bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbon Dots in Bioimaging, Biosensing and Therapeutics: A Comprehensive Review
Authors: Wang Boyang , Cai Huijuan , Waterhouse Geoffrey I. N. , Qu Xiaoli , Yang Bai , Lu Siyu
Published: May 2022

Carbon dots (CDs), comprising crystalline graphitized carbon cores and polymer surface groups, are currently attracting a lot of interest in biological fields owing to their fluorescent properties, high photostability, biocompatibility and low toxicity. In addition, the easy preparation and functionalization of CDs stimulate the development of CDs‐based composite materials with specific functions. Presently, the biological applications of CDs are growing at a remarkable speed, justifying the need for up‐to‐date review articles that capture recent progress in this blossoming field. In this review, breakthroughs in the synthesis, modification, optical properties, toxicology and biocatalytic platforms of CDs are described. Further, recent research related to bioimaging, biosensing, drug delivery, antibacterial, anticancer (photothermal therapy, photodynamic therapy and synergistic therapy) and antiviral therapies involving CDs are discussed in detail. Finally, a perspective on the prospects and challenges of CDs in the fields of biomedicine and biotechnology is provided.
Inositol hexakisphosphate primes syndapin I/PACSIN 1 activation in endocytosis
Authors: Shi Yue , Zhao Kaixuan , Yang Guang , Yu Jia , Li Yuxin , Kessels Michael M. , Yu Lina , Qualmann Britta , Berggren Per-Olof , Yang Shao-Nian
Published: May 2022

Endocytosis is controlled by a well-orchestrated molecular machinery, where the individual players as well as their precise interactions are not fully understood. We now show that syndapin I/PACSIN 1 is expressed in pancreatic β cells and that its knockdown abrogates β cell endocytosis leading to disturbed plasma membrane protein homeostasis, as exemplified by an elevated density of L-type Ca2+ channels. Intriguingly, inositol hexakisphosphate (InsP6) activates casein kinase 2 (CK2) that phosphorylates syndapin I/PACSIN 1, thereby promoting interactions between syndapin I/PACSIN 1 and neural Wiskott–Aldrich syndrome protein (N-WASP) and driving β cell endocytosis. Dominant-negative interference with endogenous syndapin I/PACSIN 1 protein complexes, by overexpression of the syndapin I/PACSIN 1 SH3 domain, decreases InsP6-stimulated endocytosis. InsP6 thus promotes syndapin I/PACSIN 1 priming by CK2-dependent phosphorylation, which endows the syndapin I/PACSIN 1 SH3 domain with the capability to interact with the endocytic machinery and thereby initiate endocytosis, as exemplified in β cells.
Predictive Value of Plasma Copeptin Level in Children with Acute Heart Failure
Authors: El Amrousy Doaa , Abdelhai Dina , Nassar Mohammed
Published: May 2022

We investigated the ability of copeptin level to predict adverse outcome in pediatric heart failure (HF) and correlated copeptin level with various clinical and echocardiographic data. This cohort study was carried out on forty children with clinical picture of acute HF as the patient group and forty healthy children of matched age and sex as the control group. Echocardiographic examination and plasma copeptin level were performed for all included children at admission. Patients were followed up for 6 months for mortality or readmission. Plasma copeptin level was significantly higher in the patient group (16.2 ± 5) pmol/L compared to the control group (4.1 ± 2.3) pmol/L, P ˂0.001. Moreover, copeptin level was positively correlated with Ross classification, being the highest in patients with class IV (19.6 ± 3.9) pmol/L compared to those with class III (15.2 ± 4) pmol/L and class II (10.4 ± 1.5) pmol/L. Copeptin levels were significantly higher in patients with bad prognosis (21.2 ± 4.1) pmol/L compared to those with good prognosis (14.5 ± 4.1) pmol/L, P ˂0.001. Copeptin level had a significant positive correlation with age, heart rate, respiratory rate, and ROSS classification. On the contrary, copeptin level had a significant negative correlation with left ventricular fraction shortening and diastolic function. Copeptin at cut-off value of ≥ 19.5 pmol/L yielded a sensitivity of 75% and a specificity of 93% to predict adverse outcome in children with HF. Plasma copeptin level has a good prognostic value to predict adverse outcome in pediatric heart failure. Moreover, copeptin correlate well with the severity of pediatric HF.
Posterior pharyngeal wall augmentation in post-adenoidectomy velopharyngeal insufficiency
Authors: Amer Ayman , Saqr Anas Magdy , Zayed Ahmed Mohamed , El-Kotb Mohamed , Elsobki Ahmed
Published: May 2022

Purpose

To assess the efficacy of posterior pharyngeal wall augmentation using septal or conchal cartilages with other bulks—according to the persistent gap and the individual anatomy of each patient—in improving velopharyngeal function in patients who acquired persistent velopharyngeal insufficiency (VPI) post-adenoidectomy.

Methods

Observational descriptive prospective case series of 24 patients (their ages ranged between 3 and 26 years) who developed persistent VPI post-adenoidectomy (more than 3 months) although they had normal speech resonance before adenoidectomy.

Results

The present study demonstrated that statistically significant improvement in auditory perceptual assessment (APA) was found regarding all obligatory speech disorders and unintelligibility of speech. Significant improvement was observed in the degree of velar mobility, size of the persistent gap, and the gap distance between velum and posterior pharyngeal wall at rest and during phonation in post-operative evaluation versus pre-operative. A significant change was observed in the closure pattern of the velopharyngeal port (VPP) as all patients turned to coronal closure.

