bluuebunny/crossref_metadata_2025 huggingface dataset:
The Dyson equalizer: adaptive noise stabilization for low-rank signal detection and recovery
Authors: Landa Boris , Kluger Yuval
Published: December 2024

Detecting and recovering a low-rank signal in a noisy data matrix is a fundamental task in data analysis. Typically, this task is addressed by inspecting and manipulating the spectrum of the observed data, e.g. thresholding the singular values of the data matrix at a certain critical level. This approach is well established in the case of homoskedastic noise, where the noise variance is identical across the entries. However, in numerous applications, the noise can be heteroskedastic, where the noise characteristics may vary considerably across the rows and columns of the data. In this scenario, the spectral behaviour of the noise can differ significantly from the homoskedastic case, posing various challenges for signal detection and recovery. To address these challenges, we develop an adaptive normalization procedure that equalizes the average noise variance across the rows and columns of a given data matrix. Our proposed procedure is data-driven and fully automatic, supporting a broad range of noise distributions, variance patterns and signal structures. Our approach relies on random matrix theory results that describe the resolvent of the noise via the so-called Dyson equation. By leveraging this relation, we can accurately infer the noise level in each row and each column directly from the resolvent of the data. We establish that in many cases, our normalization enforces the standard spectral behaviour of homoskedastic noise—the Marchenko–Pastur (MP) law, allowing for simple and reliable detection of signal components. Furthermore, we demonstrate that our approach can substantially improve signal recovery in heteroskedastic settings by manipulating the spectrum after normalization. Lastly, we apply our method to single-cell RNA sequencing and spatial transcriptomics data, showcasing accurate fits to the MP law after normalization.
Convergence study of IB methods for Stokes equations with prescribed velocity boundary conditions
Authors: Li Zhilin , Pan Kejia , Ruiz-Álvarez Juan
Published: December 2024

Peskin’s Immersed Boundary (IB) model and method are among the most important modeling tools and numerical methods. The IB method has been known to be first order accurate in the velocity for incompressible Stokes and Navier–Stokes equations. The convergence of the IB method for Stokes equations with periodic boundary conditions is discussed in Liu & Mori (2014, $L^p$ convergence of the immersed boundary method for stationary Stokes problems. SIAM J. Numer. Anal., 52, 496–514) and Mori (2008, Convergence proof of the velocity field for a Stokes flow immersed boundary method. Comm. Pure Appl. Math., 61, 1213–1263). However, almost no rigorous theoretical proof can be found in the literature for Stokes equations with a prescribed velocity boundary condition. In this paper, it has been shown that the pressure of the Stokes equation has a convergence order $O(\sqrt{h})$ in the $L^{2}$ norm, while the velocity has an $O(h |\!\log h| )$ convergence order in the infinity norm in two-space dimensions. The proofs are based on splitting the singular source terms, discrete Green functions on finite lattices with homogeneous Dirichlet and Neumann boundary conditions, properties of discrete delta functions and the convergence proof of the IB method for elliptic interface problems (Li (2015) On convergence of the immersed boundary method for elliptic interface problems. Math. Comp., 84, 1169–1188). The conclusion in this paper can apply to problems with different boundary conditions as long as the problems are well-posed. The proof process also provides an efficient way to decouple the Stokes equations into three Helmholtz/Poisson equations without affecting the order of convergence. Nontrivial numerical examples are also provided to confirm the theoretical analysis.
Plasmodium falciparum African PfCRT Mutant Isoforms Conducive to Piperaquine Resistance Are Infrequent and Impart a Major Fitness Cost
Authors: Hagenah Laura M , Yeo Tomas , Schindler Kyra A , Jeon Jin H , Bloxham Talia S , Small-Saunders Jennifer L , Mok Sachel , Fidock David A
Published: December 2024

Background

Piperaquine, used in combination with dihydroartemisinin, has been identified as a promising partner drug for uncomplicated treatment and chemoprevention of Plasmodium falciparum malaria in Africa. In light of the earlier spread of piperaquine resistance in Southeast Asia, mediated primarily by mutations in the drug efflux transporter PfCRT, we have explored whether PfCRT mutations would represent a probable path to piperaquine resistance becoming established in Africa.

Methods

We edited PfCRT mutations known to mediate piperaquine resistance in Southeast Asia into P falciparum asexual blood-stage parasites expressing 3 prevalent African mutant PfCRT haplotypes. Gene-edited clones were profiled in antimalarial concentration-response and competitive fitness assays.

Results

pfcrt-edited parasites expressing the contemporary Southeast Asian T93S or I218F mutations added to the GB4 and Cam783 haplotypes common in Africa did not mediate piperaquine resistance, with partial survival only at low drug concentrations. In contrast, parasites expressing these mutations on the rare PfCRT FCB haplotype, observed mostly in Northeast Africa, acquired a moderate level of piperaquine resistance. Dd2GB4, Dd2Cam783, and Dd2FCB lines edited to express the T93S or I218F mutations showed increased susceptibility to chloroquine. Piperaquine-resistant African PfCRT isoforms conferred a substantial fitness cost, manifesting as reduced asexual blood-stage parasite growth rates.

