bluuebunny/crossref_metadata_2025 huggingface dataset:
Increasing access to pelvic health education for women in underserved communities: a mixed-methods study
Authors: Gillett Alexis , Traywick LaVona , LaGorio Kara , Dold Anna
Published: December 2024

It is essential to provide the community with evidenced-based care to optimize healthcare outcomes; more specifically, women in underserved communities with limited access to healthcare services. The purpose of this research was to determine the effectiveness of a single virtual movement-based pelvic health education session on women’s pelvic health knowledge, adherence to performing pelvic exercises and confidence in performing the exercises. Forty-two female participants were recruited in Western Arkansas. Participants completed an online pre-session (pre) questionnaire and then received a single virtual education session led by a healthcare provider trained in pelvic health. A post-session (post-1) questionnaire was completed by each participant as well as a 1-month follow-up (post-2) questionnaire. Thirty-five women completed all three questionnaires and pelvic health knowledge, adherence to pelvic floor exercises and confidence in performing pelvic floor exercises were assessed. After the participants completed the post-2 questionnaire, they were invited for a semi-structured interview and 13 women participated. Results of this study suggest pelvic health knowledge increased after a single session of movement-based education, and this was retained 1 month later. Adherence and confidence to perform the exercises did not change; however, learning about pelvic health in a virtual movement-based method was a positive experience and initiated an eagerness to learn more about pelvic health. Pelvic health education can be implemented in a virtual approach to engage women in underserved communities to learn more about pelvic health through a positive experience for an educational baseline to gain healthcare autonomy.
Evaluation and dynamic mechanism of green low-carbon transformation of agriculture in Yangtze River Delta region
Authors: Li Zhikun , Zhao Dandan , Yan Haixiang
Published: December 2024

To break through the development dilemma of traditional agriculture, the green and low-carbon transformation of agriculture (GLCTA) has gradually become a key engine to drive the construction of ‘dual carbon’ targets and the strategy of agricultural green development. Based on the panel data of 41 cities in the Yangtze River Delta (YRD) from 2010 to 2021, this study estimates the level of GLCTA in each city, discusses its spatiotemporal evolution characteristics, and uses the spatial panel error model and the geodetector model to reveal the dynamic mechanism of GLCTA process. The results show the following: (1) The overall level of GLCTA in the YRD shows a steady upward trend from 2010 to 2021, but the overall development level is low and the room for improvement is large. The development level of different cities differs greatly, showing a general situation of ‘high in the east and low in the west’, and the high level of GLCTA continues to deepen to the west. (2) The GLCTA in the YRD has spatial dependence and spatial spillover effect, and the number of cities with high–high and Low–Low development level is relatively large. (3) Except the urbanization level and the degree of rural industrialization that negatively affect the level of GLCTA in the YRD, other dynamic factors have a positive effect. Among them, the influence of fiscal support policy and economic level on the GLCTA is increasing. This paper discusses the current situation and dynamic mechanism of GLCTA in the YRD, which is innovative in terms of research content and perspective, and puts forward corresponding policy suggestions to promote GLCTA, providing important insights and practical basis for researchers and implementers in related fields.
Antifungal activity of bamemacrolactine C against Talaromyces marneffei and its possible mechanisms of action
Authors: Jiang Cuiping , Feng Guangfu , Wang Zhou , Liu Kai , Qu Xinjian , Liu Yonghong , Yi Xiangxi , Gao Chenghai
Published: December 2024

Aims

The present study aims to investigate the in vitro antifungal activity and mechanism of action of bamemacrolactine C (BAC), a new 24-membered macrolide compound, against Talaromyces marneffei.

