bluuebunny/crossref_metadata_2025 huggingface dataset:
(181) LOW INTENSITY SHOCKWAVE THERAPY FOR ERECTILE DYSFUNCTION: A SHAM-CONTROLLED RANDOMIZED TRIAL
Authors: Goldstein Sue W , Goldstein Dr Irwin , Kim Dr Noel N
Published: June 2024

Objectives

A sham-controlled, randomized prospective trial in men with ED was performed using an electrohydraulic shockwave device (Softwave/Urogold, TRT).

Methods

In this single-blind study performed in men with ED, participants were randomized 2:1 to active low intensity shockwave therapy (LiSWT) (4 Hz, 0.12 mJ/mm2) or sham. Arm 1 consisted of 3 treatments of 5000 shocks every 3 weeks. Arm 2 consisted of 5000, 3000, 3000 shocks during weeks 1, 2, 3, respectively, followed by an identical cycle of treatment 3 weeks later. Doppler ultrasound/grayscale was performed at weeks 20 and 32. Participants completing sham treatment crossed over to LiSWT. Post-treatment end diastolic velocity (EDV) and peak systolic velocity (PSV) were measured, and visual grading scores used to assess hypoechoic regions in the corpora cavernosa. Data were analyzed by 2-way repeated measures ANOVA with Geisser-Greenhouse correction. Pairwise comparisons were performed to baseline using Dunnett’s multiple comparison test. Missing data were imputed by “last observation carried forward”.

Results

36 participants (22 active, 14 sham) were randomized. Sham treatments showed no significant changes. Visual grading scores in the proximal region were consistently higher with active LiSWT vs sham (Arm 1 = 88.9% vs. 11.1%; Arm 2 = 40.0% vs. 20.0%, respectively), statistically significant in Arm 1 at weeks 20 (p=0.005) and 32 (p=0.001). Sham participants also had improved grayscale ratings after LiSWT (Arm 1 = 33.3% vs. 11.1%; Arm 2 = 40.0% vs. 20.0%). After LiSWT, greater numbers of patients had higher PSV, lower EDV, or no worsening relative to baseline. Decrease in EDV was statistically significant in active treatment Arm 2 at Week 32 (p=0.003). Adverse events were transient.

Conclusions

Statistically significant changes from baseline between sham and active treatments in primary outcome measures with no adverse events support safety and efficacy of LiSWT for treating ED.

Conflicts of Interest

No conflicts of interest.
(388) EXTRACORPOREAL SHOCK WAVE THERAPY (ESWT) IN THE TREATMENT OF PEYRONIE'S DISEASE: OUR INITIAL EXPERIENCE
Authors: Saitta Dr Giuseppe , Di Paola Dr Giuseppe , Mantovani Dr Franco A , Meazza Dr Attilio L , Seveso Dr Mauro
Published: June 2024

Objectives

To evaluate prospectively the efficacy of Extracorporeal Shock Wave Therapy (ESWT) as a conservative treatment for Peyronie's disease.

Methods

112 patients from January 2022 to January 2023 were included in the prospective study. Each patient was treated with a minimum of three sessions of ESWT (3000 shock wavs at an energy density of 0.11-0.17 mJ/mm2) at 3-week intervals. The angulation was calculated by auto-photography: the mean angulation before treatment was 48 degrees (range 10°-100°). The severity of pain on erection was assessed by a visual analog scale (0-5): all patients had symptoms (60 scored 5). Moreover a self-evaluation questionnaire (International Index of Erectile Function) was used: 42 patients had erectile dysfunction (IIEF<18). The plaque was located by palpation. The mean disease duration was 18 months (4-60 mo). The mean follow up was 9 months (4-24).

Results

All patients completed the protocol. The tolerance and safety were excellent. The results were analysed using the Wilcoxon signed-rank test. Of the 60 patients with pain on erection, 54 (90%) noticed immediately relief after ESWT with mean reduction 2.9 on the visual analog pain scale (p<0.00001). An improvement in angulation greater than 10 degrees was observed in 64 patients (57.1%), with a mean reduction of 30 degrees (p<0.001). 11 patients with erectile dysfunction (26.2%) han an increased IIEF score greater than 4. 62 patients (55.4%) thought the plaque was smoother. Only 2 patients (1.8%) experimented minimal bruising at the site of treatment the day after, no major complications were reported.

Conclusions

ESWT represents an effective, feasable and safe conservative treatment for Peyronie's disease. It seems to reduce pain during erection and sometimes improve the penile angle. Long-term follow up and further results are required.

Conflicts of Interest

No.
(268) FAILED HYPOSPADIAS REPAIR IN ADULTHOOD - TRANSITIONAL UROLOGY
Authors: Kojovic Vladimir , Marjanovic Dr Marko , Cvetinovic Dr Ana , Cico Dr Emre , Ilic Predrag
Published: June 2024

Objectives

The exact incidence of failed hypospadias repair (FHR) in adult patients remain unknown, but the number is rapidly increasing. The study aims to evaluate the most common issues in adult patients requiring additional surgical treatment due to FHR in childhood.

Methods

From January 2015 to January 2023 patients with previous hypospadias repair in childhood, who underwent additional surgery in adulthood, were evaluated. The most common complications, total number of surgical procedures and time span between childhood and adulthood surgery were recorded. Postoperative follow-up included 1-, 3-, and 6-months evaluation and annually afterward.