Conclusions

Posterior pharyngeal wall augmentation could be used in VPI post-adenoidectomy up to 7 mm and lead to better speech outcomes. Also, it revealed that using conchal and/or septal cartilage as a graft regardless of the patient’s age is a safe procedure.
Deregulation of complement components C4A and CSMD1 peripheral expression in first-episode psychosis and links to cognitive ability
Authors: Hatzimanolis Alex , Foteli Stefania , Stefanatou Pentagiotissa , Ntigrintaki Angeliki-Aikaterini , Ralli Irene , Kollias Konstantinos , Nikolaou Chrysoula , Gazouli Maria , Stefanis Nikos C.
Published: May 2022

Up-regulation of the complement component 4A (C4A) in the brain has been associated with excessive synaptic pruning and increased schizophrenia (SZ) susceptibility. Over-expression of C4A has been observed in SZ postmortem brain tissue, and the gene encoding for a protein inhibitor of C4A activity, CUB and Sushi multiple domains 1 (CSMD1) gene, has been implicated in SZ risk and cognitive ability. Herein, we examined C4A and CSMD1 mRNA expression in peripheral blood from antipsychotic-naive individuals with first-episode psychosis (FEP; n = 73) and mentally healthy volunteers (n = 48). Imputed C4 locus structural alleles and C4A serum protein levels were investigated. Associations with symptom severity and cognitive domains performance were explored. A significant decrease in CSMD1 expression levels was noted among FEP patients compared to healthy volunteers, further indicating a positive correlation between C4A and CSMD1 mRNA levels in healthy volunteers but not in FEP cases. In addition, C4 copy number variants previously associated with SZ risk correlated with higher C4A mRNA levels in FEP cases, which confirms the regulatory effect of C4 structural variants on gene expression. Evidence also emerged for markedly elevated C4A serum concentrations in FEP cases. Within the FEP patient group, higher C4A mRNA levels correlated with more severe general psychopathology symptoms and lower CSMD1 mRNA levels predicted worse working memory performance. Overall, these findings suggest C4A complement pathway perturbations in individuals with FEP and corroborate the involvement of CSMD1 in prefrontal-mediated cognitive functioning.
Age-specific effects of childhood body mass index on multiple sclerosis risk
Authors: Hone Luke , Jacobs Benjamin M. , Marshall Charles , Giovannoni Gavin , Noyce Alastair , Dobson Ruth
Published: May 2022

Objective

Higher body mass index (BMI) during early life is thought to be a causal risk factor for multiple sclerosis (MS). We used longitudinal Mendelian randomisation (MR) to determine whether there is a critical window during which BMI influences MS risk.

Methods

Summary statistics for childhood BMI (n ~ 28,000 children) and for MS susceptibility were obtained from recent large genome-wide association studies (GWAS) (n = 14,802 MS, 26,703 controls). We generated exposure instruments for BMI during four non-overlapping age epochs (< 3 months, 3 months–1.5 years, 2–5 years, and 7–8 years) and performed MR using the inverse variance weighted method with standard sensitivity analyses. Multivariable MR was used to account for effects mediated via later-life BMI.

Results

For all age epochs other than birth, genetically determined higher BMI was associated with an increased liability to MS: Birth [Odds Ratio (OR) 0.81, 95% Confidence Interval (CI) 0.50–1.31, Number of Single-Nucleotide Polymorphisms (NSNPs) = 7, p = 0.39], Infancy (OR 1.18, 95% CI 1.04–1.33, NSNPs = 18, p = 0.01), Early childhood (OR 1.31, 95% CI 1.03–1.66, NSNPs = 4, p = 0.03), Later childhood (OR 1.34, 95% CI 1.08–1.66, NSNPs = 4, p = 0.01). Multivariable MR suggested that these effects may be mediated by effects on adult BMI.

Conclusion

We provide evidence using MR that genetically determined higher BMI during early life is associated with increased MS risk. This effect may be driven by shared genetic architecture with later-life BMI.
Prospective clinical study for claudication after endovascular aneurysm repair involving hypogastric artery embolization
Authors: Suzuki Shunya , Akamatsu Daijirou , Goto Hitoshi , Kakihana Takaaki , Sugawara Hirofumi , Tsuchida Ken , Yoshida Yoshitaro , Umetsu Michihisa , Kamei Takashi , Unno Michiaki
Published: May 2022

Purpose

This prospective study aimed to assess the prognosis of claudication after endovascular aneurysm repair (EVAR) involving hypogastric artery (HGA) embolization.

Methods

Patients who were scheduled to undergo EVAR involving bilateral or unilateral HGA embolization (BHE or UHE, respectively) between May 2017 and January 2019 were included in this study. Patients underwent the walk test preoperatively, one week postoperatively, and monthly thereafter for six months. The presence of claudication and the maximum walking distance (MWD) were recorded. A near-infrared spectroscopy monitor was placed on the buttocks, and the recovery time (RT) was determined. A walking impairment questionnaire (WIQ) was completed to determine subjective symptoms.

Results

Of the 13 patients who completed the protocol, 12 experienced claudication in the 6-min walk test. The MWD was significantly lower at one week postoperatively than preoperatively. The claudication prevalence was significantly higher at five and six months postoperatively after BHE than after UHE. BHE was associated with longer RTs and lower WIQ scores than UHE.