Methods and results

The test drug BAC initially demonstrated antifungal activity through a paper disk diffusion assay, followed by determination of the minimum inhibitory concentration value of 35.29 μg ml−1 using microdilution. The association study revealed that combination therapy exhibited additive effects (0.5 < FICI < 1.0) when combined BAC with either amphotericin B or fluconazole. A time-growth assay confirmed that treatment with 35.29 μg ml−1 of BAC completely inhibited the growth of T. marneffei and exhibited antifungal effects. Micromorphological analysis using scanning electron microscopy and transmission electron microscopy photomicrographs revealed that BAC treatment induced morphological damage in fungal cells compared to the control group. Transmembrane protein assays showed a significant reduction in the levels of Na+/K+-ATPase (P < .05) and Ca2+-ATPase (P < .01) compared to the control group. Intracellular enzyme assays demonstrated that BAC treatment significantly decreased ATP, malate dehydrogenase, and succinate dehydrogenase content (P < .01). The combination of proteomics and parallel reaction monitoring (PRM) verification indicated that BAC exhibits an antifungal mechanism against T. marneffei by downregulating ATP citric acid lyase (ACLY) levels , potentially affecting the tricarboxylic acid (TCA) cycle. Besides, the binding model of BAC and the ACLY also shows a good docking score.

Conclusions

The findings suggest that BAC exhibits antifungal activity against T. marneffei, elucidating its multifaceted mechanism of action involving disruption of cell membranes’ integrity and inhibition of intracellular enzyme activities, in which the modulation of ACLY in the TCA cycle may play an important role.
Formal but Local Transitional Justice: Memorialization of the Missing by Local Government in Nepal
Authors: Bhandari Ram Kumar , Robins Simon
Published: December 2024

This article explores how the families of the disappeared in Nepal, in the absence of any substantive state-led transitional justice process, have mobilized to created victim groups to drive local political and social engagements with violations of the decade long internal conflict. Victims’ groups have informally memorialized their missing relatives and ultimately successfully advocated with local government to advance local memorialization through official processes. Victim-led memory practices have had an impact on local government policy, and these serve to enhance the role of victim groups as agents of social change. Using case studies from two local authorities as examples, we seek to highlight how localized memory practices empower and mobilize victims, advancing their role as political and social actors in processes of social change and blurring the conceptual division between state and community-led process. This article seeks to challenge the longstanding conflation of ‘local’ and ‘informal’ (meaning initiated and led by non-state actors) to describe the transitional justice process, by showing how when led by local authorities, this process can both empower victims and challenge impunity at the federal level.
Fashion first: Buckle Ballerina shoes recognized as applied art under Danish copyright law
Authors: Kohli Vishv Priya
Published: December 2024

The case was a copyright infringement dispute between the Danish fashion house Ganni A/S and the American company Steve Madden Ltd. The Danish Maritime and Commercial Court held that Ganni A/S’s Buckle Ballerina shoes qualify as original works of applied art and are therefore, capable of copyright protection.
Benchmarks of success in radiotherapy vs systemic therapy: National Clinical Trials Network (NCTN) randomized controlled trials sponsored by the National Cancer Institute (NCI)
Authors: Sanford Nina N , Shi Qian , Hein David M , Hall William A
Published: December 2024

Background

The National Clinical Trials Network (NCTN) is the largest government-sponsored organization in the United States; it is tasked with funding randomized controlled trials in oncology. It is unknown whether there are differences in study design by treatment modality. We evaluated differences in methodology between trials testing radiation therapy (RT) vs systemic therapy.

Methods

The Clinical Trials Support Unit website was used to identify active randomized controlled trials of systemic therapy or RT across NCTN cooperative groups through December 31, 2023. Studies in disease sites with more than 5 RT trials were included. Each trial’s protocol was reviewed to obtain key design information that was descriptively compared: primary endpoint, hypothesis testing type (superiority vs noninferiority), noninferiority margin, hypothesized effect size, power, and statistical significance level.

Results

A total of 186 randomized controlled trials (142 systemic therapy, 44 RT) were examined. Comparing primary endpoints, 59.1% vs 26.8% of RT vs systemic therapy trials, respectively, had a primary endpoint of overall survival. Nearly one-third (31.2%) of RT trials were noninferiority vs 6.3% of systemic therapy trials. Among breast cancer trials, 75% of RT studies were noninferiority vs 11.1% systemic therapy. Target effect size, power, and statistical significance level were similar by treatment modality within tumor types and disease settings.