Results

Fifty-five patients were treated with a mean age of 26 years. One stage repair was performed in 47 (85.5%) and staged repairs in 8 (14.5%) patients. The most common reasons for surgical repair were: urethral stricture in 8 (14.5%) patients, failed urethroplasty with abnormal meatal position in 10 (18.2%) patients, residual curvature or deformity in 10 (18.2%) patients and combination of several complications in 27 (49.1%) patients. Urethral repair was performed using buccal mucosa graft (BMG), penile skin flap, or combination of BMG and skin flap. Penile curvature and deformities were corrected by plication procedures. Mean time interval between the last surgical procedure in childhood and the definitive correction in adulthood was 16 years. Twenty-four (43.6%) of 55 patients underwent one surgical and 31 (56.4%) patients underwent two or more surgical procedures in childhood. Mean number of procedures was 4. The mean postoperative follow-up period was 18 months. The overall successful outcome was achieved in 50 (90.9%) patients while 5 (9.1%) patients were considered failures, as additional procedures were necessary.

Conclusions

Surgical treatment of failed hypospadias repair is challenging due to poor quality of available tissue and excessive scar formation. Regular and long-term follow-up after primary repair is necessary and these patients should be referred to a center of excellence.

Conflicts of Interest

The authors declare no conflict of interest.
(143) THE EFFECT OF SMOKING CESSATION ON SEMEN QUALITY
Authors: Ragheb Dr Ahmed , Mohamed Dr Mahmoud AEK , Abdelbary Prof Ahmed , Massoud Prof Amr , Elmarakby Dr Akram
Published: June 2024

Objectives

Our primary aim was to investigate the reversibility of the negative impact of smoking on male fertility. Secondarily, we studied the effect of both time after smoking cessation as well as smoking index on semen quality improvement.

Methods

Our study included 60 participants who applied to a smoking cessation program. After completing a fertility background questionnaire, 2 semen specimens, provided 2 weeks apart, were analyzed for each candidate on three different occasions. First, right before smoking cessation then at 3 and 6 months after stopping smoking, respectively. Semen quality was compared between the 3 occasions. The degree of change was correlated with the level of smoking. Nicotine level in urine was used for smoking cessation compliance monitoring during the study.

Results

Comparing semen quality on the 3 different occasions respectively, we detected a significant improvement in semen volume (3.33 ml ± 1.07 vs. 3.88 ml ± 0.80 vs. 4.34 ml ± 0.67, P < 0.001), sperm concentration (14.77 million /ml ± 6.49 vs. 17.71 million /ml ± 6.41 vs. 19.27 million/ml ± 6.46, P < 0.001), total sperm count (49.33 million ± 25.31 vs. 70.16 million ± 30.85 vs. 84.01 million ± 31.00, P < 0.001), progressive motility (20.7% vs. 35.3% vs. 42.28%, P < 0.001), total motility (41.48% vs. 60.33% vs. 67.67%, P < 0.001) and abnormal morphology (69.32% Vs. 50.88% vs. 40.82%, P < 0.001). Improvement in all parameters was positively corelated to the duration after cessation. Higher smoking indices were related to higher levels of improvement in semen volume, sperm concentration, and total count (areas under the curve of 0.867, 0.852, and 0.863 respectively, P < 0.001 for each).

Conclusions

The negative effect of smoking on semen quality is reversible. Smoking cessation has a time-dependent positive effect on main semen parameters, hence, positive potential for fecundity improvement in men.

Conflicts of Interest

The authors have no conflicts of interest to disclose.
(266) BRAIN ACTIVATION PATTERNS IN POSTMENOPAUSAL WOMEN WITH SEXUAL DESIRE-AROUSAL DISORDER: PRELIMINARY RESULTS
Authors: Torres Dr Laura R , Acedo Sònia A , Flores Prof Camil C-B
Published: June 2024

Objectives

To define brain activation patterns in postmenopausal women with FSIAD during visual and olfactory sexual stimulation.

Methods

A cross-sectional study in a tertiary university hospital is being conducted with postmenopausal women with FSIAD (N=18) and postmenopausal women without FSIAD (N=5). A functional magnetic resonance imaging (fMRI) has been performed to measure brain blood flow and oxygen level dependent changes induced by neuronal activation during visual and olfactory stimuli (non-sexual, neutral, sexual).

Results

The mean age (mean ± SD) of our sample is 55,8 ± 6,9 years old (54,2 ± 4,3 for postmenopausal women with FSIAD, 62,3 ± 10,4 for postmenopausal women with normal sexual desire). A tendency of increase in the activation of the insular lobe and association parietooccipital cortex with sexual olfactory stimulus has been found in postmenopausal women with normal sexual desire. This differential activation has not been found in postmenopausal women with FSIAD. As for visual sexual stimuli, a tendency to activate the prefrontal cortex in postmenopausal women with FSIAD has been found, in contrast to postmenopausal women with normal sexual desire.

Conclusions

Preliminary analysis suggests an increased activation of the prefrontal cortex with visual sexual stimuli in postmenopausal women with FSIAD, which is associated with self-referential mental activity (thus related with detrimental effects on sexual functioning). A diminished brain response to olfactory sexual stimulus has also been found in these patients. However, further data needs to be collected in order to confirm these results and expand them once the recruitment is completed.

Conflicts of Interest

Authors declare no of interest.
(242) INDOOR CYCLING AND PUDENDAL ENTRAPMENT NEUROPATHY: AN INCREASINGLY COMMON CAUSE OF VULVODYNIA
Authors: Galán JM Poyato , Rodríguez Á Rivera , Bravo R Samaniego , Millán V García , Ruiz M García-Baquero
Published: June 2024

Objectives

Most cases of Vulvodynia are mainly caused by Vulvitis-Vaginitis-STD-Allergies, but past year we´ve detected an increase in the Neurotraumatic etiology for young women practicing Spinnig. We analyze the incidence and causes in our population.

