bluuebunny/crossref_metadata_2025 huggingface dataset:
241 Are Patients Really Willing to Undergo Surgery for Peyronie's Disease?
Authors: Capogrosso P , Candela L , Cazzaniga W , Costa A , Fallara G , Boeri L , Pozzi E , Belladelli F , Schifano N , Cignoli D , Dehò F , Abbate C , Montorsi F , Salonia A
Published: May 2022

Introduction

There is a current lack of effective conservative treatments for Peyronie Disease (PD). Surgery represents an effective treatment, despite being associated with bothering complications, including erectile dysfunction (ED).

Objective

We investigated patients wish of being operated for PD at a single center.

Methods

Data were prospectively collected for patients managed for penile curvature because of PD in 2016-2020. Baseline data included age, time from PD onset, penile pain, curvature degree, difficulty at penetration, concomitant hour-glass deformity and ED. All patients were offered conservative treatments, including oral therapy or topical injections regardless of curvature degree. Tunical shortening or lengthening procedures were offered as an alternative to conservative treatments. Penile prosthesis implantation was offered to those with concomitant ED. Patients compliance with surgery was recorded. Logistic regression analyses tested the profile of patients who were more likely to comply with surgery.

Results

Data were available for 218 patients. Median(IQR) age was 57(49,63) yrs and length of PD after onset was 14(3,28) months. Median curvature was 30°(20,45); of 218, 8(3.7%) patients had concomitant hour-glass deformity. Pain was complained by 30(14%) patients, while difficulty at penetration and ED were reported by 62(28%) and 87(40%) patients. Of all, 78(32%) patients had been treated with tadalafil OaD; 41(19%) patients received iontophoresis with verapamil; 35(16%) SWT; and, 31(14%) CCH injections. A significant improvement (defined as a curvature reduction≥20°) was reported in 52(24%) cases. Overall, only 59 (27%) patients were willing to eventually undergo surgery for PD. Younger patients (OR:0.95, 95%CI: 0.92,0.98;p=0.003) and patients with more severe curvatures (OR:1.03; 95%CI: 1.01,1.04;p=<0.001) were more likely to comply with surgery, after accounting for other clinical variables. According to this model, a man aged 50 yrs with a curvature <20° would accept surgery only in 24% of cases compared to 45% for a same age man with >45° of curvature (Fig1).

Conclusions

Compliance to surgery is low among patients with PD, thus further stressing the urgent need for effective conservative treatments. Surgery should be comprehensively discussed with younger patients with a severe curvature.

Disclosure

Work supported by industry: no.
261 Tocophobia
Authors: Rahne Otorepec I
Published: May 2022

Introduction

Fear of childbirth is common during pregnancy and is believed to be the most common underlying reason for requesting a caesarean section without medical indication. Despite the fact that 17%-20% of all pregnant women report extreme fear of birth, named tocophobia, in ICD -10 International Classification for Disease-10 revision – ICD-10,) there is not established diagnose Tocophobia, which can also occurs in non-pregnant women and in men. Primary tocophobia may have its onset in adolescence, affecting nulliparous women to such degree that some women never bear a child. They also describe sexual dysfunction as vaginismus and non-consummation. Secondary tocophobia may be associated with a previous traumatic birth experience such as stillbirth. Tocophobia is not just associated with antenatal psychological morbidity, but also raised rates of postnatal depression, impact on the mental well-being of the baby for life, increased length of labour, lower birth weights and increased prevalence (8%) of admission to neonatal intensive care. They can have feelings of isolation, guilt and shame, difficulties to prepare for birth. They may have sleeplessness, nightmares, stomachaches and depression with anxiety that can leads to panic attacks. Women may also be concerned with pain, their own incapability, possible obstetric injuries, lack of control, lack of partner or family support, and loss of their baby. The interventions included psychosexual education, cognitive behavioural sex therapy. Therapeutic interventions reduce the number of women who go on to have caesarean birth. Tocophobia is a common condition with both acute and chronic implications for the welfare of mothers and babies. It can cause not only mental but also physical morbidity and needs a clear both plan for the care of women and her specific fears.

Objective

Couple has started with couple sex therapy for his problems with erection before they have children. They are married; they have already two children (5y, 3y). She has recently discovered that she is pregnant for the third time and she is in gestational week 8. As nulliparous woman, she has developed sever tocophobia. She has intensive therapy with clinical psychologist through all first pregnancy time, but she still developed minor postpartum depression but without any need for antidepressants.

Methods

We present a case of a 40-years old woman with sever tocophobia and the results of the treatment interventions.

Results

Treatments include sensitive psychosexual education about the birth process, development of problem-solving skills, teaching coping strategies for labour.

Conclusions

Tocophobia is a common condition with both acute and chronic implications for the welfare of mothers and babies. It can cause not only mental but also physical morbidity and needs a clear both plan for the care of women and her specific fears.

Disclosure

Work supported by industry: no.
268 Vaginal Non-Ablative Er:YAG Laser Sexual Dysfunction Therapy in Women with Interstitial Cystitis/Bladder Pain Syndrome: A Case Series
Authors: Okui N , Gambacciani M , Okui M , Vizintin Z
Published: May 2022

Introduction

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic debilitating disease characterized by urinary frequency, urgency, and pelvic pain. Different studies have evaluated sexual well-being and e female sexual dysfunction (FSD) in IC/BPS patients. FSD in women with IC/BPS consists of dyspareunia, altered sexual desire, reduced orgasm frequency and vaginal insufficient lubrication. Recently, it has been repeatedly demonstrated that vaginal non-ablative erbium YAG laser (VEL) therapy can improve objective and subjective symptoms in different conditions. In our experience, VEL was very effective in various indications (stress urinary incontinence, mixed urinary incontinence, overactive bladder, genitourinary syndrome of menopause and FSD). In this study we evaluated the effects of VEL on FSD in women suffering from IC/BPS.