Conclusion

Among NCTN cooperative group randomized controlled trials, there were marked differences in study design between RT vs systemic therapy trials. A higher benchmark for defining success for RT interventions was observed, with greater emphasis on overall survival as the primary endpoint. This finding may reflect differences in therapeutic mechanism by modality and types of study questions posed.
The relationship between air lead and blood lead in a modern US lead-acid battery facility: a longitudinal study
Authors: Li Wenchao , Chien Jiayang , Cohen Joel M
Published: December 2024

Objectives: To date there has been little observational evidence on the relationship between air lead and blood lead at relatively low workplace air lead concentrations. This study sought to improve upon prior studies methodologically and aimed to examine this relationship in a modern workplace environment.

Methods: Personal measurements of air lead and blood lead concentrations were collected in a modern lead-acid battery manufacturing facility in the United States. A total of 236 workers and their 2221 air-blood lead measurement pairs, collected between 2001 and 2021, were included in the statistical analysis. The association between air lead and blood lead was examined using linear mixed-effects models to account for data correlation. Potential confounders adjusted for included age, sex, job department, time trend, tenure, and seasonality.

Results: The workers were mostly (83%) male and on average 29.75 years of age at the first included measurement. Their air lead concentrations ranged from 1 to 50 (arithmetic mean 16.85) μg/m3; blood lead concentrations ranged from 2 to 35 (arithmetic mean 15.47) μg/dL. After adjusting for potential confounders, a 1 μg/m3 increment in air lead was associated with a 0.025 (95% CI, 0.005-0.045; marginal, semi-partial ${R}^2$ = 0.002) μg/dL higher blood lead.

Conclusions: The relationship between air lead and blood lead at relatively low workplace air lead concentrations over a long employment period may be very weak, but this needs to be further investigated in future observational studies with quantified lead exposures from noninhalation routes and nonoccupational sources.
Development of the Job-Related Uncertainty Stress Scale for Platform Workers
Authors: Zheng Yonglin , Cheung Francis , Luo Hongchen , Xu Heng , Li Chen , Wu Dan
Published: December 2024

Objectives: This study reports the development of the Job-Related Uncertainty Stress Scale for Platform Workers (JUSSPW) and examines its reliability and validity.

Methods: The research was conducted in 2 phases. In Study 1, item analysis and exploratory factor analysis were conducted on data from 343 platform riders (males: 321; females: 22; mean (SD) age: 27.03 (6.67) years) in Guangzhou, China. In Study 2, an additional 391 platform riders (males: 328; females: 63; mean (SD) age: 30.36 (4.49) years) were recruited. This phase involved conducting confirmatory factor analysis (CFA) and assessing criterion-related validity by using the Uncertainty Stress Scale (USS-4), Maslach Burnout Inventory (MBI), and Job Satisfaction Inventory (JSI).

Results: The JUSSPW scale comprises 8 items under a unidimensional structure, covering 4 perspectives: work environment, interpersonal relationships, industry-specific characteristics, and personal development prospects; it explained 71.07% of the total variance. CFA results indicated that this 1-factor model provided a good fit (χ2/df = 2.681, Root Mean Square Error of Approximation (RMSEA) = 0.066, Comparative Fit Index (CFI) = 0.987, Incremental Fit Index (IFI) = 0.987, Goodness of Fit Index (GFI) = 0.964, Tucker-Lewis Index (TLI) = 0.982). This scale also demonstrated good convergent (Average Variance Extracted (AVE) = 0.668, Composite Reliability (CR) = 0.941) and criterion validity (area under the curve = 0.935). The total score of JUSSPW was significantly positively correlated with the USS-4 and Maslach Burnout Inventory-Emotional Exhaustion (MBI-EE) scores, and remarkably negatively correlated with the JSI scores. Cronbach α and split-half reliability were .939 and 0.935, respectively.

