bluuebunny/crossref_metadata_2025 huggingface dataset:
Categories of resistance in cotton genotypes,Gossypiumspp. against cotton-melon aphid,Aphis gossypii(Hemiptera: Aphididae)
Authors: Uthirapathy Pirithiraj , Marimuthu Murugan , Venkatasamy Balasubramani , Kannan Senguttuvan , Boopathi N Manikanda , Selladurai Hari Ramakrishnan , Nallathambi Premalatha
Published: July 2023

Cotton-melon aphid, Aphis gossypii Glover (Hemiptera: Aphididae), is emerging as a potential threat to cotton cultivation worldwide. The resistance categories in Gossypium arboreum to A. gossypii still need to be explored. We screened 87 G. arboreum and 20 Gossypium hirsutum genotypes against aphids under natural field conditions. Twenty-six selected genotypes from these 2 species were tested under glasshouse conditions for resistance categories (antixenosis, antibiosis, and tolerance). Resistance categories were assessed by no-choice antibiosis assay, free-choice aphid settling assay, cumulative aphid days using population buildup tests, chlorophyl loss index, and damage ratings. No-choice antibiosis experiment revealed that the G. arboreum genotypes GAM156, PA785, CNA1008, DSV1202, FDX235, AKA2009-6, DAS1032, DHH05-1, GAM532, and GAM216 had a significant adverse effect on aphid development time, longevity, and fecundity. Gossypium arboreum genotypes CISA111 and AKA2008-7 expressed a low level of antixenosis but possessed antibiosis and tolerance. Aphid resistance persisted uniformly at different plant developmental stages studied. The chlorophyl loss percentage and damage rating scores were lower in G. arboreum than in G. hirsutum genotypes, indicating the existence of tolerance in G. arboreum to aphids. Logical relations analysis of resistance contributing factors depicted the presence of antixenosis, antibiosis, and tolerance in the G. arboreum genotypes PA785, CNA1008, DSV1202, and FDX235, indicating their utility for evaluating the mechanisms of resistance and aphid resistance introgression breeding into G. hirsutum to develop commercially cultivated cotton lines.
A multiplex PCR assay for the identification of 5 sibling species of the Lindesayi Complex of the genus Anopheles (Diptera: Culicidae) in Bhutan
Authors: Zhou Li , Namgay Rinsin , Saeung Atiporn , Saingamsook Jassada , Phanitchakun Thanari , Harbach Ralph E , Somboon Pradya
Published: July 2023

Five sibling species of the Lindesayi Complex of the genus Anopheles have been discovered in Bhutan: An. druki Somboon, Namgay & Harbach, An. himalayensis Somboon, Namgay & Harbach, An. lindesayi Giles, An. lindesayi species B, and An. thimphuensis Somboon, Namgay & Harbach. The species are morphologically similar in the adult and/or immature stages. This study aimed to develop a multiplex PCR assay to identify the 5 species. Allele-specific primers were designed for specific nucleotide segments of ITS2 sequences previously reported for each species. The assay provided products of 183 bp for An. druki, 338 bp for An. himalayensis, 126 bp for An. lindesayi, 290 bp for An. lindesayi species B, and 370 bp for An. thimphuensis. The use of the assay produced consistent results. The assay is relatively inexpensive, enables the rapid identification of a large number of specimens, and will foster further studies of the Lindesayi Complex.
Modeling Public Opinion Over Time: a Simulation Study of Latent Trend Models
Authors: Kołczyńska Marta , Bürkner Paul-Christian
Published: July 2023

With the growing availability of multi-wave surveys, social scientists are turning to latent trend models to examine changes in social and political attitudes. Aiming to facilitate this research, we propose a framework for estimating trends in public opinion consisting of three components: the measurement model that links the observed survey responses to the latent attitude, the latent trend model that estimates a trajectory based on aggregated individual latent scores, and representativeness adjustments. We use individual-level item response theory models as the measurement model that is tailored to analyzing public opinion based on pooled data from multi-wave surveys. The main part of our analysis focuses on the second component of our framework, the latent trend models, and compares four approaches: thin-plate splines, Gaussian processes, random walk (RW) models, and autoregressive (AR) models. We examine the ability of these models to recover latent trends with simulated data that vary the shape of the true trend, model complexity, and data availability. Overall, under the conditions of our simulation study, we find that all four latent trend models perform well. We find two main performance differences: the relatively higher squared errors of AR and RW models, and the under-coverage of posterior intervals in high-frequency low-amplitude trends with thin-plate splines. For all models and across all scenarios, performance improves with increased data availability, which emphasizes the need of supplying sufficient data for accurate estimation of latent trends. To further illustrate the differences between the four latent trend models, we present a case study with an analysis of trends in political trust in Hungary, Poland, and Spain between 1995 and 2019. We note the relatively weaker performance of splines compared to other models in this application and conclude by discussing factors to consider when choosing the latent trend model, and further opportunities in this line of research.
(52) KH-001 BUT NOT OTHER TESTED ALKALOIDS DERIVED FROM SCELETIUM TORTUOSUM DELAYS EJACULATION IN THE RAT PARA-CHLOROAMPHETAMINE (PCA) MODEL
Authors: Royston A Gray , Laura M N Sahyoun , Michelle Kokkinou , Fraser R Boistelle , Ryan Protzko , Nigel Gericke , Thomas Pfeiffer
Published: July 2023

Objectives

To determine the efficacy and potency of purified alkaloids (KH-001, KH-002, KH-003, KH-004) derived from Sceletium tortuosum in the PCA-induced ejaculation rat model.