Methods

Retrospectively, 121 cases of Vulvodynia referred to our Clinic from Emergency, General Medicine and Internal Medicine (January'22 to January'23) were selected. Anthropometrics were: 49±6 years (21-59), weight 52±4Kg, height 159±9cm. 24 patients in this group performing indoor cycling (36±7 years, weight 47±5Kg, height 162±8cm) had been diagnosed with Pudendal Nerve Neuropathy. They presented perianal+vulvoperineal pain, vulvar hypoesthesias/paresthesias and diffuse genital discomfort modified with postural changes (pain when sitting, relief when standing up and disappearance when lying down). Due to Vegetative Nerve component, 18 women also reported urinary urgency.

Detailed Neurological examination was performed to identify the Sensitive nerve fascicles involved and a specific evaluation of exercise dynamics and bicycle/saddle design as causal factors.

After a joint Medicine-Physiotherapy-Psychology assessment, an integrated/individualized treatment was carried out for each case.

Results

Conclusions

1. Pudendal Neuropathy is an entity to take into account as cause of Vulvodynia

2. Often takes a few months to be correctly diagnosed

3. Mainly affects young athletic women

4. The hardness of the seats of the bicycles used in Spinning and the anterior vulvar compression position are the main causes of this disorder

Conflicts of Interest

Authors have no conflicts of interest.
(362) PSYCHOMETRIC VALIDATION OF THE FEMALE SEXUAL FUNCTION INDEX – ROMANIAN VERSION (FSFI-RO)
Authors: Dăescu Ana-Maria C , Dehelean Prof Liana , Navolan Prof Dan-Bogdan , Pop Gheorghe N , Stoian Prof Dana L
Published: June 2024

Objectives

Our study aimed to develop a Romanian Version of the Female Sexual Function Index (FSFI) and to measure its psychometric reliability and validity.

Methods

Although female sexual dysfunction (FSD) is a highly prevalent health disorder, no self-report questionnaire on female sexual function was available in Romanian. We considered the FSFI due to its excellent psychometric properties. The original version of the FSFI was translated into Romanian and then reverse translated. A pilot study was conducted to assess comprehensibility. Then, 385 women aged 18 to 51 volunteered for the present study, that were categorized into two groups, based on the DSM-5 criteria for sexual dysfunction: the FSD group and the control group. Participants then filled in the FSFI-RO. A sample of 50 women agreed to re-answer FSFI-RO in a 4-week interval in order to evaluate the test-retest validity of the questionnaire. The data were summarized using descriptive statistics.

Results

The findings demonstrated high test-retest reliability, both for the individual domains and for the total score. Regarding the internal consistency of the FSFI-RO, it was found to be high. Convergent construct validity was established as moderate to high in the desire, arousal, lubrication, orgasm, and satisfaction domains, and weak in the pain domain. In terms of discriminant construct validity, there were statistically significant differences in scores for each domain and for the total score between the FSD group and the control group. Regarding the factor structure, the six-factor solution included the domains: desire, arousal, lubrication, orgasm, satisfaction, and pain.

Conclusions

The FSFI-RO showed similar psychometric proprieties to those of the original version, therefore being a reliable and valid instrument that can be used in Romanian-speaking women in order to assess FSD.

Conflicts of Interest

The authors declare no conflict of interest.
(220) SCHIZOPHRENIA AND SEXUAL DIFFICULTIES
Authors: Biedková Paula , Androvičová Renáta , Novák Ondřej
Published: June 2024

Objectives

Patients with schizophrenia (SCH) often experience low rates of sexual satisfaction and high rates of sexual dysfunction. Despite available evidence on the specific nature of sexual difficulties in patients with SCH, current research tends to disregard this subject. Our study aims to identify whether sexual difficulties in patients with SCH could be connected to a decreased ability to interpret and respond to courtship signals.

Methods

Thirty-four male participants (23 patients, 11 controls) were exposed to our experiment “Does she like me?” task (Zikanova et al., 2018). The task involves a video stimuli that depicts a woman displaying different nonverbal behaviors (rejection, courtship, and neutral attitude). Each participant evaluated the woman’s sexual interest, attractivity, interest in this woman, and the tendency to approach/avoid the woman on a nine-point scale. For data analysis, we used Repeated measures ANOVA.

Results

While there was no statistically significant difference between the control group and patients in approach/avoidance behavior, perceived attractivity, and subjective interest, the significant interaction effect suggests different overall evaluations of women’s interest between the compared groups (F(2,64) = 7.83, p < 0.001, n2p = 0.20). The control’s reactions followed the expected pattern of positive > neutral > negative in a clear and low-variance manner. Conversely, the patient's reaction pattern was flattened with a much larger variance in ratings.

Conclusions

Findings suggest that the subjective interest in women and the ability to respond to courtship signals do not differ significantly between controls and patients. However, patients do not differentiate women's sexual interest signals in the same manner as controls. This may suggest that individuals with schizophrenia could face challenges in intimate relationships due to difficulties in detecting signals of rejection from women.

The study was supported by the Czech Health Research Council, no. NU21J-04-00024 and by the Charles University, Fac Med1, GAUK no. 56123.

Conflicts of Interest

No conflicts of interest.
(332) EXPERIENCES RELATED TO THE BODY, INTIMACY, AND SEXUALITY IN INTERSEX INDIVIDUALS
Authors: Decaro Sofia Pavanello , Anzani Dr Annalisa , Prunas Prof Antonio
Published: June 2024

Objectives

This study aimed to explore the experiences of intersex people in relation to their affective and sexual relationships, body, sexuality, and physical intimacy. It also investigated the subjective perception of the persons’ condition, and the ways and times in which their status as intersex emerged.