Conclusions

We noted a trend in adverse effects on the gluteal circulation and subjective symptoms ameliorating within six months postoperatively, with more effects being associated with BHE than with UHE. These findings should be used to make decisions concerning management strategies for HGA reconstruction.
Bearing witness through pandemic borders and film: convergent media, mobility and Windrush Betrayal
Authors: Mains Susan P.
Published: May 2022

This paper examines the role of convergent media and the film, Windrush Betrayal (2020), in representing and challenging borders, mobilities and UK government immigration policies. Print and digital news provide important contexts for exploring media geographies of current events. Documentary film is also a provocative medium for investigative analyses that go beyond more general headline reporting. This study seeks to expand on earlier studies by examining how complementary mediums such as digital news media and film can respond to each other and become part of dynamic transnational conversations around place and identity. Media formats have been pushed to incorporate new settings and styles as Covid-19 restrictions have been implemented and alternative approaches utilised in media production. Adopting innovative techniques for filming in response to pandemic restrictions, Windrush Betrayal illustrates the ongoing impacts of immigration policies on Caribbean Diaspora populations in the UK. This paper provides a timely opportunity to tease out the ways in which changes in government immigration policies, media work practices and the production of migration narratives can highlight hidden geographical stories and marginalised voices.
Towards a multimethod approach for film geography: a case study of Los Angeles’ Nate Starkman Building
Authors: Zschocke Julian
Published: May 2022

This paper introduces a multi-method approach for Film Geography that intertwines spatial analysis, cartography, textual analysis, discourse analysis, field research, and expert interviews. Historically, film studies has focused on textual analysis whereas geography has emphasized the material aspect of space through field research. However, if cinema is a double ontology of image and industry film geographers must engage with both to make a meaningful contribution to the complex interwoven discourses on cinematic space. This case study focuses on the Nate Starkman Building, a frequently filmed warehouse located in the Arts District of Los Angeles, California. This case study acts as an example of how a multi-method approach can be applied to on-location filming. I demonstrate how the methods can be combined to contextualize and pinpoint previously invisible interactions between the on-screen appearance and the cultural politics of film production and placemaking. I argue that film-geographic analysis allows for a more in-depth look into the Hollywood-machinery that has led to these unique socio-economic structures.
Antisemitismus seit 9/11: Erscheinungsformen, Hintergründe, Dynamiken
Authors: Salzborn Samuel
Published: May 2022

Der Beitrag analysiert die Entwicklung des Antisemitismus seit den Terroranschlägen von 9/11 und ordnet die
Entwicklung in ihre historischen Entstehungszusammenhänge ein.
Intensivierung, Privatisierung, Relativierung: Muster religiösen Wandels bei Geflüchteten
Authors: Nagel Alexander-Kenneth
Published: May 2022

In der Migrationsforschung wird Religion, soweit sie überhaupt in den Blick kommt, häufig unter dem Blickwinkel von Intensivierung oder Radikalisierung betrachtet. Andere Optionen religiösen Wandels wie die Abkehr von religiösen Prägungen oder die Verlagerung religiöser Praxis ins Private wurden hingegen bislang kaum systematisch erschlossen. Vor dem Hintergrund bestehender Forschung zu Migration, religiöser Transformation und Konfessionslosigkeit rückt der Beitrag Privatisierung und Relativierung als gleichrangige Varianten religiöser Veränderung in der Diaspora in den Fokus. Anhand einer qualitativen Inhaltsanalyse von 102 Interviews mit Geflüchteten unterschiedlicher Religionszugehörigkeit und Herkunft werden verschiedene Aspekte und Mechanismen der drei Grundmuster religiösen Wandels (Intensivierung, Privatisierung und Relativierung) aufgezeigt. Dabei wird deutlich, dass „erfahrene“ religiöse Minderheiten wie Yezid:innen angesichts der neu gewonnenen Religionsfreiheit zu einer nachholenden Intensivierung neigen, während Muslim:innen angesichts islamfeindlicher Stimmungen zu religiöser Privatisierung tendieren. Zugleich zeichnet sich ab, dass Frauen und jüngere Menschen eher zu religiöser Relativierung neigen. Insgesamt wird deutlich, dass viele Geflüchtete sich eine intensivere religiöse Betätigung zwar wünschen, aber durch logistische Herausforderungen (Mangel an muttersprachlichen Gemeinden, Herausforderungen des Alltags) davon abgehalten werden.
nSARS-CoV-2 and COVID-19 Pandemic: From Emergence to Vaccination
Authors: Shahid Imran
Published: May 2022

Since its first emergence in Wuhan, China, the novel severe acute respiratory syndrome coronavirus-2 (nSARS-CoV-2)-associated coronavirus disease 2019 (COVID-19) has alarmingly disrupted the world’s healthcare systems and evolved as a major public health threat around the globe. Despite the advent and emergency use listing (EUL) of mRNA- and adenovirus-based vaccines to prevent the further transmission of SARS-CoV-2 infection, the pandemic burden is still significant worldwide as new cases are being reported daily. It is the first time in vaccine history that vaccines against SARS-CoV-2 have been rapidly designed, developed, and clinically evaluated and surprisingly, they have worked better than clinical trial data predicted. However, this EUL of vaccines prior to full approvals stems from the perception of inadequate testing and experience with benefit–risk balance. Similarly, the emergence of superspreader SARS-CoV-2 mutant virus strains at the end of 2020 has also raised concerns about the efficacies of approved vaccines in real-world clinical scenarios. The inconclusive, murky, and anecdotal reports about vaccine hesitancy, antibody-dependent enhancement of disease risk in vaccine injectors, and certain severe adverse events have also frightened a large segment of the world’s population, preventing them from receiving the vaccine. This review presents an overview of the remarkable efforts rendered by different vaccine producers to combat the pandemic, explains the challenges of vaccine safety and efficacies against SARS-CoV-2 variants of concern, and explores their potential roles in eradicating the COVID-19 pandemic.
077 Gynecologic Cancer not a Negative Predictor of Seeking-Help Motivation for Female Sexual Dysfunction: Structural Equation Modeling
Authors: Tao RR , Chou YJ
Published: May 2022

Introduction

Few large-scale studies have focused on the effect of gynecologic cancer compared with other biopsychosocial factors on willingness to seek treatment among women with sexual dysfunction.