Methods

Male Wistar rats received the following compounds intraperitoneally, shortly before anaesthesia and 1h before the induction of ejaculation with PCA (5 mg/kg): KH-001 (20 μg/kg - 20 mg/kg; n=12), KH-002 (20 mg/kg; n=12), KH-003 and KH-004 (10, 20 mg/kg; n=6) or aqueous vehicle (0.5% (w/v) methylcellulose; n=12). The proportion of ejaculating rats within a dose group, the latency to first ejaculation and physiological determinants of emission (seminal vesicle pressure (SVP)) and expulsion (bulbospongiosus (BS) muscle burst) were determined. Data describing latency to first ejaculation were described by Kaplan-Meier analysis, and statistical significance relative to vehicle-treatment was determined by Cox regression. SVP and BS muscle burst were analysed using Student’s t-test or one-way ANOVA.

Results

While KH-001 increased latency to first ejaculation in a dose-dependent fashion, with a minimum effective dose of 200μg/kg, no such effect was observed with the other tested kanna alkaloids up to 20mg/kg. SV contractions were significantly reduced by all alkaloids, with no effect on BS muscle burst.

Conclusions

These novel findings indicate the potential utility of KH-001 in the symptomatic treatment of premature ejaculation in humans. Interestingly, of the four alkaloids examined, delayed ejaculation was observed with only KH-001, indicating that the various kanna alkaloids tested have a differentiated pharmacological profile. Studies are underway to determine mechanism(s) of action, and the relationship between the pharmacodynamics and pharmacokinetics of kanna-derived alkaloids.

Conflicts of Interest

RG and MK are employees and shareholders of Kanna Health Ltd. LMNS, FRB, RP, NG, and TP are shareholders of Kanna Health Ltd. RP is an employee of Kanna Health US LLC.
(253) EDUCATION DEGREE PREDICTS CARDIOVASCULAR OUTCOMES IN MEN SUFFERING FROM ERECTILE DYSFUNCTION
Authors: Dr. Dimitri Yannas , Dr. Elena Zago , Dr. Elena Cavallini , Dr. Tommaso Todisco , Prof. Linda Vignozzi , Dr. Giovanni Corona , Prof. Mario Maggi , Prof. Giulia Rastrelli
Published: July 2023

Objectives

The level of education has been recognized as a cardiovascular (CV) risk factor; nevertheless, it is often neglected in CV risk prediction. To evaluate the psychobiological correlates of the level of education and if it could predict incident major adverse CV events (MACE) in men consulting for erectile dysfunction (ED).

Methods

3733 men (49.8±13.7 years old) attending an andrology outpatient clinic for ED were studied. Sexual and psychological symptoms, hormonal and metabolic as well as instrumental (penile color Doppler ultrasound; PCDU) parameters were evaluated according to the education level (university, upper secondary, lower secondary, and primary degree). For a subset of 956 patients data on incident MACE were retrospectively collected for 3.9±2.4 years.

Results

As compared with men with university degree, those with a lower education had an increased frequency of moderate-severe ED (OR=1.21 [0.99;1.48], 1.41 [1.14;1.73], 1.70 [1.26;2.30] for upper secondary, lower secondary and primary school, respectively) and reduced flaccid peak systolic velocity at PCDU. Men with a lower level of education had a worse a greater probability of suffering from metabolic syndrome (OR=1.38 [1.06;1.79], 1.73 [1.34;2.24], 1.72 [1.24;2.37] for upper secondary, lower secondary and primary school, respectively) and were more likely to have history of previous CV events. In the longitudinal study, men with higher level of education had a significantly lower incidence of MACEs. The role of higher education as an independent predictor of MACE was established by multivariable Cox regressions (HR=2.14 [1.24-3.69]).

Conclusions

In ED subjects, lower level of education is associated with a more severely impaired erectile function with atherogenic pathogenesis and with a worse cardio-metabolic profile. In addition, a lower level of education predicts forthcoming MACEs. Therefore, education level should be considered as a costless but valuable information in the assessment of CV risk in patients with ED.

Conflicts of Interest

none
(40) BLOOD THINNERS: DO THEY NEED TO BE HELD FOR IPP SURGERY?
Authors: Dr. Niki Parikh , Dr. Reza Roshandel , Dr. Ryan Griggs , Dr. Gerard Henry , Dr. Paul Perito , Dr. Tobias Kohler
Published: July 2023

Objectives

Inflatable penile prosthesis (IPP) placement on active anticoagulation (AC) is controversial. Techniques utilized to decrease complications include use of malleable implant, partial inflation of IPP for hemostasis, and placement of drain; however risk and benefits must be weighed. We sought to assess outcomes of IPP in men on AC in a multi-institutional study.

Methods

Data from 3 high-volume implant centers was retrospectively analyzed. Demographics, comorbidities, secondary procedures, drain placement/output, and complications were recorded. Aspirin was excluded as it is not routinely held. Center 1 utilizes a penoscrotal approach without drain placement, center 2 a penoscrotal approach with drain placement (removal when output <50 mL/8 hours), and center 3 an infra-pubic approach with drain for 3 days.