Conclusions: These results suggest that this scale shows good reliability and validity and can be used as a sound measure to capture platform workers’ job-related uncertainty stress. Limitation and implications are discussed.
(018) CUFF CONUNDRUM: INFLATABLE PENILE PROTHESIS PLACEMENT IN MEN FOLLOWING TRANSCORPORAL ARTIFICIAL URINARY SPHINCTER
Authors: Ungerer G , Seyer A , Pinkhasov A , Ziegelmann M , Kohler T , Elliott D
Published: December 2024

Introduction

Concerns exist when inflatable penile prosthesis (IPP) surgery is performed following transcorporal artificial urinary sphincter (TC-AUS) due to risk of damaging the AUS cuff during proximal corporal dilation and device placement. Aside from rare case reports, no data exists on outcomes and complications in patients who undergo IPP surgery with existing TC-AUS in place.

Objective

We aim to describe perioperative complications, infections, revision rates, and device longevity when IPP surgery is performed with existing TC-AUS in place.

Methods

A retrospective search was conducted to identify all patients who had undergone TC-AUS placement at a single institution from 2015-2023. Patients who had undergone IPP placement following TC-AUS at the same institution were identified. Operative technique for IPP placement was similar to standard IPP surgery with additional care taken to avoid the AUS device and preferential use of electrocautery over sharp dissection. Operatives notes and all patient encounters were reviewed, and data on demographics, operative details, perioperative complications, infections, revision rates, and device longevity were recorded.

Results

727 patients underwent TC-AUS placement from 2015-2023. Of these, 13 patients underwent subsequent IPP placement (fig. 1). All patients had history of prostatectomy, and 6 (46%) patients had prior radiation. The median follow-up after IPP was 31.7 months and the time gap between AUS and IPP averaged 18.3 months (range 2.3 to 56.7 months). Average operative time for IPP was 85 minutes (range 53 to 202 minutes). Reservoirs were all placed contralateral to the AUS reservoir to minimize risk of injury to the AUS device. 8 patients had a 12 Fr catheter left post-operatively for less than 24 hours. Proximal dilation was noted to be difficult in 2 patients (15%), both of which were successfully dilated without perforation or damage to the AUS cuff. No infections or erosions occurred. 3 patients (23%) developed mechanical failure at a mean time of 28.7 months following IPP placement (36.5 months after AUS). Cuff leak was identified in 2 patients and the third has yet to undergo revision surgery to determine etiology.

Conclusions

IPP placement appears safe and effective in men who have previously undergone TC-AUS without increased risk of infection or device erosion. Care should be taken when dilating proximally, though proximal dilation was uneventful in most patients. Mechanical failure rates may be slightly higher compared to patients who have either device alone, and patients should be counseled accordingly.

Disclosure

No.
(063) VARIABILITY IN THE REFERENCE VALUES OF TESTOSTERONE, ITS MEASUREMENT METHODOLOGY, AND THE ASSOCIATED COSTS ACROSS LABORATORIES
Authors: Reyes-Vallejo LA , Gonzalez-Carranza HR
Published: December 2024

Introduction

Hypogonadism is defined as the gonadal failure resulting in an impaired steroid hormone production. The classic causes of male androgen deficiency are hyperprolactinemia, pituitary macroadenoma, endogenous Cushing syndrome and iron overload syndrome. Klinefelter syndrome and mild traumatic injury might also be a common cause of androgen deficiency. According to EAA guidelines, the diagnosis of hypogonadism should be based on both the presence of clinical symptoms and a low serum total testosterone. The diagnosis of hypogonadism can be complicated by the limited availability of laboratories capable of measuring testosterone, the variable reference ranges, and the costs of the test.

Objective

Investigate the variations in the normal range of testosterone levels reported by laboratories, as well as elucidate their corresponding methodologies of measurement and costs.

Methods

Telephone interviews were conducted with two hundred laboratories regarding the method they use for testosterone measurement, their reference parameters, and the cost of the assay.

Results

From the total of laboratories interviewed, only one hundred sixty of them measured total testosterone. One hundred sixteen were private laboratories, thirty-four laboratories were part of public hospitals and ten belonged to private hospitals. Sixty-six laboratories used chemiluminescence to determine testosterone, twenty-five used electrochemiluminescence, thirty-eight laboratories were unable to describe the method they use. The low reference value for total testosterone ranged from 84 to 668 ng/dL (795% difference), and the upper value ranged from 400 to 2562 ng/dL (640% difference). The average cost of testosterone testing is $35, with a maximum of $160 and a minimum of $9.