Objective

To identify predictors of the intention to treat female sexual dysfunction (FSD) among sociodemographic factors, physiologic factors, psychologic factors, gynecologic cancer, and health belief model (HBM).

Methods

This study was a cross-sectional, hospital-based survey conducted from October 2013 to September 2019. Participants included healthy women and gynecologic cancer survivors who were aged 20 years or older and had been in a monogamous relationship for at least 12 months. They were enrolled in the gynecologic departments in southern Taiwan. Those who met DSM-5 criteria of sexual dysfunction were analyzed with Structural equation modeling.

Results

448 of 643 women met DSM-5 sexual dysfunction. The mean age was 42.0 years (range: 21.8 to 68.1 years). Fifty-eight percent of women reported sexual treatment intention. The model fit was good: χ2 = 367.42, P < .001, χ2/df = 2.83, CFI = 0.933, TLI = 0.921, and RMSEA = 0.066 (95%CI: 0.058−0.074). Perceived severity, perceived benefits, perceived barriers, cue to action, self-efficacy and university education at least significantly predicted treatment intention. There were no significant differences in treatment intention regarding age and gynecologic cancer. Self-efficacy was the strongest predictor, which directly affected treatment intention (P = .001). Perceived severity was the second strongest predictor, mainly affecting treatment intention indirectly (P = .01). Perceived barriers was the third strongest predictor (P = .001), indirectly and negatively affected treatment intention.

Conclusions

Five out of six HBM factors and university education at least could significantly predict the intention to treat FSD. Gynecologic cancer was not a significant predictor.

Disclosure

Work supported by industry: no.
079 Pleasurable Ways To Spontaneously Expulse Distal Ureteral Stones: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Kloping YP , Hidayatullah F , Rahman ZA , Chung E , Hakim L
Published: May 2022

Introduction

Numerous non-invasive ways of managing distal ureteral stones have been recommended, such as administering treatments to inhibit receptors responsible for ureteral tone and peristaltic movement frequency. Nitric oxide, which is released during penile erection, causes smooth muscle relaxation by inhibiting the non-adrenergic non-cholinergic (NANC) nerves of the distal ureter and ureterovesical junction. Bladder neck contraction followed by relaxation, occurring during orgasm and ejaculation could also facilitate the passage of stones. However, the exact role of sexual activities involving these mechanisms has yet to be established.

Objective

This review aimed to evaluate the efficacy of sexual acts, including sexual intercourse and masturbation, to promote distal ureteral stones expulsion based on the findings of relevant randomized controlled trials (RCT)s.

Methods

A systematic search adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was performed in the Embase, Scopus, and Medline databases in July 2021. The initial search generated 50 articles. The articles were screened based on the eligibility criteria. Their quality was assessed using the Cochrane Risk of Bias (RoB) tool 2 for randomized trials. Measured outcomes included stone expulsion rate, expulsion time, analgesic injections frequency, and the need for a ureteroscopic (URS) lithotripsy. A fixed effects model was used for analyzing parameters with homogeneity among studies, whereas a random effects model was used for heterogenous studies. The odds ratio (OR) and mean difference (MD) among studies were displayed in forest plots using the Review Manager software version 5.4.1.

Results

A total of five RCTs with an overall low risk of bias, consisting of 406 subjects, were included in this review. Four studies evaluated sexual intercourse and one study evaluated masturbation. Both interventions were instructed to be performed for three to four times a week. The stone expulsion rate was higher in the sexual activity group compared to the control group at the two-week follow-up (OR 5.77 95%CI 3.70 - 9.01, p<0.00001) and four-week follow-up (OR 4.44 95%CI 2.73 - 7.23, p<0.00001) with a significantly lower expulsion time of the sexual activity group (MD -3.79 95% CI -6.38 - -1.20, p=0.004). The number of subjects requiring additional analgesic injections (MD -0.62 95% CI -1.03 - -0.21, p=0.003) and URS lithotripsy (OR 0.22 95% CI 0.13 – 0.37, p<0.00001) was also lower in the sexual activity group compared to the control group.

Conclusions

Performing sexual intercourse or masturbation for three to four times a week is beneficial for promoting spontaneous expulsion of distal ureteral stones. It could also reduce the use of analgesic injections and the need for a URS lithotripsy.
111 Primary Organic vs. Primary Psychogenic Erectile Dysfunction: a Cross-Sectional Study on Patient's Characteristics and Sexual Function from a Tertiary Referral Center
Authors: Pozzi E , Fallara G , Candela L , Costa A , Boeri L , Capogrosso P , Schifano N , Cignoli D , Colandrea G , Raffo M , Cornelius J , Mattei A , Montorsi F , Salonia A
Published: May 2022

Introduction

Erectile dysfunction (ED) is defined according to three different aetiological groups: organic, psychogenic and mixed. As most cases have mixed aetiology, EAU guidelines suggests using the terms "primary organic" or "primary psychogenic".

Objectives

We aimed to stratify a homogenous cohort of patients seeking medical help for ED for the first time according to the newly suggested classification, and to compare sexual function in the two groups.

