score 4 (3,4), 20% being ≤2. Median baseline PSA was 3.5 (0.4, 6) ng/mL. Pre-RT total testosterone (T) was 14 (8, 313) ng/dL. Median total T at the time of DUS was 350 (207, 457) ng/dL and 46% had low T. Median trimix dose administered at DUS was 75 (20, 100) units. 50% received 100 units. Median PSV was 43 (33, 56) cm/sec, median EDV 8 (0, 12) cm/sec. Erection reversal was requirted in 36% of men. CVOD was diagnosed in 59%. AI was diagnosed in 14%, CVOD+AI was observed in 7% of cases. On MV, the predictors of CVOD were older age, ADT duration ≥12 months, dyslipidemia (Table).

Conclusions

In men after RT for PC, CVOD was present in more than half of patients studied, with three significant predictors identified.

Disclosure

No.
(066) THE CORRELATION BETWEEN TOTAL AND FREE TESTOSTERONE LEVELS AND SELF-REPORTED SYMPTOMS IN MEN WITH LOW TESTOSTERONE LEVELS
Authors: Flores Martinez J , Ljubetic BM , Liso N , Mulhall JP
Published: December 2024

Introduction

The diagnosis of testosterone (T) deficiency requires the presence of a cluster of symptoms and/or signs combined with a documented a low total T level.

Objective

We aimed to evaluate the associations of low total and free T with self-reported symptoms.

Methods

The study population included men who (i) completed a survey assessing 11 low T symptoms (low energy, afternoon fatigue, reduced strength/endurance, reduced exercise response, reduced work productivity, muscle loss, fat gain, irritability, feeling depressed, and cognitive problems) during the initial office assessment (ii) had T assessment using LCMS and (iii) had free T measured by equilibrium dialysis (iv) conducted within one month of survey completion. Men with prior previous T treatment were excluded. Low T was defined as total T < 300 ng/dl. Spearman’s correlation assessed the relationship between the number of reported symptoms and total T and free T levels. This analysis was performed for the entire cohort (n = 467) and a sub-analysis excluded patients who reported sleep apnea (n = 262).

Results

467 men were included. Median age was 63 (57, 70) years old. 14% had diabetes, 44% had OSA, and 28% reported ≥3 comorbidities. Median total T was 358 (258-486) ng/dL, median free T 10 (7-13) ng/dL. 35% had low T. Median T symptom number was 3 (0, 6). 30% reported ≥6 symptoms. The most prevalent symptoms reported were feeling tired (53%), low energy (47%), reduced exercise response (39%), reduced strength (38%), and muscle loss (37%). Spearman’s correlation analysis showed a small significant negative correlation for both total T and free T to the number of self-reported symptoms (Table).

Conclusions

While statistically significant, the correlations were very weak suggesting that in men with low T levels, there appears to be little correlation between symptomatology and T levels, supporting the non-specificity of these symptoms.

Disclosure

No.
(080) EXPLORING INFERTILITY RISK AND SEMEN PARAMETERS IN YOUNG ADULT CANCER SURVIVORS
Authors: Langston D , Fendereski K , Halpern J , Iko I , Aston K , Emery B , Ramsay J , Horns J , Hotaling J
Published: December 2024

Introduction

Cancer treatment can affect fertility, but assessing infertility risk accurately remains challenging, leading to inconsistent discussions during cancer care. This study aims to assess semen analysis parameters, the gold standard for male fertility evaluation, in young adult oncology patients undergoing fertility preservation interventions post-treatment for the four most common cancers in this age group: testicular, lymphoma, central nervous system (CNS), and melanoma.

Objective

To examine the impact of common YA oncologic diagnoses on future fertility.

Methods

We evaluated semen analysis changes in Adolescent Young Adult (AYA) oncology patients, aged 15-39, who underwent fertility evaluation. Using a statewide patient database linked to the Subfertility Health Assisted Reproduction and Environment (SHARE) databases, we identified patients who had one or more semen analyses before and after diagnosis between 1998-2017. Multivariate analyses tested the influence of time from cancer diagnosis and cancer type on semen parameters (concentration, total sperm count, total motility).