Conclusions

The great variability in testosterone measurement methods, the reference ranges of each laboratory and their costs mean greater difficulty in establishing the diagnosis of hypogonadism.

Disclosure

No.
(070) CLOMIPHENE’S EFFICACY IN TREATING MALE HYPOGONADISM: A RETROSPECTIVE ANALYSIS OF TESTOSTERONE LEVELS, SYMPTOM IMPROVEMENT, AND SAFETY PROFILE
Authors: Boyne A , Fleming B , La T , Desai S , Saffati G , Orozco Rendon D , Khera M
Published: December 2024

Introduction

Hypogonadism in men can significantly impact quality of life. Clomiphene is a selective estrogen receptor modulator used to induce ovulation by increasing luteinizing (LH) and follicle-stimulating hormone (FSH) levels. While testosterone replacement therapy (TRT) is a common treatment, clomiphene citrate has emerged as an alternative approach. However, there is a paucity of data regarding its clinical effectiveness.

Objective

We sought to determine the efficacy of clomiphene in improving testosterone levels and hypogonadal symptoms in patients at our institution.

Methods

Patients treated with clomiphene were for hypogonadal symptoms were retrospectively identified from a single institution database. Total serum testosterone and estradiol were compared before and after treatment with clomiphene using two-tailed student’s t-test for paired analyses and Welches t-test for unpaired analyses. Odds ratios (OR) for adverse events were calculated using the Fisher-exact test.

Results

76 men (mean age 37.5 years) presenting with hypogonadism (28.9%), infertility (32.9%), or other symptoms of low energy or libido (38.2%) were prescribed clomiphene by sexual medicine specialists at our institution. Mean total testosterone measured at the first visit and last follow up were 320.93 ± 247.38 ng/dL and 568.30 ± 438.69 ng/dL respectively (p < 0.001). Patients noted improvement of ED (75.9%), libido (74.6%), energy (82%), weight (60.0%), muscle mass (67.4%), and depressive symptoms (31.3%) following administration of clomiphene. Mean estradiol measured at the first visit and last follow up were 27.31 ± 15.11 pg/mL and 34.51 ± 22.11 pg/dL respectively (p = 0.02). Men undergoing treatment with clomiphene alone (n = 42, 55.3%) had significantly lower rates of polycythemia than those undergoing treatment with testosterone replacement therapy (TRT) and clomiphene (n = 34, 44.7%) (OR 0.096 (95% confidence interval: 0.002–0.813)).

Conclusions

Our study suggests the efficacy of clomiphene for treatment of male patients presenting with hypogonadal symptoms as measured by both serum testosterone levels and reported symptom improvement. Clomiphene use alone or in combination with TRT was associated with increased estradiol levels in this patient cohort. The data supports the potential benefits of clomiphene to treat hypogonadal symptoms in select patients.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Disclosures: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast, Halozyme Investor: Sprout.
(083) FDA HUMAN STUDY TRIAL ON THE SEALED VASECTOMY PROCEDURE APPEARS TO BE SAFE AND EFFECTIVE
Authors: Mutter M , Jones L , Henry G
Published: December 2024

Introduction

The Sealed Vasectomy Procedure (SVP) is a new bipolar radiofrequency sealing tool for transdermal vasectomy in hopes of making the procedure a faster, simpler, and safer office procedure. Testing has been successful in animal models with excellent wound healing, complete vas occlusion on histology, and no sperm in post procedural semen analysis. In this next step of device testing, we present our initial human data.

Objective

Evaluate the safety and effectiveness of the SVP in sealing the vas deferens in humans.