Methods

Complete sociodemographic and clinical data from 2009 consecutive patients were analysed. All patients completed the International Index of Erectile Function (IIEF) at baseline. According to the presence of risk factors for ED (e.g., age≥ 40 yr, obesity, history of hypogonadism, hypertriglyceridemia and/or hypercholesterolemia, hypertension, cardio-vascular, peripheral vascular, neurological, chronic kidney and hepatic disease, diabetes type 1/2, COPD, hyperthyroidism, low D vitamin, use of recreational drugs, thiazides, b-blockers, antipsychotics, SSRIs and depression or anxiety under medical therapy), patients were categorised into primary organic (≥1 risk factor) or primary psychogenic (0 risk factors) ED. Linear regression analysis assessed the association between the number of risk factors and IIEF severity. Lastly, locally scatterplot smoothing (LOESS) method graphically explored the relationship between number of risk factors and IIEF.

Results

1836 (91.4%) were identified with primary organic ED whereas 173 (8.6%) with primary psychogenic ED. Median (IQR) age was 52 (42-61) vs. 30 (25-36) yr, respectively (p<0.001). The most frequently reported risk factors were smoking (53%), high blood pressure (36%), BMI > 30 (15%) and total testosterone <3ng/mL (14%). Overall, 1387 patients (9.3%) had 1 risk factor, 480 (23.9%) 2, 384 (19.1%) 3 and 577 (28.72%) ≥4 risk factors. Overall, patients with primary organic ED had lower IIEF-SD (7 [6-9] vs. 7 [5-8]; p=0.0012) and -OF scores (9 [6-10] vs. 8 [5-10]; p=0.02). Conversely, IIEF-EF, -IS and -OS domain scores were similar between the two groups. At linear regression analysis, the increasing number of ED risk factors was associated with worse IIEF-tot score (coef. -0.593 p=0.039), -EF (coef. -0.409; p=0.003), -SD (coef. -0.0.85, p=0.017) and -OF (coef. -0.203, p=0.001).

Conclusions

One out of ten patients suffer from primary psychogenic ED in the real-life settings. The increasing number of risk factors was linearly associated with lower IIEF scores at presentation.
117 Vulvar Pleasure in Chronic Vulvar Pain Conditions: Impacts on Pain-Related Anxiety, Pain Catastrophizing, and Sexual Function
Authors: Mautz T , Pukall C , Krapf J , Goldstein A
Published: May 2022

Introduction

Vulvar pain conditions are associated with pain-related anxiety and other psychosocial symptoms, which can have far-ranging effects on personal well-being and interpersonal relationships. Despite their pain, some vulvar pain patients are still capable of experiencing vulvar pleasure. The relationships between vulvar pain conditions and vulvar pleasure is not well explored in existing literature.

Objectives

To examine the frequencies with which vulvar pain patients experience vulvar pleasure, and to investigate whether the ability to experience vulvar pleasure in patients with vulvar pain conditions impacts pain-related anxiety (PRA), pain catastrophization (PC), and sexual functioning (SF).

Methods

A prospective online study was conducted of 262 patients presenting to two urban vulvovaginal specialty clinics over the course of six months. Patients presenting for initial evaluation completed validated questionnaires for PRA via the Pain Anxiety Symptoms Scale-20 (PASS-20), PC via the Pain Catastrophizing Scale (PCS), and SF via the Female Sexual Function Index (FSFI), as well as a researcher-developed questionnaire evaluating vulvar pleasure.

Results

Of the 192 patients (mean age: 39, SD: 14, range: 16-78) who completed all questionnaires and had current vulvar pain, 93.2% had experienced vulvar pleasure at some point in their lives and 76.6% had experienced some vulvar pleasure since their vulvar pain began. Patients who were able to experience vulvar pleasure since their vulvar pain began scored lowest on every subscale of both the PASS-20 and PCS and highest on the total FSFI, compared to patients who had never experienced vulvar pleasure and to patients who had not experienced vulvar pleasure since their vulvar pain began. There were significant differences in cognitive pain-related anxiety (p = 0.02), in the helplessness component of pain catastrophizing (p = 0.04), and in overall female sexual functioning (p < 0.00001) among the three groups.

Conclusions

The experience of vulvar pleasure in vulvar pain conditions is associated with lower PRA and PC, specifically in the domains of anxiety cognitions and helplessness, and higher SF overall. This was a novel study given its focus on vulvar pleasure in the context of patients with vulvar pain conditions. Clinicians should consider incorporating education and promotion of vulvar pleasure in vulvar pain treatment regimens.

Disclosure

Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Dr. Goldstein is a consultant at Ipsen and a part-time employee at Daré Bioscience).
127 Effects of Testosterone Ointment in Japanese Men with Metabolic Syndrome
Authors: Ueshiba H
Published: May 2022

The metabolic syndrome involves a cluster of clinical features including visceral obesity, insulin resistance, hypertension, glucose intolerance, and dyslipidemia. Recent studies have shown that low testosterone levels are significantly associated with metabolic syndrome and type 2 diabetes.

We examined the change in insulin resistance after testosterone treatment in 23 Japanese men with metabolic syndrome and low free testosterone levels. Testosterone supplements were administered by testosterone ointment (Glowmin,Daito Pharmaceutrical, Tokyo, Japan) for 3 to 6 months. Glowmin contains 10mg of testosterone per 1g of matrix. A 2-cm line of Glowmin was applied to the submandibular skin and contained a dosage of 3mg of testosterone and this was given twice a day in the morning and evening.