Results

202 patients were continued on AC throughout surgery: 112 on clopidogrel, 35 warfarin, 38 apixaban, 1 enoxaparin, 15 rivaroxaban, and 1 combination therapy with clopidogrel and enoxaparin. AC was most continued for peripheral vascular disease (55%), cardiac stents (11.6%), CHF (11%), and atrial fibrillation (11%). Nine patients (3.98%) experienced complications. Four significant events (1 retropubic bleed requiring transfusion, 3 IPP infections) and 5 minor events (3 hematomas, 1 wound dehiscence,1 CT-negative stroke) occurred. Average drain output for center 1 was 223 mL with no hematomas or infections noted. Average drain output for center 2 was 121 mL with most drains removed postoperative day 1. Drain output was significantly higher than historical non-AC controls (p=0.001), however complication rates were not significantly different (p>0.05). AC type, revision surgery, scrotoplasty, or reservoir technique did not affect outcomes or drainage.

Conclusions

In high-volume implant centers, major complication rate of 1.9% occurred in IPP patients on AC. Although IPP is feasible in this patient population, drain for 3 days and submuscular reservoir placement may be indicated. In most, elective IPP surgery should be delayed until it is safe to discontinue anticoagulation.

Conflicts of Interest

None
(127) CLINICAL CHARACTERISTICS AT PRESENTATION OF PEYRONIE’S DISEASE PATIENTS HAVE CHANGED OVER THE LAST 20 YEARS
Authors: Dr. Edoardo Pozzi , Dr. Giuseppe Fallara , Dr. Federico Belladelli , Dr. Simone Cilio , Dr. Christian Corsini , Dr. Francesco Lanzaro , Fausto Negri , Ludovica Cella , Margherita Fantin , Dr. Luigi Candela , Dr. Paolo Capogrosso , Dr. Luca Boeri , Dr. Alessia d'Arma , Prof. Francesco Montorsi , Prof. Andrea Salonia
Published: July 2023

Objectives

To detail and explore the changes of clinical and sociodemographic characteristics of a cohort of PD patients over a 17-yr period at a single referral centre.

Methods

Data from 616 consecutive patients complaining of PD as their primary complaint between 2005 and 2022 were analysed. Health significant comorbidities were scored with the CCI. All patients completed the IIEF at baseline. Descriptive statistics was used to detail the entire cohort characteristics. Linear regression models were applied to explore the changes in patterns of sociodemographic and clinical characteristics over a 17-yr period (2005-2022). Loess curve was used to graphically display the association between age at first clinical visit and year of assessment.

Results

Overall, the median (IQR) age and IIEF-EF were 56 (45-63) yr and 22 (10-28) respectively. Of all, 232 (37.7%) patients reported associated erectile dysfunction (ED) with 89 (14.4%) depicting criteria of severe ED (IIEF-EF <11). A CCI≥1 was found in 145 (23.5%); 193 (31.3%) patients had arterial hypertension and 72 (11.7%) had diabetes mellitus type 1 and 2. Overall, 115 (18.7%) had less than 40 yr at first presentation and 124 (20.1%) were active smokers. Over the analysed timeframe, at linear regression analysis, patients were more likely to be younger (Coeff -0.03, p<0.001), to report less comorbidities according to the CCI (Coeff -0.38, p<0.02), to have associated ED (Coeff. 1.21, p=0.002), to smoke more (Coeff 2.88, p<0.001) and to exercise more (Coeff 1.3, p<0.001). Figure 1 graphically displays the decreasing median age at first assessment over the 17-yr time-span with median (IQR) age in 2005 of 64 (59-69) yr vs. 51 (29-56) yr in 2022.

Conflicts of Interest

N/A

Conclusions

The probability of assessing younger PD patients has gradually increased over the last 20 years. In this context, one out of five patients seeking first medical help for PD is younger than 40 years of age.
(135) CHANGES IN QUALITY OF LIFE AND SEXUAL FUNCTION AFTER LHRH AGONISTS VS ORCHIECTOMY IN MEN WITH METASTATIC PROSTATE CANCER: RESULTS FROM A RANDOMIZED TRIAL
Authors: Niklas Dissing , Prof. Mikkel Fode , Prof. Jens Sønksen , Dr. Peter B Østergren
Published: July 2023

Objectives

To examine changes in quality of life (QoL) in men diagnosed with metastatic prostate cancer randomly assigned to either medical or surgical castration.

Methods

Men with de novo metastatic prostate cancer were randomized (1:1) to either Triptorelin 22.5mg/24weeks or subcapsular orchiectomy as monotherapy. QoL and sexual function were assessed using the validated questionaries EORTC-QLQ-C30, EORTC-QLQ-PR25 and Erectile Hardness Scale (EHS) before treatment and at 12, 24 and 48 weeks. Outcomes were changes in overall QoL, functional and symptom scales. Data was analyzed using linier mixed models for repeated measures.

Results

Fifty-seven men with a median age of 74 years (range 47 to 86 years) were randomized and received allocated treatment from September 2013 through March 2015. The pooled analyses, combining data from both groups, showed that QoL (p=0.003), emotional function (p<0.001), urinary symptoms (p=0.011) and hormonal treatment related symptoms (p<0.001) changed significantly between visits. Improvement from baseline in QoL (mean change 6.8 points [95%CI 2.1; 11.5]), emotional function (6.9 points [3.3; 10.6]) and urinary symptoms (-7.7 points [-12.3; -3.0]) were observed at 24 weeks. Hormonal treatment related symptoms (8.9 points [95% CI 5.9; 12.0]) worsened. No significant differences between treatment groups in any of the scales were observed.

At baseline, 29 men (51%) reported retained interest in sex and 18 were sexually active. At 12 weeks eight continued to report an interest in sex and six were sexually active. Three men had erections hard enough for penetration at baseline. This dropped to one man at 12 weeks.