Methods

After FDA and IRB approval, 8 male patients were enrolled in the trial. Pre-procedure semen analysis was performed to ensure sperm present for each participant. Each then underwent office-based, minimally invasive vasectomy using Signati Separo device, with treatment occurring outside of the scrotum/skin. They were then seen at 30 days post-procedure with plans for a 3 month and 6 month post-procedure office visit and semen analysis to collect efficacy and further safety data.

Results

To date, 6 of the 8 patients have undergone sealed vasectomy procedure. Mean procedure time was 19.05 minutes while mean sealing time was 3.58 seconds per vas deferens. All patients had sealing and separation of each vas deferens as confirmed by the treating provider. Only one 30 day pain score was greater than zero (1). No patient has experienced an adverse event to date. Five out of six pathology specimens noted complete obliteration of the lumen with the remaining noting complete transection. Post-procedure semen analyses are currently pending for all patients.

Conclusions

Based on our limited human data to date, Signati sealed vasectomy procedure appears to be safe and effective in performing vasectomies in humans.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Signati Medical.
(089) TESTICULAR VASAL DIAMETER: A NEW INTRA-OPERATIVE PREDICTOR OF SUCCESSFUL VASECTOMY REVERSAL
Authors: Armstrong D , Grant LJ , Maloney TJ , Dean RC , Hawksworth DJ
Published: December 2024

Introduction

Vasovasostomy (VV), a preferred surgical technique for vasectomy reversal (VR), carries much higher reported success rates than a more complex vasoepididymostomy (VE). Although increased patient age and obstructive interval (OI) are well-established pre-operative factors predictive of need for a VE, the ultimate choice of VR technique is made at surgeon’s discretion, based on intra-operative findings. Intra-operative vasal fluid evaluation results may be affected by the level of operative staff experience and training.

Objective

We aimed to examine vasal lumen diameters, measured by the surgeon, as additional objective predictors of VR success.

Methods

Consecutive records of patients who underwent VR at our Institution between January 2008 and June 2023 were queried retrospectively. Patient demographics, medical and social history, pre-operative physical examination, and available laboratory data (Semen Analysis, Testosterone, Estradiol, and Inhibin B) were collected. Operative reports were reviewed and data including type of reversal (VV or VE), and intra-operative findings (vasal lumen diameters, presence of sperm granuloma/surgical clips, sperm quality, and vasal fluid quality) were recorded. Patient telephone calls were conducted to collect post-VR pregnancy information. Data were analyzed with use of descriptive statistics, t-tests, ANOVA, and Mann Whitney U tests when appropriate.

Results

733 records were reviewed, consisting of 536 bilateral VV, 99 combination VV/VE, and 75 bilateral VE operations. Average patient age at reversal was 38 years with an average OI of 10 years. VE was associated with a significantly larger testicular vasal lumen diameter (0.94 mm vs 0.88 mm; p < 0.05), decreased odds of positive post-operative semen analysis (92.4% bilateral VV versus 64.4% VV/VE or bilateral VE), and increased OI (7.84 years bilateral VV versus 11.5 years VV/VE or bilateral VE).

Conclusions

This study identifies a previously unreported association between testicular vasal lumen diameter measurements and likelihood of VR success. Furthermore, the study confirms previously reported pre- and intra-operative factors predictive of VR success. Additional analysis and correlation with pregnancy outcomes are in progress.

Disclosure

No.
(093) EFFECT OF VARICOCELECTOMY ON SPERM DNA FRAGMENTATION QUANTIFICATION IN INFERTILE MEN
Authors: Fleming B , Song J , Burchfiel E , Boyne A , La T , Desai S , Applewhite J , Orozco Rendon D , Khera M
Published: December 2024

Introduction

Varicoceles are present in up to 35% of men presenting with male factor infertility and are thought to affect spermatogenesis by raising testicular temperature among other mechanisms. Varicocelectomy is a viable intervention to improve sperm quality in infertile men. One measure of sperm quality, sperm DNA fragmentation (SDF), refers to the percent of sperm with damaged DNA in an ejaculate which can be a major indicator of male infertility. While the correlation between varicoceles and elevated SDF has previously been established, there are relatively few studies that quantify the effect varicocelectomy has on SDF.