Results

The cohort included 58 individuals, primarily Non-Hispanic White (94.8%), with testis-related conditions being most common (46.6%), followed by lymphoma (24.1%), CNS disorders (20.7%), and melanoma (8.6%). Mean age at diagnosis was 29 years. Semen parameters showed no significant difference post-diagnosis compared to pre-diagnosis, though concentration and total sperm count trended downward. Sperm concentration was significantly lower in the testis diagnosis group mean 17.3 M/mL, SD 13.2) versus CNS (mean 87.8, SD 79.3, P = 0.04), with a trend toward decrease relative to lymphoma and melanoma. Total motility was significantly lower in the testis diagnosis group (mean 50.4%, SD 26.4) versus CNS (mean 65.5%, SD 19.6, P = 0.02) and a trend toward decreased motility relative to the melanoma group (mean 66.5%, SD 17.8, P = 0.09).

Conclusions

AYA survivors of testis conditions showed decreased semen health parameters compared to other common cancer diagnoses. Fertility discussions with AYA survivors should consider developmental stage and emotional resilience. Multidisciplinary care teams are crucial for offering optimal fertility advice and care given the limited understanding of cancer treatment impacts on fertility outcomes.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: StreamDx, Inherent Bioscience, Turtle Health, Maimus, Carrot Fertility.
(091) RATE OF RETURN OF SPERM AMONG MEN WITH AZOOSPERMIA POST VASECTOMY REVERSAL
Authors: Hans R , Savage J , Brearton K , Warner R , Helo S , Trost L
Published: December 2024

Introduction

Limited data exist on semen parameters post vasectomy reversal. Specifically, no studies have rigorously evaluated the likelihood of sperm return following discovery of azoospermia at some time point post vasectomy reversal.

Objective

To evaluate the rate of return of sperm among men who experience an azoospermia result post vasectomy-reversal.

Methods

A large, prospective dataset has been maintained of men undergoing vasectomy reversals at a single center from 2019 to the present. Men who had at least two post-operative semen analyses were included for review. The data were then analyzed in a manner to identify those who experienced a 0 count at varying time points and then either went on to continue to have 0’s beyond that point or who experienced a return of sperm.

Results

A total of 3414 men underwent a vasectomy reversal since 2019, with 2703 having semen analysis data available for review. Overall demographics demonstrated a mean age of 41, partner age 33, median time since vasectomy of 7 years, 92% first-time cases, and distribution of repair as noted: VV/VV (79%), VV/EV (12%), EV/EV (6%), VV/x (1%), EV/x (<1%), x/x (0%). Of men who had 0 sperm at varying time points, the percentages of those who experienced a return of sperm are noted as follows: 0 sperm at <2 months (52% experienced a return at some point, n = 349 used in calculation), 0 at 2-4 months (38% return, n = 210), 0 at 5-7 months (17% return, n = 206), 0 at 8-10 months (20% return, n = 133), 0 at 11-18 months (9% return, n = 107). The data are limited by the fact that relatively few men continued to send in semen analysis samples beyond 12 months (n = 403 with at least one result >12 months and n = 101 with results >24 months).

Conclusions

Men who experience azoospermia post-vasectomy reversal may experience a return of sperm over time, with the likelihood for return declining based on the duration of persistence of 0 sperm.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: PathRight Medical.
(095) THE USE OF EJACULATED VS TESTICULAR SPERM IN MEN WITH EITHER CRYPTOZOOSPERMIA OR NON-OBSTRUCTIVE AZOOSPERMIA
Authors: Oppenheimer A , Huang J , Rhodes Q , Nodler J , Stocks B , Lipshultz L
Published: December 2024

Introduction

Although use of ejaculated sperm for Intracytoplasmic Sperm Injection (ICSI) in men with cryptozoopsermia obviates conventional testicular sperm extraction (cTESE) or micro testicular sperm extraction (mTESE), there exists an ongoing debate as to whether testicular sperm produce better ICSI outcomes.

Objective

To better understand this issue, we identified all men presenting to single reproductive urologist’s practice and a single IVF center with cryptozoopsermia (CZ) or non-obstructive azoospermia (NOA) and analyzed ICSI outcomes. Our study represents the largest single-surgeon analysis conducted in the US.