Materials and methods

This is case series study in which women with IC/BPS were also reporting FSD. The patients were treated with VEL with protocol in which the laser firstly irradiated the whole anterior vaginal wall and then also the entire vaginal canal. Local topical anesthesia was applied to the vagina before the laser irradiation. The therapy consisted in 1 treatment every 30 days, for 3 months. For the assessment of treatment effects we evaluated the personal history including: age at onset of IC/BPS and FSD, type of IC/BPS, bladder IC/BPS surgeries, the numeric rating scale-11 (NRS-11), O'Leary-Sant interstitial cystitis symptom and problem indexes (ICSI and ICPI), functional bladder capacity, daily urinary frequency, female sexual function index (FSFI) and vaginal health index score (VHIS). Follow-up was done 6 months from the first laser session. Potential adverse effects were observed at every visit as well as at 6 months follow-up.

Results

Six women were treated with the three sessions of VEL and followed for 6 months. The FSFI and VHIS significantly improved in all patients. The NRS-11 scores and the part of pain question of ICSI and ICPI improved as well. The bladder capacity and daily urinary frequency showed a marginal improvement. The therapy effects lasted for 6 months from the first treatment. All observed adverse effects were mild and transient.

Conclusion

Women suffering from IC/BPS have often impaired sexual life. Our data suggest that, besides being safe, VEL treatment can improve sexual life reducing also pain symptoms in IC/BPS patients. Further larger studies are needed in order to ascertain the relations between vaginal conditions and bladder pain, evaluating the possible role of VEL as a new approach for the treatment of FSD in IC/BPS women.

Disclosure

Work supported by industry: no.
276 Prevalence of and Risk Factors Associated with Vaginal Lubrication Issues in Women at 6 Months Postpartum
Authors: Mbarki W , Bettaieb H , Frikha M , Abidi I , Halouani S , Boufarguine R , Oueslati H , Mbarki C
Published: May 2022

Introduction

A woman's sexuality changes during her life and varies according to endogenous and exogenous factors. In this perspective, pregnancy and childbirth create a state of sexual dysfunction. The physiological changes that occur in the postpartum period are unique to each woman, and depend on several factors, including the mode of delivery, and the postpartum period. Postpartum vaginal dryness is a common sexual disorder, caused by modifications in vaginal lubrication mechanisms.

Objective

Studying women's sexuality after childbirth by evaluating vaginal lubrication disorders in postpartum period.

Methods

This is a prospective, cross-sectional study between November 2018 and September 2019 at obstetric and gynecologic department of Ben Arous hospital of Tunisia. 150 Women were included and were followed from the third trimester of pregnancy through 6 months after childbirth. we opted for the Female Sexual Function Index (FSFI) to evaluate sexual disorder in postpartum period.

Results

On the FSFI, the average vaginal lubrication score was 4.58 during pregnancy and 3.79 after delivery. At the time of the study, 6% of women were not sexually active during pregnancy and 2% after delivery. 53% of women who were sexually active during pregnancy reported feeling the sensation of vaginal lubrication during intercourse with varying frequency. 36% of women did not claim difficulty to acquire a satisfying level of vaginal lubrication After delivery, 39 women (26%), noted a sensation of lubrication less frequently. 84 % of women reported varying degrees of difficulty in achieving vaginal moisture during sexual intercourse after delivery (very difficult: 12%, difficult: 28%, somewhat difficult: 44%). The ability to maintain vaginal moisture during sex seems decreased after childbirth. In fact, the ability to maintain an adequate vaginal lubrification during sexual intercourse was reported on postpartum in 21 women (14%) compared to 48% during pregnancy. The factors influencing the different parameters of vaginal moisture found in our series were breastfeeding, mode of delivery and contraception.

Conclusion

In postpartum period achieving vaginal moisture and maintain of an adequate vaginal lubrification during intercourse seems to be altered. Mode of birth, breastfeeding and contraception was associated with lack of vaginal lubrication. Preparing women and their partners for this during the antenatal period and advising on simple measures, such as use of lubrication could be helpful.

Disclosure

Work supported by industry: no.
018 Physical Activity and Female Sexual Dysfunction: A Lot Helps, but Not Too Much
Authors: Maseroli E. , Rastrelli G. , Stasi V. Di , Cipriani S. , Scavello I. , Tommaso T. , Gironi V. , Castellini G. , Ricca V. , Sorbi F. , Fambrini M. , Petraglia F. , Maggi M. , Vignozzi L.
Published: May 2022

Introduction

Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking.

Objective

To investigate the clinical, psychological, and sexual correlates of PA in women with FSD.

Methods

A non-selected series of n=322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regular involvement in PA and its frequency (<1 hour/week: sedentary, 1-3 hours/week: active, 4-6 hours/week: very active, >6 hours/week: extremely active) were investigated with a specific question. FSDs, including HSDD (Hypoactive sexual desire disorder) and FGAD (Female genital arousal disorder), were diagnosed according to a structured and clinical interview. Participants underwent a physical examination and a clitoral Doppler ultrasound, and were asked to complete the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Body Uneasiness Test (BUT), and Middlesex Hospital Questionnaire (MHQ).

