bluuebunny/crossref_metadata_2025 huggingface dataset:
The tryptophan metabolic pathway of the microbiome and host cells in health and disease
Authors: Miyamoto Kentaro , Sujino Tomohisa , Kanai Takanori
Published: June 2024

The intricate and dynamic tryptophan (Trp) metabolic pathway in both the microbiome and host cells highlights its profound implications for health and disease. This pathway involves complex interactions between host cellular and bacteria processes, producing bioactive compounds such as 5-hydroxytryptamine (5-HT) and kynurenine derivatives. Immune responses to Trp metabolites through specific receptors have been explored, highlighting the role of the aryl hydrocarbon receptor in inflammation modulation. Dysregulation of this pathway is implicated in various diseases, such as Alzheimer’s and Parkinson’s diseases, mood disorders, neuronal diseases, autoimmune diseases such as multiple sclerosis (MS), and cancer. In this article, we describe the impact of the 5-HT, Trp, indole, and Trp metabolites on health and disease. Furthermore, we review the impact of microbiome-derived Trp metabolites that affect immune responses and contribute to maintaining homeostasis, especially in an experimental autoimmune encephalitis model of MS.
Sugar transport in thermophiles: Bridging lignocellulose deconstruction and bioconversion
Authors: Tjo Hansen , Conway Jonathan M
Published: June 2024

Biomass degrading thermophiles play an indispensable role in building lignocellulose-based supply chains. They operate at high temperatures to improve process efficiencies and minimize mesophilic contamination, can overcome lignocellulose recalcitrance through their native carbohydrate-active enzyme (CAZyme) inventory, and can utilize a wide range of sugar substrates. However, sugar transport in thermophiles is poorly understood and investigated, as compared to enzymatic lignocellulose deconstruction and metabolic conversion of sugars to value-added chemicals. Here, we review the general modes of sugar transport in thermophilic bacteria and archaea, covering the structural, molecular, and biophysical basis of their high-affinity sugar uptake. We also discuss recent genetic studies on sugar transporter function. With this understanding of sugar transport, we discuss strategies for how sugar transport can be engineered in thermophiles, with the potential to enhance the conversion of lignocellulosic biomass into renewable products.

One-Sentence Summary

Sugar transport is the understudied link between extracellular biomass deconstruction and intracellular sugar metabolism in thermophilic lignocellulose bioprocessing.
(214) RESULTS OF THE FIRST 100 PENILE PROSTHESES
Authors: De Fuentes Dr Núria , Beato Dr Sergi , Alabat Dr Andreu , Etcheverry Dr Begoña , Castells Dr Manel , Vigués Francesc
Published: June 2024

Objectives

The implantation of a penile prosthesis (PP) stands among the most effective treatments with high satisfaction rates for erectile dysfunction. It is the treatment of choice for patients who do not respond to PDE-5 inhibitors or intracavernous injections. We present the results of the first 100 PPs implanted by the same team in our center (3 surgeons with no prior experience), along with the patients' satisfaction levels.

Methods

A prospective study of the outcomes of the first 100 PP implantations by the same team in our center from January 2022 to May 2023. Analysis of the demographic and perioperative variables, complications during follow-up and functional results. Patient satisfaction was assessed through a quality of life and sexuality questionnaire after PP implantation (QoLSPP) in outpatient consultations.

Results

With an average age of 62 years, 41% of the intervened patients had organic erectile dysfunction (ED), 34% following radical prostatectomy, 10% secondary to Peyronie's disease, 7% after cystectomy, 4% following priapism, and 4% due to other causes. The patients had an average BMI 27.8, 33% being diabetic. We implanted 97 three-component PPs and 3 malleable PPs, with a surgery time of 52 minutes. The postoperative visual analog scale at 24 hours averaged 2.3. A complication rate of 13% was reported. 4 intraoperative complications (3 crossover and 1 urethral injury) repaired during the same surgical time. 9 postoperative complications: 67% Clavien-Dindo I (5 scrotal hematoma, 1 reservoir herniation) and 33% Clavien-Dindo IIIb (1 pump extrusion, 1 cylinder herniation, 1 PP infection) requiring reintervention, antibiotic therapy and hyperbaric oxygen therapy. Patients expressed high satisfaction, with an average rating over 4/5 for all parameters except for PP rigidity (3.5).

Conclusions

The initial experience with the first 100 cases of PP implantation is very satisfactory, showing good surgical and follow-up results, a complication rate similar to published rates and high patient satisfaction.

Conflicts of Interest

None.
(213) DOES MEASURING THE DIAMETER OF THE DEEP DORSAL VEIN IN THE FLACCID STATE CONTRIBUTE TO THE OBJECTIVE ASSESSMENT OF ERECTILE DYSFUNCTION?
Authors: Appel Dr Boaz , Greenstein Prof Alexander , Shabataev Dr Valentin , Gruenwald Prof Ilan
Published: June 2024

Objectives

The association between the diameter of the Deep dorsal Vein (DV) in the flaccid penis and the indicators of Color Doppler ultrasonography (CDUS) -Peak Systolic Velocity (PSV). End Diastolic Velocity (EDV).and erection quality (EQ) according to CDUS after PGE1 injection have been scarcely tested. Our aim was to assess the association between the DV diameter (DVd) in the flaccid penis with these blood inflow and outflow indicators and with erection quality (EQ), assessed by CDUS.