Conclusions

These findings suggest that piperaquine-resistant PfCRT mutations that emerged in Southeast Asia mediate resistance only in a limited subset of African PfCRT haplotypes, with fitness costs that we suspect would likely preclude dissemination in high-transmission malaria-endemic African regions.
Key bacteria decomposing animal and plant detritus in deep sea revealed via long-term in situ incubation in different oceanic areas
Authors: Li Jianyang , Dong Chunming , Xiang Shizheng , Wei Huiyang , Lai Qiliang , Wei Guangshan , Gong Linfeng , Huang Zhaobin , Zhou Donghui , Wang Guangyi , Shao Zongze
Published: December 2024

Transport of organic matter (OM) occurs widely in the form of animal and plant detritus in global oceans, playing a crucial role in global carbon cycling. While wood- and whale-falls have been extensively studied, the in situ process of OM remineralization by microorganisms remains poorly understood particularly in pelagic regions on a global scale. Here, enrichment experiments with animal tissue or plant detritus were carried out in three deep seas for 4–12 months using the deep-sea in situ incubators. We then performed community composition analyses as well as metagenomic and metatranscriptomic analyses. The results revealed strikingly similar microbial assemblages responsible for decomposing animal and plant detritus. Genes encoding peptidases and glucoside hydrolases were highly abundant and actively transcribed in OM enrichments, which confirmed the roles of these enriched microbial assemblages in organic decomposition. Marinifilaceae, Desulfocapsaceae, Spirochaetaceae, and o-Peptostreptococcales were found to potentially contribute to nitrogen fixation. These core bacteria, acting as cosmopolitan anaerobes in decomposing fast-sinking particulate OM, may have been underestimated in terms of their role in deep-sea microbial-mediated biogeochemical cycles during conventional sampling and diversity survey.
High quality Bathyarchaeia MAGs from lignocellulose-impacted environments elucidate metabolism and evolutionary mechanisms
Authors: Nesbø Camilla Lothe , Kublanov Ilya , Yang Minqing , Sharan Anupama Achal , Meyer Torsten , Edwards Elizabeth A
Published: December 2024

The archaeal class Bathyarchaeia is widely and abundantly distributed in anoxic habitats. Metagenomic studies have suggested that they are mixotrophic, capable of CO2 fixation and heterotrophic growth, and involved in acetogenesis and lignin degradation. We analyzed 35 Bathyarchaeia metagenome-assembled genomes (MAGs), including the first complete circularized MAG (cMAG) of the Bathy-6 subgroup, from the metagenomes of three full-scale pulp and paper mill anaerobic digesters and three laboratory methanogenic enrichment cultures maintained on pre-treated poplar. Thirty-three MAGs belong to the Bathy-6, lineage while two are from the Bathy-8 lineage. In our previous analysis of the microbial community in the pulp mill digesters, Bathyarchaeia were abundant and positively correlated to hydrogenotrophic and methylotrophic methanogenesis. Several factors likely contribute to the success of the Bathy-6 lineage compared to Bathy-8 in the reactors. The Bathy-6 genomes are larger than those of Bathy-8 and have more genes involved in lignocellulose degradation, including carbohydrate-active enzymes not present in the Bathy-8. Bathy-6 also shares the Bathyarchaeal O-demethylase system recently identified in Bathy-8. All the Bathy-6 MAGs had numerous membrane-associated pyrroloquinoline quinone-domain proteins that we suggest are involved in lignin modification or degradation, together with Radical-S-adenosylmethionine (SAM) and Rieske domain proteins, and AA2, AA3, and AA6-family oxidoreductases. We also identified a complete B12 synthesis pathway and a complete nitrogenase gene locus. Finally, comparative genomic analyses revealed that Bathyarchaeia genomes are dynamic and have interacted with other organisms in their environments through gene transfer to expand their gene repertoire.
Income Inequality and Growth: Calibration and Simulation for the Kenyan Economy
Authors: Mbara Gilbert
Published: December 2024

We investigate the notable decline in wealth and income inequality in the Kenya over the 10 year period between 2005 to 2015. Using a calibrated continuous time heterogeneous agent model, we attribute up to 80% of the variation in top wealth and income inequality to a persistent but slow increase in the return to capital, a low risk free rate, and rising ‘effective’ income tax rates. Our study suggests that a macroeconomic environment characterised by low risk-free interest rates anchored by low debt-to-fiscal revenue ratios are key to reducing both wealth and income inequality.
Involvement of CorA of Mycobacterium smegmatis in exerting intrinsic resistance towards structurally unrelated antibiotics
Authors: Chatterjee Debasmita , Daya Manasi A R , Rastogi Sumit Kumar , Panda Aditya Prasad , Biju Bayomi , Bhattacharyya Debleena , Ghosh Anindya Sundar
Published: December 2024

Aim

Ubiquitous magnesium transporter, CorA of Mycobacterium smegmatis is well known for its role in maintaining magnesium homeostasis. However, little is known about its involvement in exerting antimicrobial resistance. Here, by using molecular genetics, in vivo and in silico studies, we tried to envisage the role of CorA of M. smegmatis in antimicrobial resistance of M. smegmatis and Escherichia coli.

Methods and results

Expression of corA in M. smegmatis and E. coli decreased the susceptibility of the host cells towards various antibiotics and anti-tubercular drugs, which was elucidated by determining minimum inhibitory concentrations using the micro-broth dilution method. The intracellular antibiotic accumulation assay indicated that the host cells expressing corA accumulated less EtBr, norfloxacin, and ofloxacin than the control cells. Moreover, the presence of a sub-inhibitory concentration of Mg2+ further decreased the susceptibility towards the drugs tested. Furthermore, CorA enhanced the biofilm-forming ability of cells expressing it.