Results

Mean age was 45.1±12.9, mean body mass index was 25.24±6.34 kg/m2 and 46.3% (n=149) of women were post-menopausal. At multivariate analysis, women engaging in PA (67.4%, n = 217) scored significantly higher in several FSFI domains - including desire, arousal and lubrication (see Table 1) - and showed lower sexual distress and lower resistance of clitoral arteries, as compared to sedentary women. A significant, inverse association between PA and HSDD was observed (see Table 1). In the same adjusted model, the association between PA and the vascular resistance of clitoral arteries, expressed by clitoral PI, retained statistical significance. Mediation analysis demonstrated that the negative association between PA and HSDD was partly mediated by body image concerns (BUT Global severity index), psychopathological symptoms (MHQ total score) and sexual distress (FSDS-R score). These latter two factors also partly mediated the association between PA and a reduced risk of FGAD, whilst a lower BMI was a full mediator in the relationship between PA and FGAD. Finally, extreme PA was associated with significantly worse scores in several psychosexual parameters (i,e, sexual satisfaction – see Figure 1) and histrionic/hysterical symptoms), even compared to a sedentary lifestyle.

Conclusions

In women with FSD, PA was associated with better sexual function and clitoral vascularization, lower sexual distress and reduced odds of HSDD and FGAD; the benefits of PA on sexuality were mediated by both psychological and organic determinants; excessive PA was related with a poor overall sexual function and with a low sexual satisfaction. Women consulting for FSD may gain benefits from regular PA; however, physicians should remain alert to the downsides of excessive exercise.

Disclosure

Work supported by industry: no.
025 Pathway Enrichment Analysis of Microarray Data from Human Penis of Diabetic and Peyronie's Patients, in Comparison with Diabetic Rat Erectile Dysfunction Models
Authors: Searl T. , Ohlander S. , McVary K. , Podlasek C.
Published: May 2022

Introduction

Erectile dysfunction (ED) is a debilitating medical condition in which current treatments are minimally effective in diabetic patients due to neuropathy of the cavernous nerve, a peripheral nerve that innervates the penis. Loss of innervation causes apoptosis of penile smooth muscle, remodeling of corpora cavernosa (penile erectile tissue) morphology, and ED.

Objective

In this study, microarray and pathway analysis were used to obtain a global understanding of how signaling mechanisms are altered in diabetic patients and animal models as ED develops, in order to identify novel targets for disease management, and points of intervention for clinical therapy development.

Methods

Human corpora cavernosal tissue was obtained from diabetic (n=4) and Peyronie's (control, n=3) patients that were undergoing prosthesis implant to treat ED. Rat tissue was obtained from BB/WOR diabetic (n=5) and diabetes resistant (n=5) rats. RNA was extracted using TRIzol, DNase treated, and purified by Qiagen mini kit. Microarray was performed using the Human Gene 2.0 ST Array. 1) Alterations in patient and diabetic rat pathway signaling were examined using several analytical tools (ShinyGO, Metascape, WebGestalt, STRING) and databases, 2) Strengths/weaknesses of the different pathway analysis tools were compared, and 3) Comparison of human and rat (BB/WOR and Streptozotocin) pathway analysis was performed. Two technical replicates were performed. P value (FDR) < 0.15 was used as threshold for differential expression. FDR<0.05 was considered significant.

Results

Microarray identified 182 differentially expressed protein-coding genes. Pathway analysis revealed similar enrichments with different analytical tools. Down regulated pathways include development, tubular structure, sprouting, cell death, ischemia, angiogenesis, transcription, second messengers, and stem cell differentiation. ED patients, who have diabetes, incur significant loss of normal regulatory processes required for repair and replacement of injured corpora cavernosal tissue. Combined with loss of apoptotic regulatory mechanisms, this results in significant architectural remodeling of the corpora cavernosa, and loss of regenerative capacity in the penis.

Conclusions

Penis from diabetic ED patients lacks capacity for maintenance of corpora cavernosal architecture and regeneration, which are critical points for intervention for therapy development. The analysis of tissue specific gene expression profiles provides a means of understanding drivers of disease and identifying novel pathways for clinical intervention. This first report of microarray and pathway analysis in human corpora cavernosa, is critical for identification of novel pathways pertinent to ED and for validating animal models.

Disclosure

Work supported by industry: no.
027 Recovery of Erectile Dysfunction after Administration of Hydrogen Sulfide Donor Sodium Hydrogen Sulfide and Transplantation Of Adipose-Derived Stem Cells in Rats with Bilateral Cavernous Nerve Injury
Authors: Asker H. , Sezen S.F. , Yilmaz-Oral D. , Turkcan D. , Elçi M.P. , Kirlangic O.F. , Gur S.
Published: May 2022

Introduction

Radical prostatectomy causes nerve injury-related erectile dysfunction (ED), which results in a poor response to phosphodiesterase 5 inhibitors. Hydrogen sulfide (H2S), an endogenous gasotransmitter, is produced by cystathionine-β-synthase (CBS), cystathionine-γ-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase (3-MST) and participates in erectile physiology. Adipose-derived stem cells (ADSCs) represent a promising cell source for cell replacement therapy in several degenerative diseases because of its self-renewal properties and multi-differentiation potential with low immunogenicity.