Methods

Five interviews with Italian adults with Sex Characteristic Variations were conducted in a non-directive style with the aid of a thematic outline, to allow participants to set their own priorities and respond freely. The interviews were fully transcribed and thematic analysis was carried out on. Four resulting themes were identified.

Results

The themes deal with 1) participants’ medical history, 2) identity and relationship with the body at different points in the life cycle, 3) prejudice and stigma, and 4) resources.

Conclusions

Our results show that participants were strongly impacted by their experiences with medicalization and by professionals they encountered. The resulting themes confirm that there is a need for greater visibility in scientific and professional fields such as medicine and psychology, regarding the first-person experiences of intersex people.

Conflicts of Interest

The authors have no conflict of interest to declare.
(336) CONFIGURATION OF PUDENDAL THIGH FLAP IN RECURRING PERINEAL URETHROSTOMY STENOSIS
Authors: Falcone Dr Marco , Preto Dr Mirko , Ferro Dr Ilaria , Lavagno Dr Federico , Cirigliano Dr Lorenzo , Peretti Dr Federica , Plamadeala Dr Natalia , Scavone Dr Martina , Gontero Prof Paolo
Published: June 2024

Objectives

We present the case of a 41yo transgender man, assigned female at birth. After pubic phalloplasty and configuration of perineal urethrostomy the patient suffered recurrent perineal urethrostomy stenosis, for which he underwent multiple surgical procedures, also with buccal mucosa graft, all unsuccessful. Our indication was the configuration of a pudendal thigh flap to prevent further perineal urethrostomy stenosis.

Methods

From october 2020 to july 2023 we performed 6 pudendal thigh flaps: 2 in women with vaginal stenosis, 2 in transgender females for vaginoplasty stenosis and 2 in transgender males for urethral reconstruction.

Results

Median age was 34 years, median BMI was 28 and median follow up was 13 months. Median operative time was a hundred and fifteen minutes, half of the procedures required bilateral flaps and half were monolateral. We had no intraoperative or late complication, the only complication was a wound infection, solved with antibiotic therapy.

Overall, 83% of our patients were satisfied with the aesthetic appearance after one year follow-up, all of them had a positive impact on their quality of life and all of them would suggest the procedure to a friend if needed.

Conclusions

In conclusion, Pudendal thigh flaps are very versatile and safe flaps, with few complication rates and high patients’ satisfaction rates.

Due to the rarity of cases in which indicated, this procedure should be offered in tertiary centers.

Conflicts of Interest

We have no conflict of interest.
Fundamental effective temperature measurements for eclipsing binary stars – V. The circumbinary planet system EBLM J0608–59
Authors: Maxted P F L , Miller N J , Sebastian D , Triaud A H M J , Martin D V , Duck A
Published: June 2024

EBLM J0608$-$59/TOI-1338/BEBOP-1 is a 12$^{\rm th}$-magnitude, F9 V star in an eclipsing binary with a much fainter M dwarf companion on a wide, eccentric orbit (P = 14.6 d). The binary is orbited by two circumbinary planets: one transiting on a 95-d orbit and one non-transiting on a 215-d orbit. We have used high-precision photometry from the TESS mission combined with direct mass measurements for the two stars published recently to measure the following model-independent radii: $R_1 = 1.32 \pm 0.02 {\rm R}_{\odot }$, $R_2 = 0.309 \pm 0.004 {\rm R}_{\odot }$. Using $R_1$ and the parallax from Gaia EDR3, we find that this star’s angular diameter is $\theta = 0.0309 \pm 0.0005$ mas. The apparent bolometric flux of the primary star corrected for both extinction and the contribution from the M dwarf ($\lt 0.4$ per cent) is ${\mathcal {F}}_{{\oplus },0} = (0.417\pm 0.005)\times 10^{-9}$ erg cm$^{-2}$ s$^{-1}$. Hence, this F9 V star has an effective temperature $T_{\rm eff,1} = 6031{\rm \, K} \pm 46{\rm \, K\, (rnd.)} \pm 10 {\rm \, K\, (sys.)}$. EBLM J0608$-$59 is an ideal benchmark star that can be added to the sample of such systems we are establishing for ‘end-to-end’ tests of the stellar parameters measured by large-scale spectroscopic surveys.
A statistical approach to polarimetric and photometric investigation of the intermediate-age open cluster NGC 1912
Authors: Biswas Samrat , Medhi Biman J , Deb Sushmita , Deb Sukanta , Das H S , Perren G I
Published: June 2024

This paper presents a comprehensive multiwavelength investigation of the intermediate-age open cluster NGC 1912. We identified 401 member stars for NGC 1912 using K-nearest neighbour and Gaussian Mixture Model machine learning techniques. The fundamental parameters determined for the cluster are metallicity (z) = 0.0141 $\pm$ 0.0006, log(age) = 8.519 $\pm$ 0.040, binary fraction ($b_{\text{frac}}$) = 0.445 $\pm$ 0.035, visual extinction ($A_V$) = 0.864 $\pm$ 0.033 mag, total-to-selective extinction ratio ($R_V$) = 3.007 $\pm$ 0.096, distance = 1096 $\pm$ 15 pc. The central density ($\rho _o$), core radius ($r_c$), tidal radius ($r_t$), and background density ($\rho _{\mathrm{bg}}$) for the cluster are obtained as 0.643 $\pm$ 0.067 stars arcmin$^{-2}$, 7.743 $\pm$ 0.784 arcmin, 84.633 $\pm$ 7.188 arcmin, and 0.001 $\pm$ 0.000 stars arcmin$^{-2}$, respectively. Dynamical mass segregation study revealed a concentration of some apparently massive stars towards the cluster centre. Polarimetric analysis of 90 stars in $BVR_cI_c$ wavelength bands revealed that the observed polarization in NGC 1912 is not solely attributed to interstellar dust. The Galactic magnetic field is dominant in this region. Dust grain sizes within the intracluster region are found to be relatively smaller than that of the general ISM. The extinction map revealed the existence of a potential ‘interstellar bubble’ located close to the cluster region. Towards the periphery of the probable bubble region, which displays an ovoid-like geometry, 16 probable young stellar objects have been detected, suggesting the ongoing triggering of secondary star formation events in this region.
Strengthening nuclear symmetry energy constraints using multiple resonant shattering flares of neutron stars with realistic mass uncertainties
Authors: Neill Duncan , Tsang David , Newton William G
Published: June 2024