Conclusion

CorA (MSMEG_5056), a magnesium transporter of M. smegmatis influences the extrusion of multiple structurally unrelated classes of drugs and enhances the biofilm formation of E. coli and M. smegmatis.
Modernizing USP Melatonin Liquid Chromatographic Analyses for Increased Throughput and Reduced Environmental Impact
Authors: Yang Jinchuan , Rainville Paul D , Harden Stephanie N
Published: December 2024

Background

Melatonin supplements are often used to alleviate jetlag and other sleep-depletion-related disorders. Recent studies found large inconsistencies between labeled values and actual contents of melatonin within products, which has led to concerns over the quality of melatonin supplements. In order to facilitate the QC testing of melatonin supplements, an improved and more modern approach to the liquid chromatographic analysis of melatonin is required. In addition, growing public concern over the environmental footprint of analytical laboratories exacerbates the need to modernize legacy analytical procedures with more eco-friendly or greener approaches.

Objective

This study aims to optimize the routine liquid chromatographic analyses that are prescribed in the US Pharmacopeia (USP) melatonin monograph on an HPLC system without fundamentally modifying the methods.

Methods

The melatonin assay and test for melatonin-related compounds (impurities) were optimized on a C18 column packed with 2.5 µm particles. The column length and the gradient elution parameters were adjusted following the guidelines in “Adjustment of Chromatographic Conditions” in USP General Chapter <621>. The mobile phase compositions were optimized to meet the system suitability requirements that were specified in the USP melatonin monograph. The flow rate was optimized for better separation efficiency.

Results

The optimized HPLC methods not only met the USP system suitability requirements in relative retention time (RRT), resolution, and RSD but also demonstrated excellent linearity, sensitivity, accuracy, and precision (repeatability), and would have a lower environmental impact.

Conclusion

The optimized HPLC methods for assay of melatonin and test of its related compounds achieved significantly increased throughput and a reduced environmental impact, without fundamentally modifying the methods.

Highlights

The optimized HPLC methods are significantly faster and more eco-friendly. These methods can be implemented on HPLC systems without a full re-validation.
Cannabidiol can affect morphology, morphometry, enzymatic and microbial activity of rabbit digestive system
Authors: Musco Nadia , Pascon Giulia , Addeo Nicola Francesco , Zarantoniello Matteo , Lanzieri Mariarosaria , Olivotto Ike , Tulli Francesca , Iervolino Valeria , Amato Ruggero , Lombardi Pietro , Bovera Fulvia
Published: December 2024

The present research aimed to evaluate the effects of the continuative dietary administration of a hemp oil extract containing cannabinoids (cannabidiol, CBD) on the macroscopic morphology, morphometry, and enzymatic activity of different intestinal tracts as well as on the production of short-chain fatty acids (SCFAs) in the cecum of growing rabbits. The research was performed on 16 rabbits randomly selected from 2 experimental groups (8 per group). In detail, 42 sixty-day-old New Zealand White × California rabbits (sex ratio 1:1, average weight 1621.3 ± 46.2 g) were homogeneously divided into 2 groups (21 animals/group), namely control and CBD. Both groups were fed the same commercial diet, but the CBD one was supplemented with 0.1 mL of hemp extract in coconut-based oil corresponding to 10 mg of CBD/animal/d. Up to 92 d of age (for 27 d), individual live weight and feed intake were measured weekly. At 92 d of age, 8 rabbits/group (sex ratio 1:1) were moved to a specialized slaughterhouse, and the gastrointestinal tract was separated from the carcass. Samples from 8 rabbits per dietary treatment were used for the histomorphological analysis of small and large intestines. In addition, duodenum, jejunum, ileum, and cecum were processed for enzymatic analysis. The caecal contents were used for the SCFAs determination. The administration of CBD did not affect feed intake and the final rabbits’ whole body weight (P > 0.05), but some changes were detected in the gastrointestinal tract of the animals. CBD seemed to interfere with protein digestion, with a significantly lower activity of the enzymes related to peptides in the small intestine and a consequent increase of the fermentative activity of caecal microbiota. This effect, in combination with a general decrease of fermentative activity in the caecal content of rabbits submitted to CBD treatment, was responsible for a change in the SCFA proportion mainly regarding the reduction of butyrate production (P < 0.01) that resulted significant higher in CTR group compared to CBD. This last result is very important for intestinal health. Such fermentation activity modification was coupled with changes in the relative abundance of goblet cells in the colon. Overall, our findings suggest that a relatively long-term administration of CBD may affect digestion in rabbits, in particular at enzymatic and fermentative levels.
How many species of shrimps (Decapoda: Caridea, Dendrobranchiata, Stenopodidea) in Brazil? Diversity, geographic distribution, and history of taxonomic studies based on the Catálogo Taxonômico da Fauna do Brasil (Taxonomic Catalog of the Brazilian Fauna)
Authors: Terossi Mariana , Cardoso Irene
Published: December 2024