Objective

The current study was to evaluate the effects of H2S donor, sodium hydrogen sulfide (NaHS), and transplantation of ADSCs per se and their combination treatment on bilateral cavernous nerve injury (BCNI)-induced erectile dysfunction (ED).

Methods

A total of 35 Sprague-Dawley rats were divided into 5 groups, including sham-operated (Sham), BCNI (4-wk), BCNI treated with NaHS (5.6 mg/kg/day, i.p.), BCNI treated with ADSCs (1x106 cells by intracavernosal injection) and BCNI treated with NaHS and ADSCs groups. Rats in the ADSCs treatment groups were subjected to intracavernosal injection after BCNI. Erectile function was evaluated by the ratio of intracavernous pressure (ICP)/mean arterial pressure (MAP) and total ICP. The relaxant and contractile responses of corpus cavernosum (CC) were measured from in vitro studies. Protein expression and localization of nitric oxide synthases (NOS) and H2S synthesis enzymes were analyzed by Western blotting and immunohistochemistry. The smooth muscle/collagen ratio was determined using Masson trichrome staining.

Results

Rats with BCNI displayed significantly reduced ICP/MAP and total ICP (p<0.001 vs controls) when were partially restored by NaHS and ADSCs treatments alone. Interestingly, combined treatment completely enhanced decreased in vivo erectile responses (p<0.001 vs the NC group). Relaxation responses to acetylcholine and electrical field stimulation (EFS) as well as contractile responses to phenylephrine and EFS in the CN group were less than in controls (p< 0.05), which was normalized after all treatments groups. The combined treatment modulated changes of protein expressions and reduced ratio of smooth muscle to collagen in rats with BCNI.

Conclusions

The current data indicated that the combination treatment with NaHS and ADSCs is more successful than monotherapies in reversing BCNI-induced ED. H2S and cell-based therapy most probably may have a synergistic effect on erectile function via controlling molecular regulation and morphological penile alterations, which supports combined treatment for expanding clinical outcomes radical prostatectomy-induced ED.

Disclosure

Work supported by industry: no.
028 Hydrogen Sulfide has a Role as an Endogenous Relaxation Factor in the Rat Prostate
Authors: Shimizu T. , Zou S. , Shimizu S. , Aratake T. , Higashi Y. , Yamamoto M. , Saito M.
Published: May 2022

Introduction

Hydrogen sulfide (H2S) is the third endogenous gasotransmitter besides carbon monoxide and nitric oxide, and has a wide range of physiological functions such as neuromodulation, vasorelaxation and cytoprotection. Although in human prostate cancer cells, NaHS (a H2S donor) treatment was reported to inhibit proliferation and to elevate secretory function, physiological functions of H2S in the prostate tissue had not been investigated yet. Endogenous H2S is biosynthesized from L-cysteine by cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). In addition, 3-mercaptopyruvate sulfurtransferase (MPST) synthesizes H2S from 3-mercaptopyruvate (3MP), which is produced from L-cysteine by cysteine aminotransferase (CAT) (CAT/MPST pathway). Recently, a new pathway for endogenous H2S biosynthesis is reported; D-cysteine is metabolized by D-amino acid oxidase (DAO) to 3MP, which is a substrate for MPST to synthesize H2S.

Objective

We investigated (1) tissue distribution of CBS, CSE, MPST, CAT and DAO, (2) endogenous H2S levels, and (3) effects of NaHS on contractility in the rat prostate.

Methods

Dorsolateral and ventral prostate (PR-D and PR-V), liver and cerebellum (L and C) were prepared from male Wistar rats (300-400 g) sacrificed with an overdose of sodium pentobarbital (80 mg/kg, ip). (1) Tissue distributions of 5 enzymes were investigated by real-time PCR, western blot and immunohistochemistry. L and C were used for positive controls. (2) H2S contents in the prostate tissues were measured by methylene blue method. (3) By using 1 x 5 mm strips of the prostate tissues, effects of NaHS (1 x 10-9 to 3 x 10-4 M) were evaluated on pre-contracted prostate strips by noradrenaline (10-5 M). Prostate strips were pretreated with propranolol (10-6 M) 30 min before the pre-contraction.

Results

(1) CBS, MPST and CAT were detected in the prostate. Expression levels of CBS in the PR-D were lower than those in the PR-V, and the levels of MPST in the PR-D were higher than those in the PR-V. In expression levels of CAT, there was no significant difference between two prostate tissues. On the other hand, CSE or DAO was not detected in these tissues. Immunoreactvities of these enzymes were mainly detected in the prostate glandular epithelium. (2) H2S was detected in the prostate tissues. (3) NaHS dose-dependently induced relaxation of pre-contracted PR-D and PR-V strips. There were no significant differences of the EC50 values or relaxation rate against the pre-contractions between two prostate tissues.

Conclusion

H2S synthesized by CBS- and CAT/MPST-mediated pathways has a role as an endogenous relaxation factor in the rat prostate. Therefore, endogenous H2S might open new avenues of therapeutic interventions for benign prostatic hyperplasia.

Disclosure

Work supported by industry: no.
033 Shaeer's Punch Technique: Trans-Corporeal Peyronie's Plaque Surgery and Penile Prosthesis Implantation
Authors: Shaeer O.
Published: May 2022

Introduction

Penile prosthesis implantation in cases of severe Peyronie's disease may require plaque excision/incision and grafting, that may require mobilization of the neurovascular bundle (NVB) or urethra, posing the risks of penile hyposensitivity or urethral injury, and is time consuming, possibly increasing infection risk.