With current and planned gravitational-wave (GW) observing runs, coincident multimessenger timing of resonant shattering flares (RSFs) and GWs may soon allow for neutron star (NS) asteroseismology to be used to constrain the nuclear symmetry energy, an important property of fundamental nuclear physics that influences the composition and equation of state of NSs. In this work, we examine the effects of combining multiple RSF detections on these symmetry energy constraints, and consider how realistic uncertainties in the masses of the progenitor NSs may weaken them. We show that the detection of subsequent multimessenger events has the potential to substantially improve constraints beyond those obtained from the first, and that this improvement is insensitive to the mass of the NSs that produce the RSFs and its uncertainty. This sets these asteroseismic constraints apart from bulk NS properties such as radius, for which the NS mass is highly important, meaning that any multimessenger RSF and GW events can equally improve our knowledge of fundamental physics.
Zn-ion ultrafluidity via bioinspired ion channel for ultralong lifespan Zn-ion battery
Authors: Zhang Fan , Liao Ting , Qi Dong-Chen , Wang Tony , Xu Yanan , Luo Wei , Yan Cheng , Jiang Lei , Sun Ziqi
Published: June 2024

Rechargeable aqueous Zn-ion batteries have been deemed a promising energy storage device. However, the dendrite growth and side reactions have hindered their practical application. Herein, inspired by the ultrafluidic and K+ ion-sieving flux through enzyme-gated potassium channels (KcsA) in biological plasma membranes, a metal-organic-framework (MOF-5) grafted with –ClO4 groups (MOF-ClO4) as functional enzymes is fabricated to mimic the ultrafluidic lipid-bilayer structure for gating Zn2+ ‘on’ and anions ‘off’ states. The MOF-ClO4 achieved perfect Zn2+/SO42− selectivity (∼10), enhanced Zn2+ transfer number (${{t}_{{\rm{Z}}{{{\rm{n}}}^{2 + }}}} = 0.88$) and the ultrafluidic Zn2+ flux (1.9 × 10−3 vs. 1.67 mmol m−2 s−1 for KcsA). The symmetric cells based on MOF-ClO4 achieve a lifespan of over 5400 h at 10 mA cm−2/20 mAh cm−2. Specifically, the performance of the PMCl-Zn//V2O5 pouch cell keeps 81% capacity after 2000 cycles at 1 A g−1. The regulated ion transport, by learning from a biological plasma membrane, opens a new avenue towards ultralong lifespan aqueous batteries.
The origin and evolution of Earth's nitrogen
Authors: Li Yuan
Published: June 2024

Nitrogen is a vital element for life on Earth. Its cycling between the surface (atmosphere + crust) and the mantle has a profound influence on the atmosphere and climate. However, our understanding of the origin and evolution of Earth's nitrogen is still incomplete. This review presents an overview of the current understanding of Earth's nitrogen budget and the isotope composition of different reservoirs, laboratory constraints on deep nitrogen geochemistry, and our understanding of the origin of Earth's nitrogen and the deep nitrogen cycle through plate subduction and volcanism. The Earth may have acquired its nitrogen heterogeneously during the main accretion phase, initially from reduced, enstatite-chondrite-like impactors, and subsequently from increasingly oxidized impactors and minimal CI-chondrite-like materials. Like Earth's surface, the mantle and core are also significant nitrogen reservoirs. The nitrogen abundance and isotope composition of these three reservoirs may have been fundamentally established during the main accretion phase and have been insignificantly modified afterwards by the deep nitrogen cycle, although there is a net nitrogen ingassing into Earth's mantle in modern subduction zones. However, it is estimated that the early atmosphere of Earth may have contained ∼1.4 times the present-day atmospheric nitrogen (PAN), with ∼0.4 PAN being sequestered into the crust via biotic nitrogen fixation. In order to gain a better understanding of the origin and evolution of Earth's nitrogen, directions for future research are suggested.
Multiplex Gastrointestinal Panel Testing in Hospitalized Patients With Acute Diarrhea in Thailand
Authors: Jitmuang Anupop , Lertlaksameewilai Panuwat , Poorichitiporn Arnon , Horthongkham Navin , Chayakulkeeree Methee
Published: June 2024

Background

Multiplex gastrointestinal (GI) panel testing is widely used for outpatient diagnosis of diarrhea. However, the clinical practicality of multiplex testing in hospitalized diarrheal subjects has not yet been thoroughly elucidated.

Methods

We enrolled hospitalized subjects with acute diarrhea. The subjects’ stool samples were collected in triplicate; 1 sample was tested using traditional diagnoses, and the other 2 were tested using Allplex (AP) and FilmArray (FA) GI panel testing. Clinical data were reviewed and analyzed.