The 4,461 shrimp species worldwide correspond to approximately 25% of the diversity of crustacean decapods. We surveyed the shrimp species known for Brazil based on the Catálogo Taxonômico da Fauna do Brasil (Taxonomic Catalog of the Brazilian Fauna). A total of 373 shrimp species are so far recorded from Brazil, of which 79% are Caridea, 19% Dendrobranchiata, and 2% Stenopodidea. Caridea is represented by 24 families and 294 species, Dendrobranchiata by seven families and 72 species, and Stenopodidea by three families and seven species. The Brazilian representatives of the three taxa respectively represent 8%, 14%, and 7% of the global species diversity and 21%, 49%, and 29% of the global generic biodiversity. Forty-three species of Caridea, three of Stenopodidea, and one of Dendrobranchiata are endemic to Brazil. Twelve non-native, alien species belonging to seven genera are reported for Caridea and Dendrobranchiata. The vast majority of all species are marine and brackish-water (328 species), 112 of which are from deep water (> 500 m), and 45 from fresh water. Brazil is the confirmed type locality of 81 species, but this number may be higher. The authors of these species were only from Europe and the USA until 1950, but mostly Brazilian since. This compilation aims to provide information about Brazilian shrimps to assist future research in all areas and to help governmental or non-governmental (NGO) agencies in making decisions and recommendations about conservation issues.
Perspectives from federal and state public health departments on their participation in and the utility of Ixodes scapularis (Acari: Ixodidae) and Ixodes pacificus tick and tick-borne pathogen surveillance in the United States
Authors: Eisen Rebecca J , Foster Erik , Kjemtrup Anne , Saunders Megan E M , Brown Jennifer , Green Lee , Cervantes Kim , Prusinski Melissa A , White Jennifer , Barbarin Alexis M , Williams Carl , Kwit Natalie , Bernick Joshua , Gaines David , Dykstra Elizabeth , Oltean Hanna N , Dotseth Eric , Lee Xia , Osborn Rebecca
Published: December 2024

In response to notable increases in tick-associated illnesses in the United States, recent public health policies encouraged multi-sector collaborative approaches to preventing vector-borne diseases. Primary prevention strategies focus on educating the public about risks for tick-borne diseases and encouraging adoption of personal protection strategies. Accurate descriptions of when and where people are at risk for tick-borne diseases aid in the optimization of prevention messaging. Tick and tick-borne pathogen data can be used to fill gaps in epidemiological surveillance. However, the utility of acarological data is limited by their completeness. National maps showing the distribution of medically important tick species and the pathogens they carry are often incomplete or non-existent. Recent policies encourage accelerated efforts to monitor changes in the distribution and abundance of medically important ticks and the presence and prevalence of human pathogens that they carry, and to provide actionable, evidence-based information to the public, health care providers and public health policy makers. In 2018, the Centers for Disease Control and Prevention initiated a national tick surveillance program focused on Ixodes ticks. The national program coordinated and expanded upon existing efforts led by public health departments and academic institutions. Here, we describe experiences of state public health departments engaged in Ixodes tick surveillance, including information on why they initiated Ixodes surveillance programs, programmatic objectives, and strategies for maintaining tick surveillance programs. We share experiences and challenges in interpreting or communicating tick surveillance data to stakeholders and explore how the acarological data are used to complement epidemiological data.
The evolution of NCI’s Health Information National Trends Survey: methods, data, and future directions
Authors: Blake Kelly D , Moser Richard P , D’Angelo Heather , Gaysynsky Anna , Vanderpool Robin C
Published: December 2024

The National Cancer Institute’s (NCI’s) Health Information National Trends Survey® (HINTS®) was conceived in 1997 during a multidisciplinary conference focused on risk communication that included attendees representing the fields of psychology, health behavior, health education, public health, clinical medicine, and health journalism. The key recommendation from the conference was for NCI to develop a premiere communication-specific population survey to track health and cancer communication-related phenomena. This led to NCI developing and launching HINTS in 2003. HINTS is a cross-sectional, nationally representative survey of the US noninstitutionalized adult population (18 years and older) that collects data on the public’s need for, access to, and use of health- and cancer-related information and health- and cancer-related knowledge, attitudes, and behaviors. As of 2024, HINTS had been administered 17 times over a 21-year period. The resulting datasets can be used for secondary analysis to examine a range of social and behavioral research questions in cancer control and population sciences. The datasets can be examined individually or merged to test for trends over time or to create larger samples for analysis. The evolution of the program has included testing and changing instrument administration modes, oversampling specific populations, and assessing priority constructs, as well as conducting methodological experiments to keep pace with emerging trends in survey research. HINTS has also expanded beyond its cross-sectional format to include data linkages and a longitudinal panel, enabling researchers to address a wider range of research questions. HINTS methods, data products, and impact are discussed.
The global multiple myeloma incidence and mortality burden in 2022 and predictions for 2045
Authors: Mafra Allini , Laversanne Mathieu , Marcos-Gragera Rafael , Chaves Humberto V S , Mcshane Charlene , Bray Freddie , Znaor Ariana
Published: December 2024

Background

Multiple myeloma (MM) is an important hematological malignancy in older adults, with a relatively poor prognosis. We aimed to present the current global patterns of incidence and mortality from MM, and predict new cancer cases and deaths by 2045.

Methods

Estimated numbers of MM cases and deaths and age-standardized (World) incidence and mortality rates per 100 000 people were obtained from the GLOBOCAN 2022 database covering 185 countries. Based on the incidence and mortality rates for 2022 and UN population estimates up to 2045, cases and deaths were predicted up to 2045.