Conclusions

Men with newly diagnosed metastatic prostate cancer experience improved QoL and emotional function at follow-up after starting androgen deprivation therapy. Urinary symptoms improve while hormonal treatment related symptoms worsened. Interest in sex and sexual activity was retained in a proportion of men despite androgen deprivation.

Conflicts of Interest

None.
(199) “THE ABSENCE OF ORGASM POST-OPERATIVELY IS ASSOCIATED WITH EXTRA-CAPSULAR DISEASE IN RADICAL PROSTATECTOMY PATIENTS: A STUDY OF A SEXUAL REHABILITATION CLINIC”
Authors: Stavros Kontogiannis , Anastasios Natsos , Mohammed Obaidat , Konstantinos Adamou , Evangelos Liatsikos , Petros Drettas
Published: July 2023

Objectives

After radical prostatectomy, sexual dysfunction concerns not only erectile but orgasmic function, as well. The absence of orgasm affects the patients’ quality of life and can motivate them to seek sexual treatment after surgery. Our aim was to study the orgasm frequency after radical prostatectomy and investigate any associations with the pathologic and psychosocial characteristics of the patients.

Methods

We studied retrospectively patients who visited our Sexual Rehabilitation Clinic after radical prostatectomy during the last 18 months. During the first evaluation 2 months post-operatively, we asked if the patient had experienced orgasm during penetrative sex or during masturbation. Following the biopsychosocial model of sexual dysfunctions, the patients filled in two questionnaires: the International Index of Erectile Function-5 (IIEF-5) questionnaire before and after surgery and the Hospital Anxiety and Depression Scale (HADS) after surgery. Extra-capsular prostatic disease was defined as pT3 according to the TNM classification.

Results

Seventy patients were studied with an average age and PSA of 65.7 years and 9.4 ng/dl, respectively. The percentage of patients with pT3 disease was 62.8%. The average of IIEF-5 was 20.2 pre-op and 6.5 post-op. The average HADS sub-scales scores were 7.4 for anxiety and 5.8 for depression. More than half (of the patients (51.4 %) had experienced orgasm after surgery. The absence of orgasm was associated with older age (p=0.022), the absence of morning erections (p=0.009), the absence of masturbation post-op (p=0.009) and with extra-capsular disease (pT3) of prostate cancer (p=0.040).

Conclusions

The absence of orgasm is associated with extra-capsular prostatic disease and with older age. Due to the importance of orgasm in the sexual rehabilitation after surgery, clinicians should be more aware of the orgasmic dysfunction in patients with these characteristics.

Conflicts of Interest

No conflict of interest.
(242) CLINICAL PREDICTORS AND CONSEQUENCES OF INCREASING SHBG LEVELS OVER TIME: RESULTS FROM THE EUROPEAN MALE AGEING STUDY
Authors: Prof. Giulia Rastrelli , Prof. Gyorgy Bartfai , Prof. Felipe Casanueva , Prof. Aleksander Giwercman , Prof. Ilpo Huhtaniemi , Prof. Margus Punab , Prof. Jolanta Slowikowska-Hilczer , Prof. Terence O'Neill , Prof. Dirk Vanderschueren , Prof. Frederick Wu , Prof. Mario Maggi
Published: July 2023

Objectives

Testosterone (T) circulates bound to sex hormone-binding globulin (SHBG). Although it is commonly deemed that only the amount of T not linked to proteins (free T) is biologically active, evidence supporting this hypothesis is lacking.

To investigate the predictors and clinical consequences of developing or maintaining increased SHBG levels in ageing men from European general population.

Methods

3369 men from the general population of eight European countries were recruited in the longitudinal population-based study “European Male Ageing Study”. Subjects completed questionnaires, underwent physical examination, physical and cognitive functional tests and blood sampling during two visits (one baseline and one after a median of 4.3 years of follow-up).

Results

Among a series of putative candidate predictors for new occurred-stable high SHBG, older men, reporting physical inactivity, with liver diseases and with higher T and LH at baseline were more predisposed to maintain or develop high SHBG; conversely, obesity, higher LDL and IGF1 were protective towards the occurrence of SHBG. Concerning the clinical consequences, men who develop or maintain high SHBG levels reported the new occurrence or worsening of erectile dysfunction, impaired morning erections and low sexual desire. Moreover, they had new or worsened feelings of sadness, worse physical functioning, vitality, mental and social well-being. This was confirmed by worse scoring in physical performance and memory tests, as well as by higher scores on the Beck Depression Inventory.

Conclusions

The development or maintenance of high SHBG levels is associated with symptoms of hypogonadism, independently of total T levels. Besides sexual symptoms, also physical and depressive symptoms are present. The cognitive and physical performance is also compromised. This study demonstrates that increased SHBG favor the development or worsening of hypogonadism-related symptoms. This provides evidence for the role of SHBG in limiting the biological activity of T, thus supporting the free hormone hypothesis.

Conflicts of Interest

None
(230) MICROSURGICAL VASECTOMY REVERSAL: THE EXPERIENCE OF THE SINGLE CENTER
Authors: Dr. Débora C Araújo , Dr. Rui Maciel , Dr. Samuel Bastos , Dr. Vitor Oliveira , Dr. Jorge Dias , Dr. Carolina Marramaque , Dr. Alexandre Gromicho , Dr. Luis Xambre
Published: July 2023

Objectives

We report our experience with microsurgical VR and identify predictive factors of success.