Methods

Fifty-five men, mean age 47.4 years, (range 24-70) complaining of ED were included, all underwent CDUS. DVd was measured in a transverse position with the penis in a flaccid state. After intracavernous PGE1 injection (10mcg), arterial and venous blood flow parameters were recorded every 5 minutes. We assessed EQ in the erectile state achieved after injection. The latter was subjectively rated by both the examiner & patient, comparing it to the patient’s best erection in the past (=100%) and was graded accordingly in percent. Pearson correlation coefficient was used to associate the DVd with PSV, EDV, and EQ after injection.

Results

Means of DVd were 0.14±0.1 mm, PSV≤45.3±15.2 cm/s, EDV 5.38±5.5 cm/s, and EQ 71.3±19.5%. The statistical comparison showed that the DVd vs. PSV was r=0.05, vs. EDV-r=0.12, and EQ- r=0.3. No significant direct association was found between the DVd in the flaccid state and the intra-cavernosal blood inflow or outflow or the quality of erection.

Conclusions

Measuring the DV diameter in the flaccid state does not contribute to the objective evaluation of ED and thus cannot replace the invasive CDUS, cannot suffice for obbjective ED evaluation, and does not contribute to the decision on treatment strategies.

Conflicts of Interest

No conflict of interest for all authors.
(176) IS HEMOGLOBIN A1C LEVEL A SIGNIFICANT PREDICTOR OF PENILE PROSTHESIS IMPLANTATION INFECTIONS?
Authors: Alharbi Dr Abdulrahman , Salem Dr Shady , Awwad Dr Afnan , Almuwail Dr Salman , Almutairi Dr Hamad , Alhajeri Dr Faisal
Published: June 2024

Objectives

Diabetes mellitus (DM) is a major risk factor for erectile dysfunction (ED). Penile prothesis implantation is a definitive treatment with good outcomes. However, postoperative infection remains a significant complication. This study investigates the association between Glycated Hemoglobin (HBA1c) levels and penile prosthesis infection rates.

Methods

This study is a multi-center retrospective study including all patients underwent penile prothesis implantation between 2015 and 2023. All procedures were performed by the same specialized surgeon. Preoperative, perioperative and postoperative care and prophylaxis were standardized for all patients.

Results

We retrieved and reviewed the records of 62 patients via patients electronic records. Mean age was 54.7±12.4, mean HBA1c was 6.8±1.5. Thirty-nine (62.9%) patients were diabetic. 56 (90.3%) implants were malleable, and 6 (9.6%) were inflatable devices. 11 (17.7%) patients developed penile prosthesis infection, with only 4 (6.4%) treated conservatively, whereas 7 (11.3%) patients required device removal. Patients who had implant infection had a significantly higher mean HbA1c level 8.4±1.9 vs 6.5±1.1 (P=0.002). Although mean HBA1c level was higher among patients who underwent device removal, it was not statistically significant (8.1± 2.2 vs. 6.7±1.3, P=0.093). Moreover, prosthesis infection patients were younger compared to those without prosthesis infection (45.9 ± 13.3 vs. 56.7 ± 11.5 years p=0.0113). DM, peyronie's disease, prosthesis type, operative time and smoking were not significantly associated with infection rate. On multivariate analysis, both higher HBA1c levels and young age were statistically significant predictors for post penile prosthesis infection.

Conclusions

High HBA1c level is associated with increased risk of infection after penile prosthesis implantation.

Conflicts of Interest

The authors have no conflict of interest to declare.
(1016) PATIENTS SATISFACTION RATE AFTER PENILE IMPLANT SURGERY: A CROSS-SECTIONAL INVESTIGATION IN THE MIDDLE EAST
Authors: Al-Tal Yaman , Karam Abdulrahman M , Alshawabkeh Yara , Alshrouf Mohammad A
Published: June 2024

Objectives

The aim of this study was to assess the patient’s satisfaction rate after penile implant surgery, identify the complications that occurred after the procedure, and identify the factors that are associated with the occurrence of these complications at a tertiary hospital in Jordan.

Methods

This study involved a single-center cross-sectional analysis of 56 patients who underwent penile implant surgery at Abdali Hospital in the period of 2018 and 2023. Patients were contacted and asked to complete the survey, which included demographic information, as well as clinical information including comorbidities, duration of erectile dysfunction, number of preoperative consultations, previous non-surgical treatments used, number of implant surgeries, prosthesis type, late and early complications and the modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) survey.

Results

Fifty-six ED patients, 57.1% (n = 32), were treated with hydraulic penile implants, and 42.9% (n = 24) had malleable penile implants. The mean age of the participants was 56.25 ± 9.17. The mean time for ED before surgery was 5.39 ± 3.62 years. The mean score for the EDITS questionnaire was 69.40 ± 24.48, with 85.7% statisfied and 14.3% unsatisfied with the treatment. Medically free participants were 3.462 times (95% CI 1.033-11.599; p = 0.039 and 4.909 times (95% CI 1.471-16.379; p = 0.007) more likely to not have early or late complications, respectively. The most prevalent postoperative early-term complications was decrease length (39.3%), decrease width (25.0%), and pain (221.4%). The most common postoperative late-term complications decrease length (44.6%), decrease width (32.1%), and disfigurement of the penis (14.3%). There was no significant mean difference between two types of implant surgery in the total EDITS score (p = 0.171).

Conclusions

The study showed insights that underscore the importance of personalized care in penile implant selection, providing crucial guidance for urological practice in the Middle East.