Results

Of the 199 subjects, 92 (46.5%) were male, and the mean age was 66.3 years. The median (interquartile range) onset of diarrhea was 6 (2­–14) days after hospitalization. One hundred fifty-one patients (75.9%) had sepsis, and 166 (83.4%) had received prior or were receiving current antimicrobial therapy. Positive stool cultures were obtained from 4/89 (4.5%), and Clostridioides difficile toxin gene tests were positive in 14/188 (7.4%) patients. AP and FA multiplex tests were positive for GI pathogens in 49/199 (24.6%) and 40/199 (20.1%), respectively. The target most frequently detected by AP was Aeromonas spp. Both assays commonly detected enteropathogenic E. coli (EPEC), C. difficile toxin gene, and Salmonella spp.; neither assay detected pathogens in 75.4% and 79.9%. Fever (odds ratio [OR], 2.05; 95% CI, 1.08–3.88; P = .028), watery diarrhea (OR, 2.69; 95% CI, 1.25–5.80; P = .011), and antimicrobial therapy (OR, 2.60; 95% CI, 1.18–5.71; P = .018) were independent factors associated with the negative multiplex test result.

Conclusions

Multiplex GI panel testing effectively detects enteric pathogens associated with diarrhea in hospitalized subjects. The etiology remains undiagnosed in >75% of cases. Factors contributing to negative test results should be considered before implementing the tests.
Threshold for increased liver weight is protective of other effects in Peromyscus exposed to PFNA
Authors: Narizzano Allison M , Lent Emily May , East Andrew G , Bohannon Meredith E , Quinn Michael J
Published: June 2024

Perfluorononanoic acid (PFNA) is a commercially relevant, long-chain (8 fully fluorinated carbon) perfluorinated carboxylic acid. PFNA has limited terrestrial ecotoxicity data and is detected in humans, animals, and the environment. This study is the fourth in a series with the objective of investigating the toxicity of a suite of per- and polyfluoroalkyl substances (PFAS) detected on military installations in a mammal indigenous to North America. Peromyscus leucopus (white-footed mice, ∼25/sex/dose) were exposed via oral gavage to either 0, 0.03, 0.14, 1, or 3 mg PFNA/kg-d for 112 consecutive days (4 wk premating exposure followed by an additional 12 wk of exposure after onset of mating). Parental generation animals were assessed for potential reproductive and developmental effects, organ weight changes, thyroid modulation, and immunotoxicity. Pup weight and survival were assessed at postnatal days 0, 1, 4, 7, and 10. Change in liver weight was determined to yield the most sensitive dose response according to benchmark dose analysis, and serves as the most protective point of departure (BMDL = 0.37 mg/kg-d PFNA). Other effects of PFNA exposure included reduced formation of plaque-forming cells, which are indicative of functional immune deficits (BMDL = 2.31 mg/kg-d); decreased serum thyroxine (BMDL = 0.93 mg/kg-d) without changes in some other hormones; and increased stillbirths (BMDL = 0.61 mg/kg-d PFNA). Pup weight and survival were not affected by PFNA exposure. Combined with data from previous studies, data from Peromyscus provide a One Health perspective on health effects of PFAS.
International Commodity Agreements and Cartels: Lessons and Policy Implications
Authors: Baffes John , Nagle Peter , Streifel Shane
Published: June 2024

Throughout the 20th century, countries attempted to address negative effects of boom-and-bust cycles in commodity prices through international supply management initiatives. The objectives of these agreements were usually to achieve a high and/or stable level of prices. Attempts to manage excess supplies following World War I included coffee, copper, wool, and tin, while falling prices during the Great Depression spurred agreements covering tea, natural rubber, sugar, coffee, and copper. Arrangements after World War II and in the 1970s involved producers and consumers for tropical commodities and metals. Although some agreements were successful in achieving their objectives, all ended or collapsed, often resulting in increased price volatility. OPEC may have been an exception in its longevity, but it faces similar challenges to previous agreements. We conclude that the historical experiences of these agreements caution against their use. However, during periods of significant market stress, coordinated action may be warranted. These lessons are instructive today for the energy transition. Producers of metals and minerals used in renewable technologies may be tempted to form agreements to influence prices. However, while these could have short-term successes, they would face the same issues that led to the demise of earlier agreements.
Methamphetamine Use in Psychiatric Emergency Services and Among Asian American and Pacific Islander Populations
Authors: Nakamoto Max , Onoye Jane , Kiyokawa Miki , Takeshita Junji , Lu Brett
Published: June 2024

Objectives

Addressing the methamphetamine epidemic will require a more complete understanding of its effect on healthcare systems and of the populations at risk. The objective of the study was to assess the impact of methamphetamine use on psychiatric emergency services outcomes and on Asian American (AA) and Pacific Islander (PI) populations, a historically overlooked population in substance use research.

Methods

A retrospective chart review was performed for all visits to a large level I trauma center in urban Hawaii from 2007 to 2019 that required psychiatric emergency services and in which urine drug screening was completed (N = 44,658). Demographic characteristics and emergency room courses were compared between amphetamine-positive and amphetamine-negative visits.

Results

The proportion of amphetamine-positive visits approximately doubled from 13.3% in 2007 to 25.5% in 2019. Amphetamine-positive visits were more likely to involve arrival by law enforcement (38.3% vs 27.2.%, P < 0.001), require intramuscular psychotropic medications (17.3% vs 12.3%, P < 0.001), and have longer emergency department lengths of stay (median, 420 vs 372 minutes, P < 0.001). Visits by Native Hawaiian and Hispanic/Latino patients had the highest rate of amphetamine positivity, while visits by Chinese and Korean patients had the lowest.