Objective

Evaluating trans-corporeal debulking of Peyronie's plaques by “Shaeer's Punch Technique”.

Methods

Penile prosthesis implantation and Punch technique (PPI-Punch) was performed for 26 patients. Following corporotomy and dilatation, Peyronie's plaques were punched-out from within the corpora cavernosa using the punch forceps then a penile prosthesis implanted. Comparison to a matching retrospective group of 18 patients operated upon by plaque excision-grafting and penile prosthesis implantation was performed. Outcomes were in terms of straightness of the erect penis, complication, satisfaction with length on a 5-point scale , the International Index of Erectile Function-5 (IIEF), and the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire (EDITS).

Results

Average pre-operative curvature angle was 58.1 ± 11.7 in the Punch group and 58 ± 14.8 in the excision-grafting group, p=0.99. Following surgery, all patients had a straight penis. No tunical perforations, urethral injuries or extrusions were noted. Average additional operative time for Punch technique ranged from 5 to 10 minutes (7.3 ± 1.7), in contrast to the excision-grafting group where plaque surgery duration was 50.8 minutes ± 11.1, an 85% difference, p < 0.0001. Septal plaques in the latter group could not be removed. In the PPI-Punch group, penile sensitivity was preserved in all patients, compared to the excision/grafting group with 7/18 patients reporting hyposthesia of the glans. Infection occurred in 1/26 patients in the PPI-Puch group, compared to 2/18 patients in the excision/grafting group. Satisfaction with length on a 5-point scale was 3.8 ± 0.9 in the punch group, versus 3.1 ± 1.1 in the excision-grafting group, p=0.009..

Conclusions

Shaeer's Punch Technique is a minimally invasive procedure for trans-corporeal excavation of Peyronie's plaques prior to penile prosthesis implantation. There is no need for mobilization of the neurovascular bundle or spongiosum, hence low or no risk for nerve or urethral injury and brief plaque surgery time.

Disclosure

Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Coloplast, BSC, Rigicon).
039 Effect of Retinoid Loaded Hyaluronic Acid Nanomicelle on Vaginal Epithelium in Mouse Menopausal Model
Authors: Park K. , Chung H.S. , Lee H. , Kim T.
Published: May 2022

Objective

This study aimed to develop hyaluronic acid-based retinoic acid-containing stimulation-sensitive vaginal nanoparticles and investigate the effects of newly developed vaginal nanoparticles on the regeneration of vaginal epithelial layers and aquaporin 3 expressions in the menopausal animal model.

Methods

The hyaluronic acid-based retinoic acid-loaded micelle nanoparticles were developed. Female Balb/C mice (8weeks, n=30) were divided into four groups: control, bilateral ovariectomy, HA-C18 vehicle administration group, and HA-C18RA administration group. After 4 weeks of treatment, the mouse vaginal tissue was removed, and the expressions of AQP3 were determined by Western blot and immunofluorescence staining.

Results

Three drug-loaded nanoparticles were synthesized. The content of retinoic acid supported in HA-C18 RA10, HA-C18 RA20, and HA-C18 RA 30 were 3.13%, 2.52%, and 16.67%, respectively, and the retinol acid encapsulation efficiency was 95.57%, 83.92%, and 93.24%, respectively. In the experimental group, serum estrogen levels were significantly reduced compared to the control group (p <0.05), and the vaginal mucosa epithelial layer was also significantly thinned. After 4 weeks of treatment, the vaginal mucosal epithelial layers were increased in the retinoic acid-loaded HAC18 administration group compared to the vehicle group. In addition, the expression of AQP3 was increased in the retinoic acid-carrying nanoparticle administration group.

Conclusions

The newly developed hyaluronic acid-based vaginal nanoparticles containing retinoic acid resulted in the recovery of the vaginal epithelial layers and also showed an increased expression of AQP3 in the vaginal epithelium. These results could contribute to developing functional vaginal lubricants/moisturizers for the treatment of women with vaginal dryness.

Disclosure

Work supported by industry: no.
042 Testosterone Improved the Erectile Dysfunction Induced by Anti-Cancer Agent Doxolubicine in Rats
Authors: Kataoka T. , Sanagawa A. , Hotta Y. , Hibi Y. , Kimura K.
Published: May 2022

Introduction

Many chemotherapeutic agents are administered to cancer patients worldwide. We previously reported at the world meeting on Sexual Medicine 2018 that doxorubicin (DOX) increased the risk of erectile dysfunction (ED) according to our analyses of the US Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) database. We also reported that DOX decreased erectile function in a study using rats. DOX also decreased rat testosterone levels. These studies suggest a need for a new treatment method for ED associated with anticancer drug treatment.

Objective

To investigate the effect of testosterone administration on DOX-induced ED in rats.

Methods

Twelve-week-old male Wistar ST rats were separated into Control, DOX, and DOX+T groups. DOX (3 mg/kg) was intravenously administered on days 1, 8, 15, and 22 in the DOX and DOX+T groups. Testosterone undecanoate (25 mg/kg) was administered to DOX+T rats on day 1. Erectile function was tested using ICP measurements, and endothelial function was tested by assessing isometric tension. Oxidative stress (NADPH oxidase), inflammation (IL-6), and smooth muscle factor (α-SMA, Cavin-1, and Cavin-2) mRNA expression levels were tested using real-time PCR.