Findings

Globally, 188 000 MM cases and 121 000 deaths were estimated in 2022. Eastern Asia and Northern America accounted for one-fifth of all cases each (21% and 19% respectively), followed by South-Central Asia (11%), and Western Europe (9%). The incidence rates were higher in men than in women with similar geographical patterns. While the incidence rates were highest in Northern America and Australia/New Zealand (≥4/100 000 for both sexes combined), the highest mortality rates (1.8/100 000) were found in Australia/New Zealand, Northern Europe, and Southern Africa. In the absence of changing rates, the estimated incidence and mortality of MM will increase by 71% and 79%, respectively by 2045 relative to 2022.

Interpretation

Our study highlights the substantial burden and variations in MM incidence and mortality reflecting global disparities in diagnosis and treatment. Improved surveillance and better disease control is needed to mitigate the global impact of MM in the presence of population aging and growth.
Impact of radiation therapy dose, fractionation, and immunotherapeutic partner in a mouse model of hormone receptor–positive mammary carcinogenesis
Authors: Buqué Aitziber , Bloy Norma , Petroni Giulia , Jiménez-Cortegana Carlos , Sato Ai , Iribarren Cristina , Yamazaki Takahiro , Galassi Claudia , Hensler Michal , Bhinder Bhavneet , Guarracino Andrea , Rippon Brady , Beltran-Visiedo Manuel , Soler-Agesta Ruth , Pannellini Tania , Fucikova Jitka , Demaria Sandra , Zhou Xi Kathy , Elemento Olivier , Formenti Silvia C , Galluzzi Lorenzo
Published: December 2024

Background

Hormone receptor–positive (HR+) breast cancer responds poorly to immune checkpoint inhibitors (ICIs). In some settings, radiation therapy (RT) has been shown to mediate immunostimulatory effects and promote ICI sensitivity.

Methods

We investigated whether hypofractionated RT may be successfully combined with ICIs in a mouse model of multifocal, metachronous HR+ mammary carcinogenesis. We hypothesized that focal RT targeting the first detectable (primary) tumor combined with ICIs may generate effective immunity, delaying the development of new lesions.

Results

Focal RT in various doses and fractionations limited primary tumor growth, with an optimum for a 20-Gy × 2 regimen (ablative in approximately 90% of mice). The degree of primary disease control, however, did not necessarily correlate with overall survival extension because of changes in the development of new neoplastic lesions contributing to global tumor burden. Adding a PD-1 blocker to focal RT delivered in a 10-Gy × 3, 20-Gy × 2, or 8-Gy × 6 regimen failed to alter overall survival extension enabled by RT alone. Similar results were obtained with a CTLA4 blocker, an IL-1β inhibitor, and a PD-1 blocker plus recombinant FLT3LG when combined with the 10-Gy × 3 regimen.

Conclusions

In this model of HR+ mammary carcinogenesis, RT to the primary tumor ameliorates overall survival (to an extent based on dose and fractionation). Increasing local control through RT alone or RT plus immunotherapy beyond a hitherto undefined threshold, however, does not necessarily inhibit the development of subsequent nonirradiated neoplasms and hence does not necessarily provide extra overall survival benefits.
Decoding material networks: exploring performance of deep material network and interaction-based material networks
Authors: Wan Wen-Ning , Wei Ting-Ju , Su Tung-Huan , Chen Chuin-Shan
Published: December 2024

The deep material network (DMN) is a multiscale material modeling method well-known for its ability to extrapolate learned knowledge from elastic training data to nonlinear material behaviors. DMN is based on a two-layer building block structure. In contrast, the later proposed interaction-based material network (IMN) adopts a different approach, focusing on interactions within the material nodes rather than relying on laminate composite structures. Despite the increasing interest in both models, a comprehensive comparison of these two computational frameworks has yet to be conducted. This study provides an in-depth review and comparison of DMN and IMN, examining their underlying computational frameworks of offline training and online prediction. Additionally, we present a case study where both models are trained on short-fiber reinforced composites. We trained each model using elastic linear datasets to evaluate their performance and subjected them to multiple loading tests. Their performance is closely compared, and the possible factors that cause differences are explored. The superiority of IMN in offline training and online prediction is found.
Alternative Antibiotic Selections During the 2022 Amoxicillin Shortage in the United States
Authors: Ramgopal Sriram , Rosenman Marc , Zhang Lu , Cotter Jillian M , Sartori Laura F , Lipshaw Matthew J , Banks Ashley R , Schroeder Alan R , Lales George , Alexander Kenneth A , Michelson Kenneth A , Florin Todd A
Published: December 2024

This study of 7 pediatric hospitals identified that the amoxicillin shortage in 2022 resulted in a decline in amoxicillin suspension prescribing by 30.8% with increases in use of amoxicillin nonsuspension (+7.9) and broad-spectrum antibiotics. Strategic planning and standardized guidelines are essential to address future shortages and ensure effective, guideline-based care.
Ameboma, a rare cause of intestinal obstruction in bariatric surgery patients: a case report
Authors: Palacios Mauricio , Guachilema R Alex , Lisintuña Andrea , Yepez Julio , Verboonen Sergio
Published: December 2024