Conclusions

The findings reveal a concerning rise in amphetamine positivity that is associated with increased resource utilization. There was also significant variability in the rate of amphetamine positivity within the AA and PI population, a group of ethnicities often analyzed as a single entity in previous studies. Culturally sensitive interventions may curb the methamphetamine epidemic's effect on healthcare systems and vulnerable populations.
Detection of Klebsiella pneumoniae Co-Producing KPC-2 and MCR-8 in the Feces of an ICU Patient From China
Authors: Fu Hongxin , Xu Hao , Liu Ruishan , Liu Yi , Liu Xiaojing , Ma Xiaohan , Yang Yu , Guo Kexin , Ying Chiqing , Fang Danfeng , Qian Sijie , Zheng Beiwen , Du Weibo
Published: June 2024

It is critical to acknowledge that the coexistence of genes related to carbapenem and polymyxin resistance can exacerbate challenges in antimicrobial therapy. In this study, we identified Klebsiella pneumoniae isolate L2425 from the feces of an ICU patient in China. The isolate belongs to sequence type 11 and carries the antimicrobial resistance genes bla
KPC-2, bla
CTX-M-65 and mcr-8. Through S1-nuclease pulsed-field gel electrophoresis and Southern blotting analysis, we confirmed the presence of a ~110 kb plasmid harboring the mcr-8 gene with a conserved structure (inhA-mcr-8-ompR-dgkA-IS903B). Furthermore, another ~130 kb plasmid carrying bla
KPC-2 was detected along with a composite transposon flanked by insertion sequence IS26. Conjugation experiments demonstrated that both pL2425-KPC-2 and pL2425-MCR-8 plasmids were transferable. Importantly, this is the first instance of clinical fecal samples from China containing a K. pneumoniae strain carrying both bla
KPC-2 and mcr-8 genes. These findings underscore the significance of surveillance for carbapenemases and mobile colistin–resistance variants.
Supporting Families of Children Living in Multiple Households
Authors: Puhlman Jane , Puhlman Daniel
Published: June 2024

Family-centered early intervention should include all caregivers. For some children, this may be caregivers that live in separate homes, providing a unique challenge to interventionists wanting to ensure the strategies taught are happening throughout all of the child’s contexts. One-hundred and ninety seven interventionists completed an online survey examining their perceptions of importance in sharing information across households and their strategies to do so. Despite interventionists expressing the importance of sharing information across caregivers (93%), only 12% work with both parents when working with families and 26% exclusively take measures to actively share information with the parent not present in the sessions. This may indicate potential barriers involving both parents and sharing information with them. Strategies to better incorporate parents into services when they live in separate homes are discussed.
Indocyanine green fluorescence quantification during normothermic ex situ perfusion for the assessment of porcine liver grafts after circulatory death
Authors: Goto Toru , Noguchi Yuki , Linares Ivan , Mazilescu Laura , Nogueira Emmanuel , Hobeika Christian , Ray Samrat , Parmentier Catherine , Ganesh Sujani , Peranantharuban Jathuya , Chan Harley H.L. , Reichman Trevor , Selzner Nazia , Selzner Markus
Published: June 2024

Current graft evaluation during normothermic ex situ liver perfusion lacks real-time parameters for predicting posttransplant hepatocyte and biliary function. Indocyanine green (ICG) imaging has been widely used in liver surgery, enabling the visualization of hepatic uptake and excretion through bile using near-infrared light. In this research, porcine livers under various ischemic conditions were examined during a 5-hour normothermic ex situ liver perfusion procedure, introducing ICG at 1 hour through the hepatic artery. These conditions included livers from heart-beating donors, donation after circulatory death (DCD) with warm ischemic durations of 60 minutes (DCD60) and 120 minutes (DCD120), as well as interventions utilizing tissue plasminogen activator in DCD120 cases (each n = 5). Distinct hepatic fluorescence patterns correlated with different degrees of ischemic injury (p = 0.01). Low ICG uptake in the parenchyma (less than 40% of maximum intensity) was more prevalent in DCD120 (21.4%) compared to heart-beating donors (6.2%, p = 0.06) and DCD60 (3.0%, p = 0.02). Moreover, ICG clearance from 60 minutes to 240 minutes was significantly higher in heart-beating donors (69.3%) than in DCD60 (17.5%, p < 0.001) and DCD120 (32.1%, p = 0.01). Furthermore, thrombolytic intervention using tissue plasminogen activator in DCD120 resulted in noteworthy outcomes, including significantly reduced ALP levels (p = 0.04) and improved ICG clearance (p = 0.02) with a trend toward mitigating fibrin deposition similar to DCD60, as well as enhancements in bile production (p = 0.09). In conclusion, ICG fluorescence imaging during normothermic ex situ liver perfusion provides real-time classification of hepatic vascular and biliary injuries, offering valuable insights for the more accurate selection and postintervention evaluation of marginal livers in transplantation.
Headache as the sole clinical manifestation of acute myocardial infarction: one case with cardiac cephalalgia and literature review
Authors: Cui Huili , Zhang Lifeng , Zhu Taiqing , Liu Rui , Yuan Xueqian
Published: June 2024

Objective

Cardiac cephalalgia, once seen as a rare symptom of coronary artery disease, is now more recognized. It often comes with chest discomfort and autonomic dysfunction, worsened by physical activity. However, not all cases have chest symptoms or are activity induced. This report presents a case of cardiac cephalalgia and reviews 46 previous cases.

Method

We discuss a unique case where a patient had headache attacks without chest symptoms, autonomic dysfunction, or triggers. We reviewed English case reports of cardiac cephalalgia from 1982 to 2022 using PubMed (http://www.ncbi.nlm.nih.gov/pubmed).