Conflicts of Interest

The authors report no conflicts of interest for this work.
(1009) CARDIAC STRUCTURE AND FUNCTION IN MEN WITH ERECTILE DYSFUNCTION
Authors: Durukan Dr Emil , Jensen Christian FS , Dons Dr Maria , Sengeløv Dr Morten , Landler Nino E , Skaarup Dr Kristoffer G , Østergren Peter B , Sønksen Prof Jens , Biering-Sørensen Prof Tor , Fode Prof Mikkel
Published: June 2024

Objectives

Men with erectile dysfunction (ED) are at elevated risk of heart disease. However, data on the prevalence of abnormal cardiac structure and function in ED is scarce. We utilized echocardiography to assess cardiac characteristics in men with ED.

Methods

In this prospective cohort study of men with ED referred to a tertiary urology clinic, all participants underwent transthoracic echocardiography following a predefined protocol and electrocardiogram. Erectile function was graded according to the International Index of Erectile Function - Erectile Function (IIEF-EF) questionnaire. Participants with neurological disease, a medical history of pelvic surgery or trauma were excluded. Left ventricular (LV) structure was evaluated by ventricular mass index (LVMi). LV diastolic function was evaluated according to early diastolic mitral annular velocity (e'), ratio of early transmitral filling velocity to (E/e’) and left atrial volume index (LAVi). LV systolic function was evaluated by LV ejection fraction (LVEF), and global longitudinal strain (GLS).

Results

We included 100 patients with a median age of 61 yr (IQR 13) and median IIEF-EF was 15 (IQR 14). Comorbidities included hypertension (43%), dyslipidemia (41%), diabetes mellitus (29%), ischemic heart disease (12%), arrhythmia (12%), and heart failure (3%). Regarding cardiac structure, 25 patients had LV hypertrophy. Signs of LV diastolic dysfunction were a common observation; 21 patients had an E/e' ratio > 9, while 30 patients had reduced septal and/or lateral e' velocities with only 1 patient having left atrial dilation (LAVi > 34 ml/m2). Regarding LV systolic dysfunction, 83 patients had reduced GLS (< 16%) with 14 suffering reduced LVEF < 52%. 4 patients were referred for further evaluation, due to previously undiagnosed left bundle branch block, mitral valve regurgitation, aortic valve regurgitation, and incident heart failure, respectively.

Conclusions

A majority of patients with ED demonstrated impairment of cardiac structure and function assessed by measures of diastolic dysfunction and myocardial deformation.

Conflicts of Interest

The authors declare no conflict of interest.
(429) ADHERENCE TO PDE-5 INHIBITORS IN PATIENTS WITH ERECTILE DYSFUNCTION (ED) FOLLOWING SPINAL CORD INJURY (SCI). REAL LIFE DATA AFTER 10 YEARS OF TREATMENT
Authors: Thomas Charalampos , Kratiras Prof Zisis , Samarinas Michael , Diamantis Dr Georgios , Konstantinidis Charalampos
Published: June 2024

Objectives

PDE5Is are an effective treatment for ED in SCI individuals. A real-life cohort study was performed to evaluate the adherence to PDE5Is as well as the dropout rate, almost 10 years after the initiation of treatment.

Methods

97 SCI patients suffering from ED that were treated with PDE5Is were evaluated in 2015. Concomitant cardiovascular diseases, hormonal and psychiatric disorders were excluded. Efficacy was evaluated with IIEF5 and SEP2&3 questions. We re-evaluate our data now in order to assess the adherence to PDE5Is, almost 10 years after.

Results

10 years after we collected data from 81 patients out of the original 87 responders.

From the sildenafil group, 18 out of 31 responders are still on, 6 on daily us tadalafil, 1 on intra-cavernosal injections (ICI), 1 died, 2 were lost in follow up, 2 are off treatment due to lack of sexual partner and 1 stopped the medication due to other comorbidities.

From the vardenafil group 5/13 still are on, 2 on sildenafil, 2 daily tadalafil, 1 on ICI, 1 without partner and 2 stopped due to comorbidities..

From the avanafil group, 3/7 are still on, 1 on sildenafil and 2 on daily tadalafil.

From the on demand tadalafil group, 7/22 are still on, 5 on daily tadalafil, 2 on sildenafil, 2 were lost in follow up, 1 died, 1 on ICI, 2 without partner and 2 stopped due to other comorbidities.

From daily tadalafil group, 9 are still on, 1 died, 1 on ICI, 2 on sildenafil, 1 underwent penile prosthesis implantation and 1 stopped the medication due to other comorbidities..

Conclusions

After almost 10 years of follow up, the majority of our SCI patients remained on PDE5 inhibitors, either the one prescribed initially or a different one. The medication dropout rate, in our cohort, is approximately 20%, while other comorbidities and lack of sexual partner were the major reasons for withdrawal.

Conflicts of Interest

None.
(353) HYPERPROLACTINEMIA AND MALE SEXUAL FUNCTION: FOCUS ON ERECTILE DYSFUNCTION AND SEXUAL DESIRE
Authors: Corona Dr Giovanni , Rastrelli Prof Giulia , Bianchi Dr Nicola , Sparano Dr Clotilde , Sforza Dr Alessandra , Vignozzi Prof Linda , Maggi Prof Mario
Published: June 2024

Objectives

The present study aims to meta-analyze the available studies on the relationship between male sexual function and elevated prolactin (PRL) levels (HPRL).

Methods

An extensive search was conducted using using Medline, Embase, and Cochrane up to August 31st 2022. Published articles reporting the prevalence of HPRL in men with erectile dysfunction (ED) or reduced sexual desire (RSD) and/or the effect of treatment of HPRL on sexual complaints and studies reporting the prevalnce of ED or RSD in men with HPRL were collected.