Methods

We retrospectively reviewed all patients submitted to VR by a single surgeon from 2008 to 2021 at Centro Hospitalar Vila Nova de Gaia e Espinho. Patency and pregnancy rates were evaluated. The main outcome was procedure success rate, defined by a natural pregnancy with a healthy baby. The secondary objective was to identify predictive factors of success and patient satisfaction with the procedure.

Results

Forty VRs were performed with a patency rate of 97.2%. Among those who became patent, pregnancy occurred in 14 of 35 couples by natural conception (40%). Twelve of them had a healthy delivery (34.3%). Two-layer anastomosis was significantly associated with a successful procedure (p=0.0001). We did not identify significant association between any of the other variables and successful outcome. Even without successful surgery most of the patients would do the procedure again and were very satisfied with the results (p=0.58 and p=0.46, respectively).

Conclusions

This is the largest national cohort regarding the outcomes of VR. In our study, the observed patency rate was 97.2%, resulting in a pregnancy by natural conception with a healthy delivery in 34.3%. We believe that VR is a useful technique to restore fertility in men after vasectomy wishing children by natural conception. A significant association was found between the two-layer anastomosis and a successful surgery.

Conflicts of Interest

The authors declare that they have followed the protocols of their work center on the publication of patient data.
(108) SEXUAL ANHEDONIA AND SEROTONIN 4 RECEPTOR BRAIN BINDING IN DEPRESSED PATIENTS – A NEUROPHARM POSITRON EMISSION TOMOGRAPHY STUDY
Authors: Annika L Rasmussen , Søren V Larsen , Brice Ozenne , Dea S Stenbæk , Prof. Martin B Jørgensen , Annamaria Giraldi , Vibe G Frokjaer
Published: July 2023

Objectives

Sexual dysfunction is a prominent feature of Major Depressive Disorder (MDD), which affects depressed women more frequently and more pronounced compared to men. Reduced sexual desire might reflect overall anhedonia, a core symptom of MDD, which is putatively related to disturbed reward processing. Here, we aim to illuminate plausible underlying neurobiology of sexual dysfunction and in particular sexual desire in women with depression. We map associations between serotonin 4 receptor (5-HT4R) brain binding in the striatum, a key hub of the reward circuitry, and self-reported sexual function, where we focused on sexual desire, in the unmedicated depressed state. In addition, within women, we evaluate if pre-treatment sexual desire score predicted treatment outcome after eight weeks of treatment.

Methods

From the NeuroPharm study, we had access to brain scans of 5-HT4R binding and self-reports on sexual functioning (CSFQ-14 F&M) from 85 untreated MDD patients (71% women) who underwent eight weeks of antidepressant drug treatment. Whether pre-treatment sexual desire score predicted treatment outcome was evaluated using the area under the ROC curve (AUC). Treatment outcome was dichotomized as 50% or more reduction in Hamilton Depression Rating Scale 6-item (HDRS6) or not at 8 weeks clinical follow-up.

Results

We found a positive association between sexual desire and 5-HT4R binding in women (b=0.07, 95%CI [0.02:0.13], p.adj=0.024), but not in men (b=0.05, 95%CI [-0.05:0.15], p.adj=0.62). We did not find an association between overall sexual functioning and serotonin 4 receptor binding neither in women nor in men. Sexual desire at baseline did not predict treatment outcome i.e. ≥50% reduction in HDRS6 from baseline to week 8 (AUC=51.7% [36%:67%]).

Conclusions

Taken together, we find evidence for an association between low sexual desire and low striatal 5-HT4R agonist capacity in depressed women. Interestingly, this raises the question if direct 5-HT4R agonism can target reduced sexual desire in MDD.

Conflicts of Interest

Annamaria Giraldi declares that she has served as a lecturer for Eli Lilly, Pfizer, Astellas, Viatris in addition to serving as a consultant for Eli Lilly as well as being on the advisory board of Futura Medical, OvacoBio and FREYA Pharmaceuticals. Further, she states that she holds stocks in Novo Nordic. Vibe G Frokjaer declares that she has served as a consultant for H. Lundbeck and Sage Therapeutics.
(179) ARE ENDOGENOUS ANDROGENS LINKED TO FEMALE SEXUAL FUNCTION? A SYSTEMIC REVIEW AND META-ANALYSIS
Authors: Dr. Elisa Maseroli , Dr. Sarah Cipriani , Prof. Linda Vignozzi , Dr. Serena Ravelli
Published: July 2023

Objectives

Our aim was to answer the question: is there an association between endogenous levels of androgens and sexual function in women?

Methods

An extensive search was performed in MEDLINE, Embase and PsycInfo. Four separate meta-analyses were conducted for total T, free T, Free Androgen Index (FAI), and Dehydroepiandrosterone sulphate (DHEAS). Cohort, cross-sectional, and prospective studies were included. The effect measure was expressed as standardized mean difference (SMD).

Results

The meta-analysis on total T included 34 studies involving 3,268 women, mean age 36.5 years. In 11 studies, a significant association was found between sexual desire, measured by validated psychometric instruments, and total T (SMD = 0.59 [0.29;0.88], P < 0.0001), with a moderate effect. The association with global sexual function (n = 12 studies) was also significant (SMD = 0.44 [0.21;0.67], P <0.0001). Overall, total T was associated with a better sexual function (SMD = 0.55 [0.28;0.82)], P < 0.0001), with similar results obtained when poor quality studies were removed. Age showed a negative relationship with the overall outcome. No differences were found when stratifying the studies according to menopausal status, type of menopause, age at menopause, use of hormonal replacement therapy, relationship status, method for T measurement, phase of the menstrual cycle or use of hormonal contraception. The meta-analysis of T derivatives (free T and FAI) also showed a significant, moderate association with sexual desire. In contrast, DHEAS seems not to exert any significant influence on desire, whilst showing a positive association with global sexual function.