Fasting plasma glucose (FPG), fasting serum insulin (F-IRI), HbA1c, total cholesterol(TCHO), triglyceride(TG), HDL-C, LDL-C, free testosterone, LH, FSH, BMI and waist circumference were measured. We used homeostasis model assessment (HOMA-R) as an index of insulin resistance and investigated the change in insulin resistance and lipid profiles after testosterone treatment.

After treatment, F-IRI, HOMA-R, TCHO and LDL-C were significantly decreased from 17.3±6.2μIU/ml to 11.9±4.0μIU/ml, 4.70±1.86 to 3.09±1.20, 252±23mg/dl to 216±19mg/dl and 175±25mg/dl to 139±22mg/dl, respectively. Free testosterone was significantly increased from 5.7±1.0pg/ml to 9.1±1.4pg/ml. Other parameters were not changed significantly.

In conclusion, these results suggest that testosterone replacement therapy by testosterone ointment improves insulin resistance in Japanese men with metabolic syndrome and low free testosterone levels.

Disclosure

Work supported by industry: no.
135 A Case of Late-Onset Hypogonadism Syndrome with Rapidly Elevated Prostate Specific Antigen
Authors: Ichikawa T , Kusumi N , Tsushima T , Shiraishi H , Watari S , Sakuma T , Kubota R
Published: May 2022

Introduction

Cases of developing prostate cancer during hormone therapy for late-onset hypogonadism syndrome are rare.

Objective

We report a case of prostate cancer that developed and died during hormone therapy for late-onset hypogonadism syndrome.

Case

A 63-year-old man was diagnosed with depression around 2010. In 2011, he visited a private urologic clinic with complaints of depression and decreased libido, and was started on androgen replacement therapy (ART) with a diagnosis of late-onset hypogonadism (LOH) syndrome. His PSA was 0.87 ng/mL in 2012, but was 3.335 ng/mL at the time of his 2017 municipal checkup. He continued to receive hormone injections every 1-2 months, but his PSA was not retested. In August 2018, he had difficulty in urination and visited his local physician, who referred him to our hospital because of a markedly elevated PSA of 213.3 ng/mL. Prostate biopsy showed adenocarcinoma, Gleason score 5+4, and CT scan showed supraclavicular, mediastinal, and retroperitoneal lymph node metastases. He underwent maximal androgen blockade therapy with castration and bicalutamide. He died after PSA failure despite chemotherapy and other treatments.

Conclusions

There is no evidence that ART, which is the main treatment for LOH syndrome, directly causes prostate cancer. In this case, a rapid increase in PSA was observed during ART treatment, which may indicate that the treatment caused latent prostate cancer to become apparent, resulting in a rapid increase in PSA. However, in this case, the detection of prostate cancer might have been delayed because PSA levels, which were required during ART treatment, were not measured regularly. In addition, the psychiatric symptoms of LOH syndrome are similar to those of depression, and it is difficult to differentiate them. When there is a history of depression, as in this case, a more careful diagnosis and treatment strategy are required.

Disclosure

Work supported by industry: no.
164 Platelet Rich Plasma as a Treatment for Erectile Dysfunction
Authors: Alkhayal S.
Published: May 2022

Introduction

Platelet Rich Plasma (PRP) has been recently explored as a treatment for erectile dysfunction (ED). Nevertheless, standardization of technique and data on efficacy and applicability remains uncertain.

Objective

We hereby report our experience using PRP to treat erectile dysfunction in 1061 patients, over the last 6 years.

Methods

10 ml of concentrated and activated TRU PRP using a special platelet separator was administered into the glans and penile corpora cavernosa of men with various grades of organic ED. Patients with neurogenic or psychogenic causes were excluded from the study with the aid of Duplex Doppler study. International Index of erectile function (IIEF5) questionnaire were collected before and at least 4 weeks after the procedure along with GAQ (improvement of erectile function) and SEP-3 questionnaire (achievement of satisfactory intercourse).

Results

Complete data could be obtained on 204 patients with an average age of 41.8 years (21-80) median of 40y. The mean follow up was 12 weeks (4-115) median of 6 weeks. 80% (164 patients) reported Improvement of erectile function on the GAQ. The IIEF5 increased in 77.5% (158 patients) with an average of 4.8 points (1-15) median of 4, P=<0.001. 82% (130) of the improved patients achieved satisfactory intercourse according to SEP 3 questionnaire. There was no statistically significant difference with regards to Pre-treatment IIEF5, age, or comorbidities between the improved and non-improved patients. There was also no correlation between grade of Erectile dysfunction and points of improvement in IIEF5. No adverse events were reported by any patient.

Conclusions

TRU PRP Injections seem to be a safe and effective treatment modality to improve erectile function in patients with mild to severe ED. Further studies to check if additional /multiple treatments would be required to achieve better results.

Disclosure

Work supported by industry: no.
165 Pre- and Post-Injection Pain in Patients Undergoing First Intracavernosal Injection
Authors: Baird B. , Broderick G.
Published: May 2022

Introduction

Intracavernosal injections (ICI) are a well-established treatment option with great success rates for men with erectile dysfunction. Unfortunately, the anticipation of pain with injections remains a significant barrier to the use of ICI.

Objective

This study aims to utilize a standardized verbal pain scale to examine the perception of pre- and post-injection pain in men who are undergoing their first injection with an intracavernosal erectile agent. Thus, inclusion criteria required no previous penile injection of any type, including but not limited to erectile medications and collagenase.

Methods

We determined a prospective pre-post observational study would be best to examine men undergoing their first ICI. Men who had no previous history of intracavernosal injection of any kind were asked to predict the pain associated with their first ICI with a score of zero to ten. Patients then received a 10 microgram (mcg) injection of prostaglandin E1 (PGE1). Immediately after they received their injection, they were asked to rate the pain they perceived with the injection on the same scale (0-10). The same physician administered pre- and post-injection scales in a standardized fashion.