Results

25 papers were included in the analysis. Of these, 11 investigated the prevalence of HPRL in patients with sexual dysfunction, whereas 15 and 14 investigated the rate of ED and RSD in subjects with HPRL, respectively. The effects of medical or surgical treatment on sexual function in HPRL patients were investigated in 13 studies. Among 10,980 patients, HPRL was detected in 2% of subjects with ED. The prevalence dropped to 0.9[0.6;1.5]% when severe HPRL (PRL>35 ng/ml) was considered. The rate of ED and RSD was investigated in 628 and 616 patients with HPRL and the prevalence was 57[44-69]% and 49[32-66]%, respectively. Higher PRL and lower testosterone at baseline, as well as year of study publication correlated indipendently with the ED rate (B=0.450; p<0.000, −0.158; p<0.001 and −0.237; p<0.0001, respectively). When compared to the baseline, ED was six-fold less frequent after treatment for HPRL, irrespectively of the treatment. When sexual desire was considered, any treatment of the condition resulted in a increased probability of not reporting the symptom at follow-up (OR=59.7 [13.2;269.5]; p<0.0001).

Conclusions

Normalization of PRL levels is able to improve libido. The role of HPRL in ED remains inconclusive. Either HPRL or reduced T levels were independently associated with ED rate. The normalization of PRL levels only partially restored ED whereas sexual desire was greatly improved.

Conflicts of Interest

The authors declare no conflict of interest.
(428) SIS GRAFT BULBAR URETHROPLASTY IS A VIABLE TECHNIQUE: RESULTS COMPARED TO BUCCAL MUCOSA GRAFT URETHROPLASTY AFTER PROPENSITY SCORE MATCHING
Authors: Palminteri Dr Enzo , Toso Dr Stefano , Buffi Prof Nicolò M , Ferrari Dr Giovanni , Nava Dr Luciano , Pane Dr Manuela , di Dio Dr Michele , Preto Dr Mirko , Gobbo Dr Andrea
Published: June 2024

Objectives

Despite some promising reports, the published series on SIS graft urethroplasty (SISU) suffer from short follow-up (FU), inhomogeneous patients, and a lack of a control group. This study aims to report the outcomes of bulbar SISU compared to a buccal mucosa graft urethroplasty (BMU) propensity score-matched cohort.

Methods

From our institutional database of 1132 bulbar urethroplasties, 25 BMU and 25 SISU cases were selected using propensity score matching with nearest-neighbor without replacement. The matching variables were age, stricture length, and history of urethrotomy. Failure was defined as any treatment after urethroplasty, and data were censored at 156mo. Survival analyses were used to analyze treatment failure occurrence.

Results

Matching resulted in a complete correction of bias between the two samples, except for the FU duration, which was slightly longer in the SIS group (125 vs 156mo). At a median FU of 156mo, 8/17 SISU and 4/21 BMU failed. At Kaplan-Meier analysis, the cumulative treatment success probability of BMU and SISU at 156mo was 83.4% and 68%, respectively. At multivariable Cox regression, SIS graft, previous urethrotomy, stricture length, and lower postoperative Qmax (within 2mo after catheter removal) were predictors of failure. Stricture length had a more remarkable effect on treatment success in patients undergoing SISU, with an estimated survival probability from the Cox model lower than 80% in strictures >=3cm. On the contrary, BMU had an estimated success consistently higher than 90%.

Conclusions

This study has the longest FU and the greatest sample of bulbar SISU available. The first postoperative uroflowmetry can identify patients at risk of failure and is a readily available measure useful to tailor FU. The best candidates for SISU are patients with strictures shorter than 3cm, preferably without a history of DVIU. Overall, SISU is a viable technique in selected patients, particularly when BMU is not feasible.

Conflicts of Interest

No conflict of interest to disclose.
(195) DIAGNOSTICS OF CHRONIC PROSTATITIS IN WOMEN OF REPRODUCTIVE AGE
Authors: Grygorenko V , Romashchenko O , Biloholovska V , Melnykov S , Yakovenko L
Published: June 2024

Objectives

Improvement of the diagnostics of chronic prostatitis (CP) in women of reproductive age.

Methods

A gynecological, urological, and sexological examination of 34 women aged from 24 to 34 (31±4.1) with CP lasting between 1 and 4 years was carried out. An ultrasound study of the female prostate gland and paraurethral zone was conducted using the ultrasound diagnostical system APLIO of TOSHIBA expert class brand in the regime of grey scale using the Doppler method.

Results

CP was formed at the background of latent course of an inflammatory disease in pelvic organs and was characterised by vivid symptoms (pain and discomfort during urination, local pain in perineum and the frontal wall of the vagina, heavy secretions from urethra). In 28 (82.4%) patients we found dyspareunia, which was accompanied by alibidemia in 18 (52.9%) of the examined.

During the ultrasound study of female prostate gland, a hypodense lesion having the volume from 0.7 to 1.7 cm with a clear capsule was exposed in the projection of the distal part of urethra in 24 (70.6%) women, in the projection of the proximal part of urethra – in 6 (17.6%) women, and along the urethra – in 4 (11.8%) women. The vascular markings of the paraurethral zone of female prostate gland during the coloured Doppler carding (CDC) were intense. At the same time during the CDC, it was established that the hypodense lesion was nonvascular, with single tiny vessels in the capsule zone.

Conclusions

CP in women of reproductive age was characterised by the explicit clinical recurrent course at the background of latent development of the inflammatory disease of pelvic organs and was formed mostly (70.6%) in patients with the distal location of paraurethral glands, accompanied with the spectre of sexual dysfunctions, where sexual pain should be distinguished as a diagnostical feature of this disease.