Results

After the 4-week observation period, the ICP/MAP ratio in the DOX group (0.32 ± 0.03) was significantly decreased compared to the Control group (0.72 ± 0.05) (P <0.01). The ICP/MAP ratio in the DOX + T group (0.61 ± 0.07) was increased significantly compared to the DOX group (P <0.01). According to isometric tension measurements, reactivity to acetylcholine was significantly lower in the DOX group (35.0 ± 5.1%) than in the control group (77.6 ± 7.9%), whereas reactivity in the DOX + T group (69.8 ± 8.5%) was significantly improved (P <0.05). NADPH oxidase-1 and IL-6 mRNA levels were increased in the DOX group compared to the Control group (P <0.01), and levels were decreased relative to the DOX group in the DOX+T group. α-SMA, Cavin-1, and Cavin-2 mRNA levels were decreased in the DOX group compered to the Control group. These levels were improved in the DOX+T group.

Conclusions

We have demonstrated in rats that androgen replacement therapy may mitigate ED induced by DOX administration. We hypothesize that administration of testosterone improves smooth muscle function and vascular endothelial cell function by suppressing oxidative stress and inflammatory response in the corpus cavernosum, and maintaining normal levels of caveolin-related factors. When androgen deficiency symptoms are observed due to administration of anticancer drugs such as DOX, androgen replacement therapy is expected to be one viable treatment option. Our study sheds light on possible treatment strategies for improving quality of life for cancer survivors.

Disclosure

Work supported by industry: no.
049 Factors Associated with Premature Ejaculation Might Influence the Female Sexual Function
Authors: Gao J. , Zhang Y. , Li H. , Gao P. , Zhang X.
Published: May 2022

Introduction

Premature ejaculation (PE) is a multifactorial disease with complicated etiology, and has detrimental effects on the female partners’ sexual function. However, our country are lack of studies on the relationship between the factors related to PE and female sexual dysfunction (FSD) presently.

Objective

To investigate factors associated with premature ejaculation which might influence the female sexual function

Methods

From January 2018 to January 2019, an observational and cross-sectional field survey was conducted in the first affiliated hospital of Anhui medical university in Anhui province of China. A total of 761 couples that met our criteria made up our study population. Subjects were divided into two groups, including group with PE complaint and group without PE complaint. The survey was conducted by a professional Andrology doctor through the face-to-face guidance. All subjects were required to complete a questionnaire, including demographic information (e.g, age, education level and employment status), duration of PE and medical and sexual histories (e.g, Intravaginal ejaculation latency time [IELT], sexual desire,sexual frequency per month). In addition, we also investigated men's characters, incidence of men's negative psychology burden and different attitude toward to PE problem. Female partner of the patient were also evaluated by the Chinese vision of female sexual function index (FSFI), which included six dimensions (sexual desire, arousal, lubrication, orgasm, satisfaction and pain).

Results

The A total of 761 couples’ information were collected in this study, including 445 couples with PE complaint and 316 without PE complaint. In PE complaint group, the mean ages of men in PE and without PE complaint were 6.29 ± 9.87 years and 34.26 ± 8.83 years. Female partners in group with PE complaint reported lower total and sub-domain scores of FSFI, and approximately 65% of them were diagnosed with FSD (vs. control group: 31.96%). Duration of PE more than 14 months, self-estimated IELT less than 2 minutes, negative attitude toward PE problem, and men's introversion character and depression were the risk factors of FSD in PE complaint group.

Conclusions

In summary, PE and related factors are closely related to FSD, which implied that the focus of treatment for PE should transmit from men to the both sides and intensely emphasize the combination between mental behavioral therapy combined and drug therapy.

Disclosure

Work supported by industry: no.
062 Basic Research to Determine Normal Levels of Androgens (Testosterone, Free Testosterone, DHEA-S) in Japanese Middle-Aged Women
Authors: Sekiguchi Y. , Kumamoto Y. , Nakamura R. , Minami K. , Fujii M.
Published: May 2022

Introduction

We surveyed the age distribution (30-80s) of blood androgen levels (testosterone, free testosterone, DHEA-S) in healthy Japanese women at the testing center currently used by general clinicians measure by method for creating androgen reference values ​​of Japanese women. In addition, the major female hormones estradiol, the gonadotropins LH and FSH, and IGF-1, which reflected growth hormone were measured at the same time.

Objective & Methods

We collected the bloods of 160 healthy volunteer women who visited the Women's Clinic LUNA JAPAN, Sapporo Toho Hospital, and Caress Sapporo Clock Tower Memorial Hospital between Oct. 2020 and Feb.2021 and measured testosterone, free testosterone, DHEA-S, estradiol, LH, FSH and IGF-1. The measurement was outsourced to the Biochemical Blood Testing Department of LSI Medience Corporation, and the androgen level was collectively measured by the CLIA method. The survey was conducted with the approval of the medical corporation LEADING GIERLS Ethics Committee and with the written consent of all patients.

Results

The average age of volunteer women was 45, the median was 41, the maximum was 87, and the minimum was 20. The number distribution was 16 in their 20’s, 52 in their 30’s, 43 in their 40’s, 17 in their 50’s, 15 in their 60’s, 10 in their 70’s, and 7 in their 80’s.