Results

A 69-year-old man presented with a sudden headache without triggers or typical symptoms. Coronary computed tomography angiography (CTA) showed diffuse stenosis in the left anterior descending and the first diagonal branch arteries. His headache improved after percutaneous coronary intervention. Cardiac cephalalgia is usually marked by severe headaches, autonomic signs, and often affects the occipital region. Electrocardiogram (ECG) might not always show abnormalities, and chest pain is not always present. In such cases, elevated cardiac enzymes can be crucial for diagnosis.

Conclusion

When a headache is the sole symptom of an acute coronary event, consider moderate to severe intensity, older age at onset, occipital localization, and autonomic signs. ECG, cardiac enzymes, and coronary CTA are valuable for accurate diagnosis and treatment.
Child Care Center Staff Readiness to Change in an Early Childhood Obesity Prevention Program
Authors: Lebron Cynthia N. , Atem Folefac , Rana Priyanka , Natale Ruby , Messiah Sarah E.
Published: June 2024

Context:

The childcare center (CCC) setting has the potential to be a strong foundation that supports the introduction of sustainable healthy lifestyle behaviors to prevent childhood obesity. It is important to assess barriers and facilitators to healthy weight development initiatives via program evaluation, including measuring CCC staff readiness to change.

Objective:

The overall goal of this study was to assess the readiness level over 1 school year among CCC staff who participated in “Healthy Caregivers-Healthy Children” (HC2), a cluster randomized controlled trial that evaluated the effectiveness of a childhood obesity prevention program from 2015 to 2018 in 24 low-income, racially/ethnically diverse centers. A secondary outcome was to assess how a CCC's stage of readiness to change was associated with CCC nutrition and physical activity environment, measured via the Environment and Policy Assessment and Observation (EPAO) tool.

Design:

Mixed-models analysis with the CCC as the random effect assessed the impact of readiness to change over time on EPAO outcomes.

Participants:

Eighty-eight CCC teachers and support staff completed the HC2 readiness to change survey in August 2015 and 68 in August 2016. Only teachers and staff randomized to the treatment arm of the trial were included.

Main Outcome:

Readiness to change and the EPAO.

Results:

Results showed the majority of CCC staff in advanced stages of readiness to change at both time points. For every increase in readiness to change stage over 1 year (eg, precontemplation to contemplation), there was a 0.28 increase in EPAO nutrition scores (95% confidence interval [CI], 0.04-0.53; P = .02) and a 0.52 increase in PA score (95% CI, 0.09-0.95; P = .02).

Conclusions:

This analysis highlights the importance between CCC staff readiness to change and the CCC environment to support healthy weight development. Future similar efforts can include consistent support for CCC staff who may not be ready for change to support successful outcomes.
Development and Utility of an Interactive Online Dashboard for Monitoring Data Collection and Data Processing During a School-Based Health Survey
Authors: Tan LeeAnn , Ganapathy Shubash Shander , Lim Kuang Kuay , Ahmad Noor Ani
Published: June 2024

We built an interactive online dashboard using Google Looker Studio to monitor data collection and data processing activities during the Adolescent Health Survey (AHS) 2022, a large-scale nationwide survey conducted among school-going adolescents in Malaysia. Through user testing and training, refinements were made to the initial dashboard, resulting in a more streamlined and concise dashboard design. The dashboard comprised 2 pages that provided key metrics on the progress of data collection and data processing, respectively. The introduction of the dashboard enhanced the quality and ease of weekly progress reporting during meetings of the survey’s central coordinating team, while its drill-down and filtering functionalities helped us detect arising issues early and supported collaborative problem-solving. Research teams coordinating comparable school-based health surveys are invited to duplicate the dashboard using Looker Studio’s built-in “Make a copy” function and customize it further based on their country- or survey-specific requirements.
Overview of State Laws Restricting Alcohol Outlet Density in the United States
Authors: Michel Katie H. , Treffers Ryan D. , O’Malley Erin , Adler Sabrina S.
Published: June 2024

Objectives:

Complementing the extensive research literature demonstrating that increased alcohol outlet density is associated with excessive alcohol consumption and related harms, this article synthesizes information on the types of alcohol outlet density restrictions in US state-level laws.

Design:

Statutes and regulations related to alcohol outlet density in all 50 states and the District of Columbia in effect as of January 1, 2022, were collected using Westlaw. State-level density restrictions were coded according to 4 variables and overlaid with existing research on state-specific local authority to regulate outlet density. Alcohol outlet density laws in Michigan and Massachusetts were analyzed in detail as case studies.

Setting:

United States.

Main Outcome Measure:

US state-level licensing laws restricting alcohol outlet density.

Results:

Thirty-three states and the District of Columbia have state-level licensing laws that limit alcohol outlet density. Of those, 25 have population-based restrictions, 8 have distance-based restrictions, 7 have quotas, and 6 require the licensing agency to consider density-related factors. Within the same group of 34 jurisdictions, 22 apply restrictions to both on- and off-premises outlets, 5 apply them only to on-premises outlets, and 7 apply them only to off-premises outlets. Among the 32 states where localities lack authority to license alcohol outlets, two-thirds have state-level laws restricting outlet density. State-level density restrictions also exist in approximately two-thirds of the states where localities have licensing authority. Case studies of Michigan and Massachusetts highlight how state-level density restrictions operate in practice.

Conclusions:

Two-thirds of jurisdictions have state-level alcohol outlet density restrictions, with population-based restrictions being the most common. In addition, outlet density restrictions may exist regardless of limits on local control and whether localities with authority to enact density restrictions have done so. Policymakers and others can reference this assessment to identify examples and opportunities to strengthen the alcohol policy environment in any given state.