Conflicts of Interest

No conflict of interest.
(172) FEMALE SEXUAL FUNCTIONING DURING PREGNANCY: A SINGLE-CENTER SURVEY ON POLISH WOMEN
Authors: Szymanska Edyta , Kisielewski Rafał , Kisielewska Dr Lidia , Tomaszewski Janusz
Published: June 2024

Objectives

Sexual life of pregnant women alters during pregnancy due to the physiological, anatomical and hormonal changes in their body. Therefore, the aim of this study was to evaluate female sexual functioning after becoming pregnant.

Methods

A prospective survey study included 148 pregnant women. An anonymous questionnaire including 60 inquiries concerning the intimate relationship before and during pregnancy was performed. The following statistical test were used: chi-square test of independence, Spearman's rank correlation coefficient and Wilcoxon test. The significance level of p = 0.05 was assumed.

Results

Most of the respondents were between 31 and 40 years old (55%). Majority of them were married (86%). During pregnancy, slightly more than half of women had a moderate need for sexual intercourse (51%), a large percentage of them had a low need (32%), a high need for intercourse was declared by 17% of women. The correlation analysis showed a statistically significant relationship between women's education and the need for sex before pregnancy (p = 0.049). Respondents with higher degrees of education more often felt the need for intercourse before pregnancy. No correlation was found between education and the need for intercourse during pregnancy (p = 0.107). After becoming pregnant, 51% of women had less need for intercourse, 7% more, and 42% the same as before pregnancy, and these differences were statistically significant (p < 0.001). Also, a decreased satisfaction with sexual intercourse was reported during pregnancy (p < 0.001). After getting pregnant, the average number of intercourses decreased in majority (71%) of respondents, and differences in the number of intercourses before and during pregnancy were statistically significant (p < 0.001).

Conclusions

Pregnancy has a significant impact on woman’s sexuality. After becoming pregnant, majority of women declare less need for sexual intercourses and a decreased number of intercourses with less satisfaction.

Conflicts of Interest

No connflict of interests.
(427) UNVEILING UNMET NEEDS: A USER-CENTERED APPROACH TO A DIGITAL INTERVENTION FOR WOMEN AFFECTED BY GYNECOLOGICAL CONDITIONS WITH SEXUAL DISTRESS
Authors: Kosman Eden , Kronthaler Selina M , Franck Lilian R , von der Reidt Antonia , Beier Prof Klaus M , Hatzler Dr Laura
Published: June 2024

Objectives

While many women affected by gynecological conditions (e.g., endometriosis) and sexual distress actively seek medical help, their needs are hardly met within the healthcare system. The primary aim of the study is to develop a user-centered mobile digital intervention tailored to the needs of those affected, employing an iterative approach.

Methods

Phase 1 involved 20 participants in Free List Interviews to identify the unmet needs. During Phase 2, comprising 9 key informants, we conducted Thinking Aloud Interviews to assess the initial prototype's usability and user experience. Furthermore, we have intentions to include an additional 11 participants in the evaluation of an adapted prototype. Phase 3 will entail Focus Group Discussions involving affected individuals, their partners, and healthcare providers to validate pervious findings. Inductive and deductive thematic analysis was and will be used for interview protocol analysis.

Results

The preliminary results of Phase 1 highlight challenges within the healthcare system such as the lack of information for affected individuals, the insufficient knowledge of healthcare providers, and the sense of not being taken seriously. Participants expressed receiving understanding, information about support services, and alternatives for pursuing a fulfilling sexual life as their needs. To address these needs digitally, the focus should be on providing information on sexuality and on support services. Key factors for an effective digital intervention were the inclusion of videos and data privacy, alongside making it accessible through information dissemination in clinical facilities and broad advertisement.

Conclusions

This qualitative study identifies critical challenges within the healthcare system faced by women with gynecological conditions and sexual distress. The study's findings highlight the importance of developing a user-centered digital intervention to address these needs. This research contributes to a more patient-centered approach and aims to improve the quality of care for this underserved population.

Conflicts of Interest

-
(415) THE BRIDGE PROJECT: USING CULTURAL INTERVIEW FORMULATION (CFI) TO ADAPT ONLINE INTERVENTIONS FOR CSAM USERS
Authors: Šímová Leona , Klapilová Kateřina , Metenko Prof Jozef , Vaaranen-Valkonen Nina , Ballester-Arnal Prof Rafael , Briken Prof Peer , Rahm Christoffer
Published: June 2024

Objectives

The BRIDGE intervention-research project is exploring the perceptions of anonymous CSAM users on their material using, their need for specialist care, their experiences of seeking care, and also intervenes with time-limited online interventions aimed at motivating change.. This research project aims to gain the cultural perspective of participants, from which intervention strategies can be culturally adapted. Cultural perspective will be surveyed on users from 6 EU countries using the Cultural Formulation Interview (CFI) method.

Methods

This research is implemented using the CFI method, which is part of the DSM-V. The goal is to gain the client's perspective and to uncover the cultural influences that enter into the client's experience and coping. In the field of sexology, the CFI method was used for the first time and its use was tested in advance in a pilot study. Findings specific to the adaptation of the CFI for the sexological domain will also be presented. The analysis of the interviews will be carried out using the qualitative software ATLAS.ti. In each of the participating countries, thematic analysis will identify common and also country-specific themes. The results will be used to adapt the motivational interviewing used in the BRIDGE project interventions and the ReDirection self-help programme.