Results

A total of 17 of men were asked to rate their pain as discussed in the Methods Section. The average age of men sampled was 61.8 years of age. On review of history, 64.7% of men were found to have used some type of PDE-5 inhibitor before visiting our clinic. The majority of men we saw had erectile dysfunction (70.6%) and/or Peyronie's Disease (58.8%). The average pre-injection prediction pain score was 5.29 +/- 1.90; the average post-injection perceived pain score was 1.21 +/- 0.81. Thus, there was an average decrease of over 4 points in predicted pain versus perceived pain. A two-sample t-test was performed; in addition, a Wilcoxson Signed Rank Test was performed. Both tests showed statistical significance in the difference between pre- and post-injection pain scores (p <0.001).

Conclusions

We found that patients who are undergoing ICI for their first time have a significantly higher prediction of pain versus perception of pain after the injection. We have utilized this data in our clinic to explain to patients that while the majority of patients predict high pain scores associated with injection, the vast majority of patients report very minimal pain associated with the injection. Patients can be more open-minded to ICI therapy which could help aid them with their erectile status; this can particularly be helpful in patients who want to avoid surgery and in patients who are not good surgical candidates.

Disclosure

Work supported by industry: no, by N/A.
166 Combined Intracavernous Injection of Prostaglandin E1 and a Phosphodiesterase Type 5 Inhibitors in 5 Cases after Non-Nerve Sparing Radical Prostatectomy
Authors: Sawada N. , Aikawa J. , MItsui T. , Takeda M.
Published: May 2022

Introduction and Objectives

Erectile dysfunction (ED) usually occurs in the surgical treatment of prostate cancer (PC). Since many patients are reluctant to discuss ED when facing PC treatment, some patients choose non-nerve sparing radical prostatectomy and later seek for ED treatment. We had 5 cases of patients who were treated with combination therapy of intracavernous injection (ICI) therapy of prostaglandin E1 (PGE1) and PDE5 inhibitors for ED after non-nerve sparing RP and retrospectively investigated the effectiveness of the combination therapy.

Material and Methods

The mean age when the patients had RP was 65.4 years. Following the 2016 National Comprehensive Cancer Network (NCCN) risk classification guidelines, 2 patients had high risk, and 3 had intermediate risk. The mean period up to the introduction of ICI from the date of RP was 40.2 months (12-120 months). All patients were given PDE5 inhibitors 3-4 weeks prior to ICI therapy. Erection was evaluated by the induction of ICI of 20 μg of prostaglandin E1 (PGE1), using Erection Hardness Score of 1 to 4; a score of 3 or 4 was classified as successful. Self-injection regimen was introduced by the physicians after the evaluation, and a total of 5 patients were tested.

Results

The response was Grade 1 in 1 patient, Grade 3 in 3 cases, Grade 4 in 1 case. The effectiveness rate was 80%. Penile self-injection therapy was adopted by 4 patients, and IIEF-5 and SHIM score improved from 5.3 to 17.5 and 4.3 to 14.8, respectively. No drug adverse effect was observed in the 4 cases.

Conclusions

Combination of ICI therapy and PDE5 inhibitors can be a candidate for ED patients who unluckily chose non-nerve sparing radical prostatectomy when treated prostate carcinoma.

Disclosure

Work supported by industry: no.
170 Low Intensity Extracorporeal Shockwave Therapy Improved the Resistance Index of Cavernosal Artery in Venous Occlusive Erectile Dysfunction
Authors: Chang H. , Chung T. , Chang I. , Chiang I. , Liu S.
Published: May 2022

Introduction

Veno-occlusive dysfunction has become a recognized cause of organic impotence. No effective management can improve venous occlusion. Although Low intensity extracorporeal shockwave therapy (LiESWT) has been an effective treatment for arteriogenic erectile dysfunction (ED) for years, we still did not know the effects for venous occlusive function.

Objective

This study aimed to measure the change of resistance index of cavernosal artery in patients with venous occlusive ED after LiESWT.

Methods

Totally 65 patients with ED were enrolled in our study. LiESWT with one treatment session per week for six consecutive weeks were introduced to our patients and then we recorded patient's resistance index (RI) before and after the LiESWT with penile doppler ultrasound.

Results

The RI (Mean±SEM) did not increase significantly after LiESWT (0.85±0.01 vs 0.86±0.01, p=0.395). However, those patients with pre-LiESWT RI lower than 0.85 who were more likely to have veno-occlusive ED showed significant increase of RI after the LiESWT in comparison to those with pre LiESWT RI higher than 0.85 (% Change of RI after LiESWT: 4.34±1.47 vs before LiESWT: -0.89±0.99, p<0.05).

Conclusions

Most of the previous studies focus the effect of LiESWT on PSV and erectile function score which was thought to be the major parameter of erectile function especially in arteriogenic ED. However, RI as an important parameter which indicated the venous leakage problem in ED also improved after the LiESWT in people with low RI. Our result shows the potential of LiESWT in repairing the tissue and decreasing the venous leakage in patients with venous occlusive ED.

Disclosure

Work supported by industry: no.
176 Is Immediate Preoperative Blood Glucose or Hemoglobin A1c a Risk Factor for Infection Following Penile Prosthesis Placement? A Systematic Review of Literature
Authors: Huynh L. , Huang E. , Choi E. , Yafi F.
Published: May 2022

Introduction

Diabetes mellitus is historically associated with increased risk of surgical site infection, but its role in increasing infection following penile prosthesis implantation is controversial.