Conclusions

There appears to be a moderate association between total T and sexual desire/global sexual function, which is confirmed, although weak, in studies employing liquid chromatography-mass spectrometry (LC-MS). Similar results on desire were obtained for free T and FAI. DHEAS only showed a positive association with global sexual function. More research is needed.

Conflicts of Interest

LV received scientific research grants, advisory board attendance and speaker honoraria from Therascience, Theramex, Bayer Schering Pharma, Intercept, Lipocine, Ibsa. EM and SC have nothing to declare.
(53) INVESTIGATION ON A TREATMENT OPTION FOR CERVICAL CANCER CAUSED BY PERSISTING HPV16 INFECTIONS: PHASE 1 DOSE-ESCALATION STUDY OF IMMUNOTHERAPY WITH DELNSE6E7 IN HPV-16 INFECTED WOMEN WITH NORMAL CYTOLOGY, CIN1 OR CIN2
Authors: Michaela Bayerle-Eder , Carola Fuchs , Michael Wolzt
Published: July 2023

Objectives

Assessment

Methods

randomised, double-blind, 1:3 placebo-controlled, phase 1 dose-escalation study in up to 36 subjects.

Results

24 otherwise healthy women with persistent HPV 16 infections were randomised, one was excluded and 17 patients have completed the study. 6 patients are currently in the treatment phase of the clinical trial. The study is still ongoing and open for recruitment. Preliminary results will be presented at the ESSM 2023.

Conclusions

Introduction/Conclusion:

Human papillomavirus (HPV) infection is the most common viral infection of the reproductive tract. Most sexually active individuals are exposed trough lifetime, but 90% of HPV infections usually recover within a few months. A small proportion of infections with high-risk types of HPV virus subtypes can persist and progress to cancer.

Thus persistent HPV16 infection cause 55 % of cervical cancer world-wide, which is most often diagnosed between 35 and 44 years.

Regardless of HPV vaccination status there is no treatment for persistent HPV16 infections, which causes not only a physiological but also a psychological burden.

Immune therapy with delNSE6E7, which has been effective against papilloma virus induced cancer in horses may offer future treatment options for persisting HPV16 infections preventing development of cervical, oropharyngeal or anal cancer in humans.

Conflicts of Interest

Michaela Bayerle-Eder is involved in patient recruitment for BlueSkyGmbH, which developed delNSE6E7.
(186) VAGINAL CHANGES, SEXUAL FUNCTIONING AND DISTRESS OF WOMEN WITH LOCALLY ADVANCED CERVICAL CANCER TREATED IN THE EMBRACE VAGINAL MORBIDITY SUBSTUDY
Authors: Isabelle Suvaal , Dr. Kathrin Kirchheiner , Prof. Remi A Nout , Dr. Alina E Sturdza , Prof. Erik Van Limbergen , Dr. Jacob C Lindegaard , Prof. Hein Putter , Dr. Ina M Jürgenliemk-Schulz , Prof. Cyrus Chargari , Dr. Kari Tanderup , Prof. Richard Pötter , Prof. Carien L Creutzberg , Dr. Moniek M ter Kuile
Published: July 2023

Objectives

The EMBRACE-vaginal morbidity substudy prospectively evaluated physician-assessed vaginal changes and patient-reported-outcomes (PRO) on vaginal and sexual functioning problems, and sexual distress in the first 2-years after radio(chemo)therapy with image-guided adaptive brachytherapy for locally advanced cervical cancer.

Methods

Eligible patients had FIGO 2009 stage IB1-IIIB cervical cancer with no or only limited (<5mm) vaginal involvement. Comprehensive assessment of vaginal changes was done before treatment, at 4-6 weeks and 3, 6, 12 and 24 months thereafter and graded using CTCAE. PRO were assessed at the same timepoints using validated Quality of Life and sexual questionnaires. Statistical methods included Generalized Linear Mixed Model analysis and Spearman’s rho correlation coefficients.

Results

113 eligible patients were included. Over time, mostly mild (grade 1) vaginal changes were reported in 10.8-36.8% of the participants. At 24 months, 46.7% reported not being sexually active, mostly because of losing interest in sex or lacking a partner. Among the 41-53 sexually active women, 43.2-51.3% reported vaginal functioning problems starting at 4-6 weeks and more severe sexual problems and distress were reported by 5-15% of them. Physician-assessed vaginal changes and PRO sexual satisfaction differed significantly (p≤.05) between baseline and first follow-up, without further changes over time. No or only small associations between vaginal changes and vaginal functioning problems and sexual distress were found.

Conclusions

Relatively mild vaginal changes were reported after image-guided radio(chemo)therapy and brachytherapy according to EMBRACE-protocol. Although vaginal and sexual functioning problems and sexual distress were frequently reported, the rate of more substantial problems and distress was relatively low. These results are favorable compared to previous data, potentially due to the combination of tumors with limited vaginal involvement, EMBRACE-specific treatment optimization and rehabilitation recommendations. The lack of association between vaginal changes, vaginal functioning problems and sexual distress shows that sexual functioning is more complex than vaginal morbidity alone.