Table 1 shows the mean ± standard deviation of testosterone, free testosterone, DHEA-S, LH, FSH, estradiol, and IGF-1 for each age group. (Table 1)

Conclusions

In this group, regarding male hormones, DHEA and free testosterone decreased with age. In addition, IGF-1 also decreased with age. On the other hand, with regard to testosterone, the level of decrease is smaller than those of the other two androgens. Regarding estradiol, it decreased rapidly after menopause, but it is maintained at 10 to 20 pg / ml even after menopause. Healthy middle-aged women in Japan may maintain the lowest levels of testosterone and estradiol by eating a diet rich in sex hormone-like flavonoids such as soy isoflavones. However, the sexual function of healthy middle-aged and elderly people in Japan is said to be lower in both men and women than in Europe and the United States, and further research is needed on the relationship between Japanese sex hormone levels and sexual function and culture.

Disclosure

Work supported by industry: no.
Noise reduction mechanisms for insert-type serrations of the NACA-0012 airfoil
Authors: Hu Ya-Sen , Wan Zhen-Hua , Ye Chuang-Chao , Sun De-Jun , Lu Xi-Yun
Published: May 2022

Trailing-edge serrations inspired by owls are capable of reducing broadband noise. In this study, the wall-resolved large-eddy simulations (LES) are carried out on the flow over NACA-0012 airfoil with additional serrated trailing edges. The computations are conducted with the high-order flux reconstruction method on unstructured meshes. Three kinds of serrations with different lengths are studied and compared with the straight trailing-edge case, and all three types of serration achieved a certain degree of noise reduction. Presently, the medium-length serration achieves the best noise reduction effect. The maximum decrease of overall sound pressure level is approximately 2.4 dB, implying that the length of serration has a substantial impact on the noise reduction effect. The serration has no significant effect on the upstream turbulence statistics, but it changes the flow structure near the serration, such as inducing side vortex pairs attached to the serration edges. Moreover, dynamic mode decomposition shows that the pressure structures vary with the serration length. For the most unstable hydrodynamic wave, the spanwise coherence of the mode structure of pressure in the upstream boundary layer is weakened. In addition, serrations can redistribute the dipole sources on the surfaces of airfoil and serrations. The destructive interference is enhanced to some extent, which is favourable for noise reduction. In contrast with LES simulations, the pure dipole analysis shows that the longest serration case seems to be the best. Furthermore, a recently developed noise theory is used to evaluate the influence of serrations on the flow noise sources qualitatively and quantitatively. It is found that the serrations can mitigate noise source intensity near the serration edges but increase the source intensity in the near wake. The combined effect of serration on the dipole source and flow noise source determines the overall noise reduction effect. To conclude, destructive interference plays a primary role in suppressing noise radiation by serrated trailing edges, and the dual effect of flow noise sources should be considered in future serration designs. As the influence of turbulence structure will make it more difficult to find the optimal serration parameters, the position of high-fidelity simulation will become increasingly important.
SETTLED PRACTICE IN STATUTORY INTERPRETATION
Authors: Bailey Diggory
Published: May 2022

What use (if any) may be made of settled practice in statutory interpretation and what are the potential justifications for its use? Debate about the use of settled practice is often framed in terms of a tension between legal certainty, on the one hand, and legal correctness in giving effect to Parliament's will, on the other. That account presents a false choice. This article explores the use of settled practice and argues that it has a legitimate role to play in statutory interpretation and one that is consistent with the prevailing approach of the courts to statutory interpretation.
Akzeptanz- und Commitment-Therapie (ACT)
Authors: Eifert Georg H.
Published: May 2022

Die Akzeptanz- und Commitment-Therapie (ACT) ist ein transdiagnostischer kognitiv-verhaltenstherapeutischer Ansatz, der darauf abzielt, Menschen zu vermitteln, emotionalen Problemen mit Achtsamkeit und Mitgefühl offen zu begegnen und gleichzeitig in ihrem Leben das zu verfolgen, was ihnen wirklich am Herzen liegt. Die Neubearbeitung des Bandes liefert eine Einführung in die Grundlagen und Methoden der ACT und stellt störungsübergreifende therapeutische Strategien praxisnah dar.
In der ACT geht es nicht primär um die Beseitigung und Kontrolle von Symptomen, sondern darum, eine größere psychologische Flexibilität durch das Lernen von achtsamer Akzeptanz zu entwickeln. Anhand zahlreicher Beispiele beschreibt der Band, wie Klientinnen und Klienten lernen können, mit mehr Freundlichkeit auf ihr ungewolltes inneres Erleben zu reagieren, sanft mit ihren Gefühls- und Gedankenbarrieren umzugehen sowie den Fokus auf die Verfolgung von Lebenszielen zu konzentrieren, die bisher oft dem Management von Ängsten, Sorgen, Depressionen und anderen Belastungen zum Opfer gefallen sind. Dazu werden zahlreiche erfahrungsbezogene Übungen, Metaphern, Achtsamkeitstechniken und Methoden der Verhaltensaktivierung vorgestellt. Die Neuauflage des Bandes informiert über aktuelle Entwicklungen der ACT: So ist in den letzten Jahren die Evidenzbasis der ACT durch zahlreiche Studien enorm angewachsen, das Verständnis der Therapieprozesse hat sich insbesondere in Bezug auf die Beobachterperspektive vertieft und der therapeutische Fokus hat sich durch ein stärkeres Betonen des Beobachtens schwieriger Erlebensinhalte aus der Beobachterperspektive und durch die Integration von Techniken zur Förderung von Selbstmitgefühl erweitert.
COVID-19 Prevention – Global Research Study of Relevance to Psychology and Health
Authors: Romano John L. , Israelashvili Jacob , Becker Martin Swanbrow , Israelashvili Moshe
Published: May 2022