Methods

All men presenting to a single reproductive urologist’s practice with CZ or NOA and who subsequently underwent ICSI were identified during 2012 to 2023. Per our practice pattern, men with NOA first underwent Testicular Core Extraction (TCE); those with sperm underwent office cTESE and those without sperm underwent operative mTESE. Three groups undergoing ICSI cycles were then identified: Cryptozoospermic men in which ejaculated sperm was used (n = 30), cTESE in which extracted sperm were used after a positive TCE (n = 33), and mTESE in which operatively extracted sperm was used after a negative TCE (n = 7). Fertilization and embryo rates per number of eggs inseminated were compared between groups using GraphPad Prism Software. P < 0.05 deemed significance using One-way ANOVA.

Results

Fertilization rates were highest within the cTESE group (81%) v. the ejaculated group (74%) v. the mTESE group (40%) (p = 0.02). As expected, embryo rates were overall lower than fertilization rates; however, the same pattern emerged albeit non-significantly: cTESE 36%, ejaculated 31%, and mTESE 10% (p = 0.2). Following our practice pattern, men undergoing operative mTESE after negative TCE had significantly poorer ICSI outcomes (p = 0.0004).

Conclusions

Advances in ICSI technology have resulted in successful birth outcomes from the ejaculate of male partners with CZ. As such, many male partners go directly to IVF and never undergo appropriate workup and treatment by a reproductive urologist. Testicular sperm harbor less DNA damage, ejaculatory contaminate, and diminished exposure to reactive oxygen species. Per our data, the use of testicular sperm is associated with improved ICSI outcomes. Furthermore, we demonstrate that men requiring operative mTESE after negative TCE have a lesser chance of successful ICSI results.

Disclosure

No.
(104) THE IMPORTANCE OF ERECTILE FUNCTION IN FOSTERING INTIMACY IN HETEROSEXUAL RELATIONSHIPS FROM THE FEMALE PERSPECTIVE
Authors: Nham E , Vigil H , Flannigan R , Brotto L , Witherspoon L
Published: December 2024

Introduction

Heterosexual men with erectile dysfunction (ED) commonly site fear of losing intimate partners due to lack of sexual performance and pursue invasive treatments to maintain erections. Female views on the significance of erectile function in healthy relationships remains under-explored, however. This study examines female perspectives on the importance of erections in relationships.

Objective

The objective of the study is to explore female perspectives on importance of erections in relationships and determine if female partners will pursue and/or maintain relationships with males with ED.

Methods

A survey-based study employed a virtual 35-item questionnaire adapted from the McCoy Female Sexuality Questionnaire. Participants included heterosexual females aged 18 years and older.

Results

From May to November 2024, 217 survey responses were received, 56 of which had >50% incomplete entries leaving 161 for analysis. The average age of participants and their male partners was 33 (Standard Deviation, SD = 11) and 35 (SD = 10) years, respectively. A majority were either married or in long-term relationships (93/161). Only 89 of 161 female respondents considered penetrative intercourse important for their connection with their partners, citing narrative reasons such as partner satisfaction, stress relief, and viewing intercourse as an expression of love, attraction, intimacy, and vulnerability. Some females (47/161) felt that a lack of penetrative intercourse would negatively impact their relationships with narrative concerns around changes in relationship dynamics, male partner masculinity, his mental well-being, and female sexual gratification. Conversely, 33 of 161 females saw penetrative intercourse as non-essential, emphasizing other aspects of intimacy. Majority of females (79/161) indicated they would not end a relationship due to a partner’s erectile dysfunction (Fig. 1). When asked if they would start a relationship with a male with erectile dysfunction 56 of 161 of females said they were open to it, while 51 of 161 were not.

Conclusions

While penetrative intercourse holds significance as a means of intimacy for many heterosexual females, it is only one component of relationships and other aspects of intimacy are also highly valued. The outcomes of our study can help counsel men considering invasive treatments for erectile function and provide context on how women view erectile dysfunction and its significance on current and new relationships.