Conflicts of Interest

The authors declare that they have no competing interests. The EMBRACE vaginal morbidity substudy was supported by Elekta AB and Varian Medical system through unrestricted research grants and study sponsoring through the Medical University of Vienna.
(72) IMPACT OF COVID-19 PANDEMIC ON VIOLENCE AGAINST WOMEN IN THE REPUBLIC OF ARMENIA
Authors: Satenik Sahakyan , Ruzanna Azatyan , Arsen Grigoryan , Prof. Aram Hakobyan
Published: July 2023

Objectives

The purpose of this study was to identify potential incidents of female violence during the COVID-19 pandemic as well as the prevalence of female violence in the Republic of Armenia

Methods

Women in Armenia who are at least 18 years old and have lived there for at least six months prior to the COVID-19 pandemic are included in the study. From November 30 to December 14 2021, an online and paper version of a 16-item survey was sent out. The questionnaire assessed emotional, physical, sexual abuse, mood disturbances 6 months before and during COVID-19 self-isolation measures in Armenia.

Results

353 adult Armenian women participated in the study. Before COVID-19 sexual abuse was reported by 3% of study participants. These women were abused once in 1.5% of cases and multiple times in 1.5% as well. During COVID-19 pandemic participants reported sexual abuse in 6.1% (8) of cases, with 2.3% being abused once and 3.8% being abused multiple times. Differences between these two periods were significant (p<0.05).

Conclusions

Overall, during COVID-19 self-isolation partner abuse rates were high in Armenia. Sexual abuse in a normal setting, i.e. 6 months before COVID-19 pandemic, was reported by nearly every 20th woman in our sample. During lockdown the ratio increased up to one in 9 women experiencing violent sexual behavior by partner. According to the results of the current study, the risk of intimate partner violence during the COVID-19 lockdown was influenced by social isolation, extended homestays, and heightened social and economic pressure.

Conflicts of Interest

All authors declare that they have no conflicts of interest.
(96) IMPACT OF MINDFULNESS MONOTHERAPY ON FEMALE SEXUAL DYSFUNCTION SYMPTOMS AND SEX-RELATED QUALITY OF LIFE
Authors: Izabela Jąderek , Katarzyna Obarska , Prof. Michał Lew-Starowicz
Published: July 2023

Objectives

The aim of the study was to assess the effect of mindfulness monotherapy on the reduction of sexual dysfunctions symptoms and sex-related quality of life, and the persistence of the effects after its completion.

Methods

We conducted four weeks mindfulness-based therapy (MBT) for two groups of heterosexual females: women with psychogenic sexual dysfunctions (WSD) and women with no sexual dysfunctions (NSD) who wanted to improve their sexual life and learn meditation. Sexual dysfunction was evaluated in clinical interview according to the DSM-5 criteria. The effects of the therapy were evaluated with Female Sexual Function Index (FSFI), Five Facet Mindfulness Questionnaire (FFMQ) and The Sexual Satisfaction Questionnaire (KSS) at baseline, one week after MBT, and follow-up after 12 weeks.

Results

93 women were recruited for the study: 53 to the WSD group, 40 to the NSD group. Participants in WSD group reported a significant increase in the level of sexual desire (p <0.001), arousal (p<0.001), lubrication (p=0.003), and orgasm (p=0.001) between measurements. The overall risk for sexual dysfunction (as indicated by the FSFI score) decreased compared to baseline in both treatment arms: from 90.6% at baseline to 46.7% at follow up in WSD group and from 32.5% at baseline to 6.9% at follow up in the NSD group. A significant increase in sex-related quality of life (KSS score) was observed in both study groups.

Conclusions

MBT was found effective in the treatment of sexual dysfunction and improved sexual satisfaction both among heterosexual women with or without sexual dysfunction. More research is needed to explore the potential of MBT in the treatment of sexual dysfunction in other samples (e.g., men and non-heterosexual women).

Conflicts of Interest

No conflict of interest
(152) WILL WE LEARN ABOUT SEXUAL HEALTH? A SCOPING REVIEW ON THE INCLUSION OF SEXUAL HEALTH IN THE CURRICULUMS OF EUROPEAN MEDICAL SCHOOLS
Authors: Beatriz F Lopes , Inês Tavares , Ana L Q Gomes
Published: July 2023

Objectives

Sexual health is an insufficiently addressed topic within the scope of medical training programs in both pre and postgraduate Medicine levels, being identified by doctors as a gap area in their professional training. The lack of sexual health topics in medical training programs often leads to insecurity of this professionals in dealing with their patients’ sexual problems. The aim of this study is to collect information on sexuality/sexual health training currently available at pre and postgraduate levels in the main national and European medical schools, as well as specifically within the scope of medical internship.

Methods

Using the mailing list provided by European Academy of General Medicine of the European Academy of General Medicine (EURACT) and available online, we contacted the main national and European medical schools to have access to their medical curriculums and training programs, type of training provided on pre and postgraduate sexuality/sexual health, learning strategies and specific competences in sexuality/sexual health. We examined 1) whether medical curricula included the topic of sexual health/sexuality, 2) which sexuality topics were addressed, and 3) which learning strategies were used.

Results

The results of this study allowed us to understand the state of the European medical training in sexuality/sexual health within and between European countries. Besides, we could evaluate the training content and specific skills on sexuality/sexual health, as well as identify strategies and different types of exposure to training content practiced in national and European medical schools.

Conclusions

We hope the current results will serve as the basis for the development of future studies and practices aimed to enhance medical doctor’s approach when handling sexual health topics. In addition to the scientific implications, we hope it will also have ethical, social, and political impact, by motivating national policies and raising awareness of the lack of education in the community regarding sexual health.