Ameboma is a rare complication of invasive amebiases caused by the intestinal protozoan Entamoeba histolytica. The disease is characterized by tumorous, exophytic, inflammatory masses in the lower-right quadrant of the abdomen. Symptoms are nonspecific but may include intestinal obstruction and gastrointestinal bleeding. Although computed tomography and ultrasound can identify colonic masses, biopsy is the most accurate diagnostic method for ameboma. Differential diagnosis includes Crohn’s disease and colon carcinoma. Treatment involves killing the trophozoites in most cases and surgical intervention in patients with intestinal obstruction or perforation, phlegmon, or toxic megacolon. This study reports a case of intestinal obstruction caused by ameboma within the ascending colon of a bariatric surgery patient.
Laparoscopic treatment of a large simple hepatic cyst misinterpreted as hydatid
Authors: Shumarova Svetlana
Published: December 2024

In addition to becoming the gold standard for surgical treatment of a number of diseases, laparoscopy is sometimes needed as a diagnostic method to differentiate one disease from another. We present a case of a 75-year-old man with an incidentally found liver cyst, which was suspected to be hydatid. We performed a laparoscopic deroofing and a simple cyst was found, which diagnosis was confirmed the final pathological analysis of the cyst wall.
(151) CHARACTERIZATION AND QUALITY ASSESSMENT OF TOP 50 PENILE ENHANCEMENT YOUTUBE VIDEOS
Authors: Lutchka J , Morrison C , Richard C , Liaw A
Published: December 2024

Introduction

YouTube is widely used for seeking medical information, however, there is no review process to prevent poor quality content from making it to the top. Penile enhancement is a popular, yet under-studied area and thus, information regarding it is sparse. DISCERN scores assess the quality and reliability of content.

Objective

To accurately characterize and assess quality of the top 50 most popular YouTube videos surrounding penile enhancement.

Methods

“Penile enhancement” was searched on YouTube and video metrics were collected. Medical students and urologists assigned DISCERN scores, using The DISCERN Instrument protocol, for the top 50 videos by view count. Descriptive statistics and targeted regression analyses were executed.

Results

Three videos not produced in English and five videos not pertaining to penile enhancement were excluded from the study. A total of 47 videos were analyzed. The average DISCERN score was 2.54 ± 0.92 with most videos (n = 30) scoring in the lower half of possible DISCERN scores, between 1-2.99. The group that made the most content was non-urologist healthcare workers (40%) with urologists making 28% of the content and non-healthcare workers making 28%. No significant associations (-.8 > r > .8) were found between DISCERN scores and views (p > .05), followers (p > .05), likes (p < .05) or creator occupation (p < .05).

Conclusions

The quality and reliability surrounding penile enhancement YouTube videos is generally poor and it would be in the public interest to have more high-quality educational content in this area produced by specialists.

Disclosure

No.
(152) LISTENER SATISFACTION AND UTILITY OF UROLOGIC PODCASTS: A NATIONAL SURVEY OF PATIENTS AND PROVIDERS
Authors: Dolendo I , Fan A , Kennedy A , Casperson K , Dubin J , Malik R , Pierorazio P , Raman J , Bagrodia A
Published: December 2024

Introduction

Despite the multitude of urology podcasts developed for both patients and providers, there is little research on the use of urology podcasts and the effects of these podcasts on listeners and their behaviors.

Objective

We sought to identify listener interests and satisfaction with urology podcasts and determine whether the podcasts influences the listeners’ behaviors or health-related decisions.

Methods

Qualtrics surveys were distributed to both patients and providers who listen to urology podcasts via social media. Survey information assessed self-reported demographics and podcast listening habits. Participants selected specific urology podcast(s) and answered questions about satisfaction with the selected podcasts and how the podcast influenced their behaviors. A subset of questions were administered to providers about the podcast appropriateness for their level of training and whether the podcast influenced their practice.

Results

There were 212 survey participants. Demographics and podcast listening habits are listed in Table 1. Of the participants, 81.13% agreed or strongly agreed that the podcast(s) improved their knowledge of topics covered and 82.08% agreed or strongly agreed that the podcast(s) were clear and easy to understand. 85.19% were likely or extremely likely to recommend the podcast(s) to a friend. After listening to the podcast(s), 84.66% reported changing their behavior (i.e., went to the doctor, changed their practice). The most valuable aspects of the podcasts were the ability to review materials at their own pace (33.33%) and at any time (24.56%). The preferred lengths for podcasts were 15-30 minutes (35.47%) and 30-45 minutes (30.23%). Once weekly was the ideal frequency of new episodes (51.18%) while solo lecture-style was the preferred format (40.35%). Half of the healthcare providers were attendings, 17.39% were fellows, 10.87% were residents, 13.04% were students, 6.52% were advanced practice providers, and 2.17% were physical therapists. 91.84% agreed or strongly agreed that the podcasts were appropriate for their training. After listening to the podcast(s) 81.63% changed or planned to change their practice.

Conclusions

Urology podcasts are effective forms of education for patients and providers. Majority of listeners would recommend the podcast(s) to a friend and endorsed changing their behavior after listening to the podcast(s).

Disclosure

No.
(160) POST-PANDEMIC AMERICAN UROLOGICAL ASSOCIATION SECTION MEETINGS SUCCESSFULLY FEATURE WOMEN UROLOGISTS IN SEXUAL MEDICINE
Authors: Wright N , Paz A , Pantoja G , Khera M
Published: December 2024

Introduction

Sexual medicine is a historically male-dominated urological subspecialty, potentially exacerbating the critical lack of research in female sexual medicine. Rates of invited women speakers, moderators, and panelists can correlate to conference planning committees’ representation efforts.