Objective

The present systematic review seeks to assess whether preoperative hemoglobin a1c (HbA1c) or serum glucose are independent predictors of infection following PP implantation in diabetic men.

Methods

A stepwise literature search of MEDLINE database resulted in 192 articles regarding PP and DM. Of the 16 articles including either HbA1c and/or serum glucose in diabetic men with and without infection, studies utilizing only healthy controls and non-human subjects were excluded, resulting in 9 studies.

Results

Eight and three studies assessing HbA1c and serum glucose (n¼3,516 patients), respectively, and meeting inclusion criteria were included. Three studies indicated HbA1c as a significant indicator of PP infection, all of which included both diabetic and healthy controls; the remaining five included only diabetic patients and found no associations between HbA1c and infection. One study reported serum glucose to be significantly higher in those with PP infection, but included a significant number of patients with uncontrolled DM. Of note, since the year 2000, following advent of antibiotic-impregnated prosthesis and the no-touch surgical technique, studies have found no association between HbA1c or serum glucose with risk of infection. Furthermore, these studies reported significantly lower (<4%) infection rate in diabetic patients undergoing PP implantation.

Conclusions

Data exploring HbA1c and serum glucose on PP infection were heterogeneous in time period, study design, and patient populations. Only three (33%) and one (11%) of the studies reported p HbA1c and serum glucose levels to be predictive of PP infection, respectively. However, studies following the year 2000 and restricted to only diabetic patients did not find HbA1c nor blood glucose to be accurate predictors of PP infection.

Disclosure

Work supported by industry: no.
206 Psychoeducational Group of Men with Prostate Cancer
Authors: Silva I. , Naccarato A. , Denardi F. , Ferreira U. , Matheus W.
Published: May 2022

The incidence of cancer in the world population in 2002 was estimated at 11 million new cases, while in 2020 this estimate is approximately 20 million. Cancer is a global public health problem.

Prostate cancer (PCa) is a multifocal disease, with a wide clinical variety among patients. The male survivor of PCa has unique chronic side effects compared to other cancer survivors, with challenges in achieving physical and social well-being, and satisfaction with life in general.

This study aims to evaluate the impact of psychotherapy, in an open group, on Health-Related Quality of Life (HRQOL) and Sexuality in patients with PC who underwent treatment – ​​surgery, radiotherapy or who are under supervised follow-up.

Data is been collected through an initial interview (Identification, Anamnesis, Health Anamnesis, Degree of Satisfaction with Life and Sexuality, Affective-Emotional Assessment and Treatment Data), SF-36 and IIEF-5 short form questionnaire, in patients who are diagnosed, who have undergone treatment - surgery, radiotherapy or supervised monitoring - or who are being monitored at the clinic, and reapplication in the last semester of operation of the group. Each session will be answered 5 questions related to the perception of the previous session.

The group is available for 2 years, once a week, and the patient will attend 12 sessions. The sessions last 90 minutes, conducted by the same psychologist.

The research is been developed considering the ethical principles of secrecy, privacy, confidentiality and non-identification of the interviewees' data.

The study does not pose risks to the subjects and invasive techniques of the body or psychological suffering will not be used. Before starting the process, the Informed Consent Form (TCLE) is been delivered, as well as the provision of all details regarding the research. It is also explained that participation is voluntary and that the participant can leave the research at any time, without prejudice to their treatment and monitoring.

Only patients who meet all these criteria will be included, after signing the informed consent.

Disclosure

Work supported by industry: no.
207 Sexual Activity of Aged Japanese Women Who Visited a Female Urological Outpatient Clinic
Authors: Masuo Y. , Taniguchi H. , Taguchi M. , Mishima T. , Matsuda T. , Kinoshita H.
Published: May 2022

Introduction

The previous reports according to sexual activity of aged woman is limited. Sexual activity of aged women would be related to QOL of them. Recently, sexual dysfunction of aged women recognized as Female Sexual Dysfunction (FSD).

Objective

To clarify the sexual activity of aged Japanese women, sexual activity of the female patients who visited a female urological outpatient clinic was investigated.

Methods

Between June 2010 and August 2018, 404 aged female patients who visit our female urological outpatient clinic and answered the King's Health Questionnaire (KHQ) were enrolled in this study. The main chief complaint of these patients was pelvic organ prolapse. Self-reported data of KHQ, question number 5a and 5b which ask the patients about the relationship between urine voiding and sexual activity were reviewed retrospectively. Associations between sexual activity (as reported in the questionnaire) and patients’ background, partners status, and change of sexual activity after treatment for pelvic organ prolapse were analyzed.

Results

The mean age of the patients was 71.0 years, with 80.9% in their 60s and 70s. Sexual intercourse was practiced by 19.7% (n = 77) of all patients with 40.0% in their under 50s, 27.9% in their under 60s, 15.2% in their 70s, and 0% in their 80s. 31.2% (n = 119/381) of patients had their partners. Among the patients with a partner, the percentage who practiced sexual intercourse was 58.0% of all patients with 65.4% and 55.6% of women in their 60s and 70s, respectively. Among the patients who had sexual intercourse, 64.9% had chief complains of pelvic organ prolapse. 71% of patients who had sexual intercourse received surgery and 91% of them was tension-free vaginal mesh (TVM). After the surgery 63.8% of patients continued sexual activity.

Conclusion

A patient survey revealed the sexual activity of a Japanese older female population who visited a urological outpatient clinic with the chief complaint of pelvic organ prolapse.

Disclosure

Work supported by industry: no.