Abstract. Despite advances in COVID-19 vaccine development, global immunization has proceeded slowly, with low-income countries being disadvantaged in the distribution of vaccines ( York, 2020 ). Hence, a large portion of the global population will remain unprotected against the virus unless they strictly keep up with the prevention measures. To support the UN Sustainable Goal 3 and related targets of improving prevention efforts to promote good health and well-being, this paper shares participants’ adherence to recommended prevention behaviors and their relationship to demographic characteristics, personal health beliefs, and well-being across a large, nonrandomized sample from over 60 countries. The findings indicate more variability in adherence to behaviors within countries than between them, with women and those with more education and subjective socioeconomic status being more compliant with prevention recommendations. Positive feelings toward one’s ability to stay healthy impacted behavior more than fear of contracting the disease. Implications for the importance of prevention science to further positive behavior change supporting the UN Sustainable Goal of promoting health and well-being are highlighted.
Analyzing the Ambiguity of the Remanent‐Magnetization Direction Separated Into Induced and Remanent Magnetic Sources
Authors: Gonzalez Shayane P. , Barbosa Valéria C. F. , Oliveira Vanderlei C.
Published: May 2022

We developed a new ambiguity analysis method to investigate the remanence of a uniformly magnetized source. We wrote the unit vector of the total‐magnetization direction as the weighted sum of the unit vectors of the induced‐ and remanent‐magnetization directions. The unit vectors of the induced‐ and remanent‐magnetization directions are weighted, respectively, by the ratio between the induced and total‐magnetization intensities (λ), and by the multiplication of λ by the Koenigsberger ratio . We obtained analytical estimators for and the remanent magnetic inclination Ir and declination Dr. We constructed a family of ambiguity curves of , , and for a fixed total‐magnetization direction and for λ value. We estimated the total magnetic inclination It and declination Dt via the equivalent‐layer technique constrained by an all‐positive magnetic‐moment distribution. We also used some total‐magnetization directions associated with prespecified data‐residual errors. We performed a systematic search for both It and Dt to obtain a discrete data‐residual map on the plane It × Dt. We picked some It and Dt from the data‐residual map associated with a percent of data‐residual error and created some families of ambiguity curves of Ir, Dr, and λ versus . These ambiguity curves are quickly built up because we inverted the data only once. Tests with synthetic and field data from the Goiás Alkaline Province, Brazil, illustrated a wider perspective of the relationships between the remanent‐magnetization direction and for different data‐residual errors.
Three Types of Typhoon‐Induced Upwellings Enhance Coastal Algal Blooms: A Case Study
Authors: Li Yuxuan , Yang Dezhou , Xu Lingjing , Gao Guandong , He Zhiwei , Cui Xuan , Jiang Wenxin , Feng Xingru , Yin Baoshu
Published: May 2022

Satellite data show that typhoon Chan‐hom did trigger an algal bloom several days after passing by the East China Sea. To investigate dynamic connections between this enhanced chlorophyll‐a and phosphate‐rich Kuroshio subsurface water (KSSW), we set up a fine‐resolution coupled physical‐biological model, which effectively reproduced the oceanic conditions during this typhoon. Furthermore, we released a passive tracer along a zonal transect northeast of Taiwan. The modeled surface tracer variations along the coast of Zhejiang agreed very well with satellite data and chlorophyll‐a changes in the biological model. The lowest structural similarity index between chlorophyll‐a and KSSW was 0.77. Model results along a coastal section imply that typhoon Chan‐hom induced additional upwellings and enhanced vertical mixing, leading to more KSSW outcropping. Through horizontal dynamic diagnostic and vertical velocity decomposition, we distinguished three types of dynamical mechanisms for the upward motions. At first, the linear wind Ekman effect existed around the coastal areas and led to intense Ekman pumping. Second, a pronounced nonlinear effect led to upwellings, and spectrum analysis revealed that this nonlinearity consisted of high‐frequency near‐inertial waves and low‐frequency coastal shelf waves. At last, an eddy field remained after the typhoon, continuously supplying nutrients upward to the surface layer by eddy‐induced Ekman pumping. This study reveals that these mechanisms may be general on the continental shelf, where typhoons can pump phosphate‐rich bottom water into the upper layer and enhance primary productivity there. The results also prove typhoon‐induced nonlinear wave motions on the continental shelf contribute to the outcrop of nutrients.
Magnons and magnetic fluctuations in atomically thin MnBi2Te4
Authors: Lujan David , Choe Jeongheon , Rodriguez-Vega Martin , Ye Zhipeng , Leonardo Aritz , Nunley T. Nathan , Chang Liang-Juan , Lee Shang-Fan , Yan Jiaqiang , Fiete Gregory A. , He Rui , Li Xiaoqin
Published: May 2022

Electron band topology is combined with intrinsic magnetic orders in MnBi2Te4, leading to novel quantum phases. Here we investigate collective spin excitations (i.e. magnons) and spin fluctuations in atomically thin MnBi2Te4 flakes using Raman spectroscopy. In a two-septuple layer with non-trivial topology, magnon characteristics evolve as an external magnetic field tunes the ground state through three ordered phases: antiferromagnet, canted antiferromagnet, and ferromagnet. The Raman selection rules are determined by both the crystal symmetry and magnetic order while the magnon energy is determined by different interaction terms. Using non-interacting spin-wave theory, we extract the spin-wave gap at zero magnetic field, an anisotropy energy, and interlayer exchange in bilayers. We also find magnetic fluctuations increase with reduced thickness, which may contribute to a less robust magnetic order in single layers.