Objective

An analysis of women urologists in sexual medicine invited as speakers to the 2021-2023 Main and section meetings of the American Urological Association (AUA) was performed to increase understanding of post-pandemic female representation. Historical records were reviewed to stratify sections based on number of past female presidents for further analysis.

Methods

Review of programs from the AUA Main and section meetings in 2021, 2022, and 2023 was performed. The gender of sexual medicine plenary speakers, moderators, and panelists along with moderators of poster/podium/video sessions was recorded and confirmed via institutional websites or U.S. News & World Report. The number and gender of section past presidents was similarly recorded and confirmed. AUA Census data from 2021 and 2022 was queried for further analysis. Statistical methods included chi-square and two-proportion Z tests (α = 0.05).

Results

Across 26 meetings (summarized in Table 1), there were 50 women out of 252 sexual medicine speakers (19.8%). There was a range of 13.8% (South Central) to 34.3% (North Central) female speakers across the 9 conferences. Of interest, only North Central had a statistically significant higher proportion of women sexual medicine speakers relative to their proportion of censused practicing women urologists (p < 0.001). When comparing individual section conferences to the Main conference, only North Central had a statistically significant higher proportion of women sexual medicine speakers (p < 0.001). When comparing sections with past female presidents (Northeastern, New England, Mid-Atlantic, Western) to those without (New York, North Central, Southeastern, South Central), there was no statistically significant difference in the overall proportion of female speakers (p = 0.74), women taking part in plenary sessions (p = 0.46), or peer moderators who were female (p = 0.06).

Conclusions

In contrast to pre-pandemic literature, this study indicated all contemporary AUA conferences have a representative proportion of women sexual medicine speakers compared to their censused proportion of practicing women urologists. Additionally, no section invites a lower proportion of female speakers than the Main conference. Of interest, sections without a previous female president do not invite fewer women sexual medicine speakers or invite them to less prestigious roles. This data supports the efficacy of current diversity and inclusion efforts across the AUA and encourages continued monitoring of female speakers in all subspecialties.

Disclosure

No.
(161) THE 30-DAY WAITING PERIOD FOR ELECTIVE STERILIZATION IN NEW YORK STATE
Authors: Jackson J , Joshi P , Schoor R
Published: December 2024

Introduction

Current studies have shown that men who elect to undergo vasectomies do so willingly and with their eyes wide open: regret following vasectomy is quite rare, even in childless men. In the current era of patient autonomy, all that is required ethically for an adult male to undergo elective sterilization is capacity and a proper and complete informed consent discussion from a vasectomist skilled in the procedure. Why, then, must Medicaid covered men here in New York State and nationally wait 30 days following a consultation to have a vasectomy?

Objective

The purpose of the present study is to review the history of the 30-day-wait period for elective sterilization and to point out its inequities and dangers.

Methods

Public data search of primary source data: PubMed, Nexus/Lexus, NYTimes, NYUS DOH.

Results

In the 1970s, reports of sterilization abuse resulted in a movement to combat coercion in the form of regulations on publicly funded sterilization. The Department of Health, Education, and Welfare enacted regulations including a 72-hour waiting period before sterilization and prohibition of sterilization of those younger than 21 years old. In 1978 the waiting period was extended to 30 days. The New York State Sterilization Consent Form contains a policy length of 10 or more pages and exceeds the minimum reading levels required for patient education material and informed consent documents. The New York form requires a witness to certify that they were present while the counselor read and explained the consent to the patient, and that the witness saw the patient sign the consent form with his/her own handwriting.

Conclusions

Delays in access to reproductive care can, have and will continue to result in unwanted pregnancies. In the present post-Dobbs era, unwanted pregnancies have already caused morbidity and mortality in women and will only continue to so. Moreover, placing barriers to reproductive care for both men and women increases the woman’s reproductive burden and serves to promulgate generational poverty. Though mandatory wait period regulations came in response to public outcry related to improper sterilizations performed on vulnerable populations but in its current form, mandatory 30-day wait periods serve no one: not society nor the poor the policies claim to protect. Mandatory 30-day wait periods reek of inequity and must be abolished. This fight starts at the level of county and state medical societies.

Disclosure

No.
(186) THE USE OF THE FLUORESCENT NUCLEAR STAIN DAPI TO IDENTIFY SEMINAL LEUKOCYTES
Authors: Stocks B , Oppenheimer A , Tran L , Huang J , Lipshultz L
Published: December 2024

Introduction

Emerging animal-based research highlights the requisite role of the immune system in maintaining tolerance to spermatozoa. Critically, however, there exists a paucity of studies investigating the role of the immune system in clinical male factor infertility. Current protocols investigating seminal fluid resident white blood cells (leukocytes) include peroxidase staining; however, further investigation of these cells is rarely performed due to the extremely low frequency of these cells. The AUA and ASRM have no guidelines regarding the workup or treatment of leukospermia.

Objective

We sought to develop a streamlined and simple assay to identify and better characterize rare leukocytes within spermatozoa-rich semen samples.

Methods

We identified 15 patients with “Too Numerous to Count” round cells from our seminal fluid cryobank. These semen samples were thawed and exposed to a formalin/saponin based buffer to fix and permeabilize cells. Cells were then stained with the fluorescent nuclear stain DAPI and fluorescently conjugated antibodies directed against CD45. Sample acquisition was performed on a BD LSRFortessa Flow Cytometer and data analyzed using FlowJo software.