Results

During the pilot phase, which lasted 2 months, 6 CFIs with English-speaking participants, 1 with German-speaking, 1 with Spanish-speaking and 1 with Swedish-speaking participants were completed. Preliminary results will be presented during the konference.

Conclusions

The results will help to target care delivery designs more effectively. As the darkweb is a global platform, there is a need to have data regarding different cultural backgrounds of its users. The results of the study can also be used by other future intervention programs. Without cultural adaptation of intervention strategies, the best quality intervention effect cannot be achieved.

Conflicts of Interest

Hereby I confirm there is no conflict of interest.
Radial Tully–Fisher relation and the local variance of Hubble parameter
Authors: Haridasu Balakrishna S , Salucci Paolo , Sharma Gauri
Published: June 2024

Utilizing the well-established radial Tully–Fisher (RTF) relation observed in a ‘large’ (843) sample of local galaxies, we report the maximum allowed variance in the Hubble parameter, $H_{0}$. We estimate the total intrinsic scatter in the magnitude of the RTF relation(s) implementing a cosmological model-independent cosmographic expansion. We find that the maximum allowed local ‘radial’ variation in our baseline analysis, using four RTF relations in the galaxy sample is $\Delta H_0/H_0\lesssim 3\ \hbox{per cent}$ at a 95 per cent C.L. significance, which is implied form a constraint of $\Delta H_0/H_0= 0.54^{+1.32}_{-1.37}\ \hbox{per cent}$ estimated at $D_{\rm L}\sim 10\, [{\rm Mpc}]$. Using only one ‘best-constrained’ radial bin, we report a conservative 95 per cent C.L. limit of $\Delta H_0/H_0\lesssim 4\ \hbox{per cent}$. Through our estimate of maximum variation, we propose a novel method to validate several late-time/local modifications put forth to alleviate the $H_0$ tension. We find that within the range of the current galaxy sample redshift distribution $10 \, [{\rm Mpc}] \le D_{\rm L}\le 140\, [{\rm Mpc}]$, it is highly unlikely to obtain a variation of $\Delta H_0/H_0\sim 9\ \hbox{per cent}$, necessary to alleviate the $H_0$-tension. However, we also elaborate on the possible alternative inferences when the innermost radial bin is included in the analysis. Alongside the primary analysis of fitting the individual RTF relations independently, we propose and perform a joint analysis of the RTF relations useful to create a pseudo-standardizable sample of galaxies. We also test for the spatial variation of $H_0$, finding that the current samples’ galaxies distributed only in the Southern hemisphere support the null hypothesis of isotropy within the allowed noise levels.
Phase I and pharmacodynamic study of arsenic trioxide plus radiotherapy in patients with newly diagnosed glioblastoma
Authors: Ryu Samuel , Ye Xiaobu , Olson Jeffrey J , Mikkelsen Tom , Bangiyev Lev , Lesser Glenn J , Batchelor Tracy , Nabors Burt , Desideri Serena , Walbert Tobias , Grossman Stuart A
Published: June 2024

Background

When arsenic trioxide (ATO) was combined with radiation for treatment of transplanted murine gliomas in the brain, tumor response improved with disrupted tumor blood flow and survival was significantly prolonged.

Methods

Total of 31 patients with newly diagnosed glioblastoma were accrued to a multi-institutional, NCI-funded, phase I study to determine the maximum tolerated dose (MTD) of ATO administered with radiation. Secondary objectives were survival and pharmacodynamic changes in perfusion on magnetic resonance imaging (MRI). Patients (unknown MGMT and IDH status) received ATO either once or twice weekly during radiation without concurrent or adjuvant temozolomide.

Results

Median age: 54.9 years, male: 68%, KPS ≥ 90: 77%, debulking surgery: 77%. Treatments were well-tolerated: 81% of patients received all the planned ATO doses. Dose-limiting toxicities included elevated liver function tests, hypokalemia, and edema. The MTD on the weekly schedule was 0.4 mg/kg and on the biweekly was 0.3 mg/kg. The median survival (mOS) for all patients was 17.7 months. Survival on the biweekly schedule (22.8 months) was longer than on the weekly schedule (12.1 months) (P = .039) as was progression-free survival (P = .004). Similarly, cerebral blood flow was significantly reduced in patients treated on the biweekly schedule (P = .007).

Conclusions

ATO with standard radiation is well tolerated in patients with newly diagnosed glioblastoma. Even without temozolomide or adjuvant therapy, the overall survival of all patients (17.7 months) and especially patients who received biweekly ATO (22.8 months) is surprising and accompanied by pharmacodynamic changes on MRI. Further studies of this regimen are warranted.
A tool to assist rheumatologists to engage their lupus patients: the Purple Butterfly
Authors: Huot Sandrine , Fortin Paul R , Godbout Alexandra , Laflamme Cynthia , Pouliot Marc
Published: June 2024

Objective

Translating the highly technical medical jargon of SLE into understandable concepts for patients, their families and individuals without expertise in SLE is a serious challenge. To facilitate communication and enable self-management in SLE, we aimed to create an innovative visual tool, the Purple Butterfly.

Methods

We selected clinically representative criteria for SLE and transposed them as graphical features in an attractive and meaningful visual. We developed a script in R programming language that automatically transposes clinical data into this visualization. We asked SLE patients from a local cohort about the relevance, usefulness and acceptability of this visual tool in an online pilot survey.