Conflicts of Interest

The authors report no conflicts of interest.
(164) FROM IDEA TO REALITY: A FRAMEWORK FOR THE CREATION AND DISSEMINATION OF NEW EDUCATIONAL MATERIAL ON SEXUAL HEALTH
Authors: Sam Geuens , Anna-Polona Mivšek , Woet Gianotten
Published: July 2023

Objectives

This presentation aims to present sexual health professionals with practical advice on creating, publishing and disseminating new educational source material on a global scale. Drawing on the combined experience of the presenters a framework shall be presented, starting at the early stages of an emerging idea, covering topics as conceptualization of topics, outlining gaps in educational material, deciding on type and form of educational material, gathering a dream team, partnering up with professional organizations, fund raising, etc. to create new educational material usable both in the training of new health care professionals and the lifelong learning of practicing health care professionals.

Methods

An inside look at the developmental process behind the soon to be published Springer Nature textbook ‘Sexuality & Midwifery’ shall function as a case example allowing a step by step reflection on the developmental process of creating globally, free accessible educational material on sexual health.

Results

.

Conclusions

While sexuality and sexual health should be a part of the educational curriculum of all professionals active in healthcare settings, it remains a topic easily passed over in many healthcare oriented training programmes around the world, both in medical, paramedical and psychological curricula.

Educationalists often find it difficult to include sexuality into degree programmes. The lack of ready to use educational material can makes it daunting even for motivated educationalists to adequately incorporate sexuality into training programmes.

On the other hand sexual health experts willing to share their knowledge for educational purposes could use help when it comes to getting from an idea to a fully worked out and easily accessible new educational resource. The framework and practical advice provided in this presentation can help sexual health experts make their ideas for new educational tools become reality.

Conflicts of Interest

No conflicts of interest are present.
(140) DISTAL REPAIR OF PENILE PROSTHESIS HERNIATION WITH POLYPROPYLENE MESH REINFORCEMENT
Authors: Carlo Ceruti , Omid Sedigh , Marco Falcone , Massimiliano Timpano , Mirko Preto , Mattia Sibona , Ilaria Ferro , Natalia Plamadeala , Federica Peretti , Lorenzo Cirigliano , Emanuele Annunziata , Chiara Polito , Luigi Rolle , Paolo Gontero
Published: July 2023

Objectives

Apical erosions are the most frequent clinical presentation of a structural failure of the tunica albuginea.

In cases of limited erosion, if a thick pseudocapsule is available, it is possible to repair the failure without grafts, but in many cases it’s necessary to strengthen the apex with biomaterials.

We present our technique and our experience in apicoplasty for wide distal erosions using a polypropylene mesh reinforcement.

Methods

Surgical Technique:

Surgery is performed through a subcoronal incision. The extent of apical dissection depends on the width of the tunical failure: in many cases it is sufficient to dissect the apices from the glans, in others a wider release of the distal corpora with disassembly of the glans is necessary. A conventional Polypropylene hernia mesh has been used, tailored over the apices in order to avoid folds and compressions on the urethra and the neurovascular bundle.

Clinical experience

12 patients, presented with impending erosion after implantation of inflatable implant (7 cases), malleable implant (4 cases), Apollo Expander (1 case), have been treated and followed up (median 16 months).

Results

We didn’t report any major (Clavien>=3) complication; among grade 2 complications we reported transitory numbness of glans (2), glans blister and/or escara with complete restitutio ad integrum (2), peno scrotal haematoma (3) No relapses of herniation nor infections were recorded and all the patients resumed satisfying penetrative sexual activity. The underlying penile implant made the mesh not palpable in 75% of patients, and no patient referred any complaint; in only 1 case the partner reported a mild dyscomfort during intercourse.

Conclusions

After a previous experience with the use of a porcine dermal graft we shifted to polypropylene mesh in order to increase graft resistence. The repair using a polypropylene mesh appears to be a reliable and well accepted solution to definetively treat extensive albugineal failures.

Conflicts of Interest

None.
(191) COMPLEX FEMALE URETHRAL DIVERTICULUM WITH STAGED URETHRALRECONSTRUCTION
Authors: Senad Bajramovic , Prof. Damir Aganovic , Nirvana Sabanovic Bajramovic
Published: July 2023

Objectives

Urethral diverticulum (UD), whether congenital or acquired, represents a rare urological condition, usually presented with diverse and nonspecific clinical symptoms. Although the diagnosis of UD may be assumed by patient’s history and physical examination, appropriate radiological imaging is crucial for establishing the diagnosis.

Methods

In this report, we present a case of a 34 years old female patient, with frequent urinary tract infections (UTIs) accompanied by purulent urethral discharge during the last three years. The patient was sexually active, and was not subjected to any previous gynecological interventions. Physical examination indicated the presence of cystic formation on anterior vaginal wall. MRI scans of urethra revealed one large, saddle bag UD and another, smaller UD.

Results

After the diagnosis was established, we performed diverticulectomy, followed by urethral reconstruction (urethroplasty) using labia minora and surrounding tissue. Following the urinary catheter extraction, the patient was able to control the urination, having weak urinary stream. Instrumental dilatation of urethra was done periodically, although the effect was not long-lasting, and the patient still experienced the weak stream. Local findings were normal without any inflammation. After one year, repeated MRI findings did not show any recurrence of UD, so we performed urethroplasty, using buccal mucosa graft. Following catheter extraction the patient was able to urinate normally, maintaining high uroflow, without any disuric symptoms, or urinary leak.

Conclusions

Individual approach to the patient and gradual resolution of the problem represent a key to treatment success.

Conflicts of Interest

No conflicts.