Results

DAPI nuclear staining clearly separates DAPI dim spermatozoa (haploid cells) from DAPI bright leukocytes (diploid cells). Subsequent dual-channel CD45 antibody staining confirms the absence of CD45 on haploid spermatozoa (98% negative) and positivity of CD45 on diploid leukocytes (87.2% positive). Appropriate DAPI signal intensity of the leukocytes within the semen samples was confirmed by spiking semen samples with peripheral blood mononuclear cells. Overall, CD45 positive leukocytes represented 0.003% to 2.93% +/- 0.88% of the leukocytes found in the seminal plasma of infertile patients.

Conclusions

50% of male factor infertility remains undefined. Preclinical evidence reveals a required role of the immune system in maintaining immunologic tolerance to “foreign” spermatozoa. Breaks in this system may perpetuate male factor infertility but clinical investigation of this paradigm remains to be pursued.

Disclosure

No.
(192) THE PAUCITY OF FEMALE SEXUAL DYSFUNCTION TRAINING IN UROLOGY AND OBGYN RESIDENCIES
Authors: Brink S , Implicito C , Cadiente A , Ullah N , Nguyen J , Shin D
Published: December 2024

Introduction

Female sexual dysfunction (FSD) is an underappreciated field, receiving much less attention than male sexual dysfunction (MSD). As the AUA Core Curriculum includes lessons on both MSD and FSD, urology residencies should be providing education on both; however, unlike MSD, FSD can also be treated by OBGYNs so it is worthwhile to compare Urology and OBGYN education on this topic.

Objective

We sought to evaluate all AUA- and ACOG-accredited residency program websites to determine the availability of FSD information and to compare this to the availability of MSD information in Urology programs.

Methods

The AUA and ACOG residency program lists were used to identify Urology (n = 148) and OBGYN (n = 228) residency program websites, respectively. Each website was independently analyzed by three reviewers to collect: FSD (“sexual health/function/dysfunction” specifically related to females) and MSD (“erectile dysfunction,” “impotence,” “men’s health,” “sexual health/function/dysfunction,” “prosthetics”) content, number of clicks to reach each topic, curricula, subspecialists on faculty, and program directors (PDs). Data was stratified by AUA section and ACOG district where appropriate. Chi-square analysis was performed to compare FSD and MSD content.

Results

Surprisingly, there were only two (1.4%) urology residency program websites which included FSD content, with a median of 1 click (range 0-2) to access that content, compared to 12 (5.3%) OBGYN websites also with a median of 1 click (range 0-3). 74 (50%) urology websites include MSD content also with a median of 1 click (range 0-3) to access that content, which is a > 37% difference compared to OBGYN FSD content (p < .05). OBGYN FSD content was included in 10/12 (83%) of listed curricula; while MSD was only included in 33/74 (45%) of curricula (p < .05). Neither Andrology or Sexual Medicine subspecialist(s) on faculty nor PD specialization in Andrology or Sexual Medicine predicted MSD content (p > .05); however, an OBGYN FSD faculty member predicted FSD content (p < .05). Concordant PD gender did not predict MSD content (p > .05), but predicted OBGYN FSD content (p < .05). Programs with FSD content were represented in districts II, III, V, VII, VIII, and IX; while all AUA sections were represented in MSD content.

Conclusions

FSD content is lacking on urology residency program websites and severely underrepresented in urology training in comparison to MSD content and training. Only about 5% of OBGYN residency program websites include FSD content, which combined with urology’s lack of training, leads to a paucity of FSD-trained physicians. Both specialties must make great strides to fill the gap and care for women’s sexual concerns. We cannot rely on fellowship training to balance this inequity.

Disclosure

No.
(197) PENILE FRACTURE MANAGEMENT AT TRAUMA CENTERS IN THE UNITED STATES
Authors: Furuyama W , Dwyer K , Huang L , Koyama T , Johnsen N
Published: December 2024

Introduction

Current American Urological Association Urotrauma guidelines recommend prompt surgical intervention for patients presenting with acute penile fracture to minimize potential risks of erectile dysfunction and penile curvature. Given its relatively rare occurrence, there have been few large national studies evaluating real-world management of penile fracture.

Objective

To understand if there is variability in intervention for patients presenting with penile fracture associated with patients’ clinical and demographic characteristics and hospital characteristics.

Methods

The Trauma Quality Improvement Program (TQIP) database from 2007 to 2017 was analyzed and patients with diagnosis codes for penile fracture were identified. Patient demographic data and hospital characteristics were analyzed. Multivariable analysis was performed to identify patient and hospital characteristics associated with surgical intervention for penile fracture.

Results

We identified 940 patients presenting with penile fracture. The median age was 39 (quartiles: 31-47). Of the 940 patients, 658 (70%) of patients underwent surgery for penile fracture during index admission. On multivariable regression analysis, hospital teaching status, type of insurance, and concomitant urethral injury diagnosis were significantly associated with the likelihood of intervention.

Conclusions

In this large, retrospective study, most patients underwent guideline-based management. However, several patients did not have surgery at the time of their presentation, which was associated with presenting to a non-teaching hospital, using Medicaid or Medicare insurance, and the absence of urethral injury. TQIP is focused on trauma centers, thus this study may not reflect practice patterns across the United States. Further understanding of nonoperative management may improve adherence to guideline-based care.

Disclosure

No.