Results

The innovative Purple Butterfly features 11 key clinical criteria: age; sex; organ damage; disease activity; comorbidities; use of antimalarials, prednisone, immunosuppressants and biologics; and patient-reported physical and mental health–related quality of life. Each Purple Butterfly provides the health portrait of one SLE patient at one medical visit, and the automatic compilation of the butterflies can illustrate a patient’s clinical journey over time. All survey participants agreed that they would like to use the Purple Butterfly to visualize the course of their SLE over time, and 9 of 10 agreed it should be used during their medical consultations.

Conclusion

The Purple Butterfly nurtures effective doctor–patient communication by providing concise visual summaries of lupus patients’ health conditions. We believe the Purple Butterfly has the potential to empower patients to take charge of their condition, enhance healthcare coordination and raise awareness about SLE.
Cutting-edge care: unleashing artificial intelligence's potential in gynecologic surgery
Authors: Leaf Marie-Claire , Musselman Kelsey , Wang Karen C.
Published: June 2024

Purpose of review

Artificial intelligence (AI) is now integrated in our daily life. It has also been incorporated in medicine with algorithms to diagnose, recommend treatment options, and estimate prognosis.

Recent findings

AI in surgery differs from virtual AI used for clinical application. Physical AI in the form of computer vision and augmented reality is used to improve surgeon's skills, performance, and patient outcomes.

Several applications of AI and augmented reality are utilized in gynecologic surgery. AI's potential use can be found in all phases of surgery: preoperatively, intra-operatively, and postoperatively. Its current benefits are for improving accuracy, surgeon's precision, and reducing complications.
The Long-Term Benefit of Exercise With and Without Manual Therapy for Mild Chronic Obstructive Pulmonary Disease
Authors: Engel Roger Mark , Gonski Peter , Vemulpad Subramanyam , Graham Petra L.
Published: June 2024

Purpose:

Chronic obstructive pulmonary disease (COPD) is characterized by decreasing exercise capacity and deteriorating quality of life (QoL). Recent evidence indicates that combining exercise with manual therapy (MT) delivers greater improvements in exercise capacity than exercise alone in moderate COPD. The aim of this study was to investigate whether this combination delivers similar results in mild COPD.

Methods:

A total of 71 participants aged 50-65 yr with mild COPD were randomly allocated to two groups: exercise only (Ex) or MT plus exercise (MT + Ex). Both groups received 16 wk of exercise with the MT + Ex group also receiving 8 MT sessions. Lung function (forced vital capacity [FVC] and forced expiratory volume in the 1st sec [FEV1]), exercise capacity (6-min walk test [6MWT]), and QoL (St George’s Respiratory Questionnaire [SGRQ] and Hospital Anxiety and Depression Scale [HADS]) were measured at baseline, 4, 8, 16, 24, 32, and 48 wk.

Results:

Although there was no difference in the mean effect over time between groups for lung function (FEV1, P= .97; FVC, P= .98), exercise capacity (6MWT, P= .98), and QoL (SGRQ, P= .41; HADS anxiety, P= .52; and HADS depression, P= .06), there were clinically meaningful improvements at 48 wk for 6MWT (30 m; 95% CI, 10-51 m; P< .001), SGRQ (6.3 units; 95% CI, 2.5-10.0; P< .001), and HADS anxiety (1.5 units; 95% CI, 0.3-2.8 units; P= .006) across the entire cohort.

Conclusions:

While adding MT to Ex did not produce any additional benefits, exercise alone did deliver sustained modest improvements in exercise capacity and QoL in mild COPD.
Metatarsalgia: Clinical Profile and Comfort from Foot Orthoses Treatment
Authors: Robb Kelly A. , Ryan Michael B.
Published: June 2024

Introduction

The biomechanical factors influencing metatarsalgia etiology have been well documented; however, patient characteristics of individuals suffering from this condition and the effectiveness of foot orthosis therapy remain unknown.

Objectives

The objectives of this study were 1) to characterize the metatarsalgia profile of patients seeking treatment in a footwear and orthotic clinic, and 2) to explore the association between comfort and pain in patients with metatarsalgia who were treated with foot orthosis intervention.

Study Design

This study is a retrospective chart review.

Methods

Metatarsalgia assessment and follow-up data (case group n = 2137) were extracted from a research database (control group n = 82,822) from patients visiting a private foot care clinic. A clinical assessment was performed by a Canadian-certified pedorthist, and footwear recommendations and bilateral custom foot orthoses were provided to all patients. Feet were casted using a three-dimensional volumetric laser scanner. Orthoses (80% of cases) were manufactured from a direct mill polypropylene shell; additional rearfoot, forefoot postings, and/or metatarsal support was added according to the patient’s personalized treatment plan.

Results

Eighty-one percent (81%) of metatarsalgia patients reported symptom improvement following custom orthoses treatment. The average pain reduction from the orthotic intervention was 58.55%. The average self-reported comfort scores were 7.7 ± 2.2/10 at follow-up.

Compared with our control group, patients with metatarsalgia were more frequently self-identified as females, over 51 years of age, and the condition was observed in a higher prevalence of high cavus feet.

Conclusions

Our results suggest that a pes cavus foot posture is a biomechanical risk factor to the development of metatarsalgia. Custom foot orthoses that are manufactured according to a patient’s personalized treatment plan are an effective conservative treatment option for pain reduction in patients suffering from metatarsalgia.