Disclosure

No.
Impulse control and its association with ejaculation time in men with premature ejaculation
Authors: Sağlam Tarık , Takım Uğur , Kavla Yasin , Demir Demirhan Örsan , Turan Şenol
Published: December 2024

Background

The relationship between impulse control and premature ejaculation (PE), the most common sexual dysfunction in men, is not yet well understood.

Aim

To assess the association between impulse control issues and the severity of PE in men with a lifelong diagnosis of this condition.

Methods

A cross-sectional observational study was designed to evaluate patients who presented to the clinic with complaints of PE between March 2023 and March 2024. The final study sample comprised 40 men with lifelong PE and 40 healthy control subjects.

Outcomes

Impulse control was evaluated with the UPPS Impulsive Behavior Scale and the Barratt Impulsivity Scale-11 (BIS-11), while depression and anxiety levels were measured using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The severity of PE was assessed using the Arabic Index of PE (AIPE).

Results

The mean AIPE score was 15.13 ± 3.33 in the PE group and 32.05 ± 2.06 in the control group (P ˂ 0.001). Compared to the control group, the PE group had significantly higher UPSS Impulsive Behavior Scale scores in all subscales (P ˂ 0.001 for planning, urgency, and lack of perseverance; P = 0. 001 for sensation seeking) and total scores (P ˂ 0.001). The BIS-11 scores were also significantly higher in the PE group compared to the control group for all subscales (P ˂ 0.001 for all). The patients in the PE group also had higher levels of anxiety and depression (P ˂ 0.001 for all).

Clinical Implications

A clinician’s quantitative assessment of ejaculation time and the severity of PE among men presenting to the clinic with complaints of PE may reveal accompanying comorbid conditions more effectively.

Strength and Limitations

The current study is a novel investigation that quantitatively evaluates PE in terms of intravaginal ejaculatory latency time and severity, aiming to identify comorbid conditions. As a limitation, the necessity for patients and their partners to measure the time to ejaculation limited the sample size, making it challenging to generalize the findings.

Conclusion

Our findings suggest that impulse control plays a significant role in lifelong PE. It is important for clinicians to assess impulse control and consider therapeutic interventions for men presenting with PE complaints, particularly in those classified as severe.
Investigating the link between severity of dyspareunia and female sexual distress among a group of women with endometriosis: the mediating role of body functionality appreciation
Authors: Grano Caterina , Spinoni Marta , Porpora Maria Grazia , Di Gesto Cristian
Published: December 2024

Background

While existing studies have predominantly focused on negative body image and its potential link to female sexual distress in women with endometriosis, no studies have investigated how positive body image (ie, body functionality appreciation) mediates the association between dyspareunia severity and sexual distress in this population.

Aim

This study aimed to investigate the mediating role of body functionality appreciation in the relationship between severity of dyspareunia and sexual distress in women living with endometriosis.

Methods

A total of 232 women with endometriosis (M = 35 years) took part in the study. Participants completed an anonymous questionnaire evaluating dyspareunia severity, functionality appreciation, female sexual distress, sociodemographic factors, and endometriosis-related clinical information. All participants were administered the following questionnaires: numerical rating scale, body functionality appreciation, female sexual distress scale.

Outcomes

Using a mediation model, the study analyzed both the direct and indirect effects of dyspareunia severity on sexual distress, with functionality appreciation as a mediator.

Results

The findings suggest that the severity of dyspareunia significantly contributes to sexual distress both directly and indirectly, by diminishing the appreciation for body functionality.

Clinical implications

Clinicians should not only focus on the severity of dyspareunia when evaluating sexual distress in women; instead, they should also acknowledge the protective role of positive body image. Integrated treatments that promote body functionality appreciation could enhance treatment outcomes.

Strengths and Limitations

The study is the first to examine the mediating role of body functionality appreciation in the relationship between dyspareunia severity and sexual distress in a sample of women with endometriosis; however, the assessment was cross-sectional and did not encompass other factors that may influence the connection between dyspareunia severity and sexual distress.

Conclusion

These findings, in addition to advancing theoretical understanding of the role of positive body image in women with dyspareunia, may be valuable in guiding the design of interventions aimed at reducing sexual distress in women with high levels of dyspareunia severity.