Clinical Relevance Statement

Foot orthoses are an effective conservative treatment option for pain reduction in metatarsalgia patients.
Proposal for reclassification of the species Hungatella xylanolytica as Lacrimispora xylanisolvens nom. nov. and transfer of the genus Hungatella to the family Lachnospiraceae
Authors: Heng Yu Chyuan , Kittelmann Sandra
Published: June 2024

Hungatella xylanolytica X5-1T is an anaerobic, xylan-fermenting bacterium first isolated from methane-producing cattle manure. Initially identified as Bacteroides xylanolyticus, this species was later reclassified as H. xylanolytica in 2019. Although this reclassification found support through Genome blast Distance Phylogeny analysis which placed H. xylanolytica X5-1T into the same clade as Hungatella effluvii DSM 24995T, it was contradicted by 16S rRNA gene phylogenetic analysis, which associated it with a set of misnamed Clostridium species later reassigned into the genus Lacrimispora. To ascertain its taxonomic position, comparative analyses were performed to re-examine the relationship between H. xylanolytica X5-1T and all species of the genera Hungatella and Lacrimispora. The ranges of 16S rRNA gene sequence similarity, average amino acid identity, and percentage of conserved protein prediction values were higher between H. xylanolytica X5-1T and species of the genus Lacrimispora than Hungatella. In addition, H. xylanolytica X5-1T was found to harbour genes and pathways conserved and exclusive to species within the genus Lacrimispora but not Hungatella. Essentially, in both the 16S rRNA gene phylogenetic tree and the core-genome phylogenomic tree, H. xylanolytica X5-1T clustered into the same clade as species of the genus Lacrimispora, distinct from species of the genus Hungatella. It is thus clear that H. xylanolytica X5-1T represents a species within the genus Lacrimispora, which we propose to reclassify as Lacrimispora xylanisolvens nom. nov. Finally, based on the results from the phylogenetic and comparative analyses, the genus Hungatella was transferred to the family Lachnospiraceae.
Panacus: fast and exact pangenome growth and core size estimation
Authors: Parmigiani Luca , Garrison Erik , Stoye Jens , Marschall Tobias , Doerr Daniel
Published: June 2024

Motivation

Using a single linear reference genome poses a limitation to exploring the full genomic diversity of a species. The release of a draft human pangenome underscores the increasing relevance of pangenomics to overcome these limitations. Pangenomes are commonly represented as graphs, which can represent billions of base pairs of sequence. Presently, there is a lack of scalable software able to perform key tasks on pangenomes, such as quantifying universally shared sequence across genomes (thecore genome) and measuring the extent of genomic variability as a function of sample size (pangenome growth).

Results

We introduce Panacus (pangenome-abacus), a tool designed to rapidly perform these tasks and visualize the results in interactive plots. Panacus can process GFA files, the accepted standard for pangenome graphs, and is able to analyze a human pangenome graph with 110 million nodes in less than one hour.

Availability

Panacus is implemented in Rust and is published as Open Source software under the MIT license. The source code and documentation are available athttps://github.com/marschall-lab/panacus. Panacus can be installed via Bioconda athttps://bioconda.github.io/recipes/panacus/README.html.

Contact

Luca Parmigiani (luca.parmigiani@uni-bielefeld.de), Daniel Doerr (daniel.doerr@hhu.de).
Mimicking physiological stiffness or oxygen levels in vitro reorganizes mesenchymal stem cells machinery toward a more naïve phenotype
Authors: Caramelo Inês , Mendes Vera M. , Domingues Catarina , Anjo Sandra I. , Geraldo Margarida , Cardoso Carla M. P. , Grãos Mário , Manadas Bruno
Published: June 2024

Mesenchymal stem cells (MSCs) offer a promising therapeutic potential for a wide variety of pathologies. However, obtaining minimal effective doses requires an extensivein vitroexpansion, which compromises their stemness and therapeutic properties. The stiffness of the umbilical cord ranges between 2 and 5kPa, and the oxygen levels fluctuate from 2.4% to 3.8%, differing from the standardin vitroculture conditions where MSCs are exposed to the stiffness of the Petri dish (2-3 GPa) and near atmospheric oxygen levels (18.5% O2). Since MSCs can sense and respond to biomechanical and chemical characteristics of the microenvironment, it was hypothesized that expanding MSCs on 3kPa platforms – mechanomodulation – or at 5% O2levels – physioxia – could potentially impact the cellular proteome of MSCs, for long (7-10 days) or short (48h) periods. Data analysis has unveiled that culturing MSCs on soft substrates for long periods promotes the expression of various proteins related to cell redox homeostasis, such as thioredoxins and peroxiredoxins. Conversely, culturing these cells during the same period but under low oxygen levels leads to an increase in chaperone machinery proteins, such as HSP90 or TRiC. These proteins can favor the clearance of misfolded proteins and telomerase maintenance processes, possibly preventing MSCs from being driven to a senescent phenotype. Although mechanomodulation and physioxia are two distinct stimuli, both converge in downregulating the expression of histones and several ribosomal subunits, possibly decreasing translational complexity, which could hypothetically favor a more naïve phenotype for MSCs. Interestingly, priming UC-MSCs (48h) leads to a differential expression of proteins of the extracellular matrix and histone subtypes. Understanding the role of these proteins in transducing environmental cues might provide insights into how conventional culture conditions significantlyalter fundamental cellular processes and support the development of a more efficient protocol to expand and empower the therapeutic potential of MSCs. In the future, employing a combination of reduced stiffness and lower oxygen levels may present a promising strategic approach.

Highlights

Culturing MSCs on a soft substrate (3kPa) enhances the expression of antioxidant proteins, such as thioredoxins and peroxiredoxins

Protein homeostasis is remodeled in MSCs cultured under physiological levels of oxygen (5% O2) through the differential expression of the chaperone machinery

Lowering stiffness or oxygen levels duringin vitroMSCs expansion decreases histones and ribosomal subunits expression, possibly favoring a more naïve phenotype