Objective

The purpose of this study is to quantify the change in SDF following varicocelectomy in a cohort of infertile men from a single institution at three months post varicocelectomy and at the time of their most recent follow up visit compared to their initial preoperative SDF measurements.

Methods

An ongoing retrospective chart review of infertile men who underwent varicocelectomy from 2009-2024 at our high-volume men’s health center was undertaken. A total of 338 adult men with no prior varicocelectomy at an outside institution were included in our database. Only patients with SDF assays obtained before and after varicocele repair were included in our analysis (n = 21). The mean difference between SDF baseline values and SDF values at three months and at the time of their most recent follow up visit post varicocelectomy was calculated for each patient, and a paired t-test was used to test for significance.

Results

In our cohort, the average age at presentation was 34.3 (SD 1.812) years, and each subject was referred to our clinic for possible male factor infertility. Initial SDF assays (measured from 0-100%) performed before varicocelectomy revealed a mean baseline SDF of 38.19% (SD 6.613). The SDF assays performed at three months post varicocelectomy revealed a mean reduction in SDF of 6.19% (SD 3.44; p = .02), equating to a mean SDF of 32.0%. At the time of the patients’ most recent follow up (mean 9.47 ± 1.77 months), SDF decreased by a mean of 9.38% (SD 6.23; p = .03), which equates to a mean SDF of 28.81%.

Conclusions

Our results indicate that varicocelectomy significantly reduces SDF in infertile men at both their three month and most recent follow up visits. In our sample, patients’ SDF values improved from the time of their three months visit to their most recent. This study can eventually be used to manage expectations for infertile patients who undergo varicocelectomy, however additional research is necessary to determine how the grade of varicocele at presentation, laterality, and number of veins ligated affect SDF change.

Disclosure

No.
(098) IMPACT OF PRE-TREATMENT COUNSELLING ON DECISIONAL REGRET OF PROSTATE CANCER SURVIVORS: CROSS-SECTIONAL ANALYSIS OF PATIENT REPORTED EXPERIENCE FOLLOWING DIAGNOSIS OR TREATMENT
Authors: Southall T , Chung D , Sidhom K , Nayak J , Patel P
Published: December 2024

Introduction

Prostate cancer (PCa) impacts patient lives beyond oncological concerns alone. PCa survivorship includes the mental, physical, sexual, emotional, and financial effects patients endure from time of diagnosis, through treatment, and beyond. For some, this includes decision regret (DR). We aim to determine survivor experiences and understanding from a functional perspective throughout survivorship.

Objective

Our objective was to describe the local experiences and perspectives of PCa survivors regarding their functional outcomes at both the pre and post treatment level. Additionally, we sought to investigate the relationship between patients’ understanding of sexual and urinary side effects of treatment as well as modality of care delivery (ie virtual or in person) and development of treatment DR.

Methods

This is a cross-sectional survey of survivors. Our survey was circulated to all members of the Manitoba Prostate Cancer Support Group. Topics included erectile dysfunction (ED), penile shortening, urinary incontinence, and patient understanding throughout their care. Survey items included binary and Likert scale questions regarding patient understanding and treatment impact, as well as an open answered question asking how survivorship care may be improved. Responses were used identify predictors of DR.

Results

514 patients received our survey with a response rate of 23.7% (n = 122). The average age of diagnosis and treatment were 65.2 and 65.9 respectively. Most common treatments included 63.9% radical prostatectomy (RP), 54.1% radiotherapy (RT), and 36.1% androgen deprivation therapy (ADT). 71.9% reported sexual health to be very or somewhat important, but 27.9% reported no pre-treatment discussion of potential ED. 14.9% reported lacking understanding of treatment impact on erections. 76.9% reported no counselling on penile shortening and 95.0% reported no counselling on climacturia, prior to treatment. 27.3% reported no pre-treatment discussion of urinary incontinence and 11.5% reported lacking understanding of treatment impact on urination. Predictors of DR included treatment with RP, and low pre-treatment understanding of potential ED and urinary incontinence. Common open answer responses included desire for more information regarding support groups, treatment side effects, and management of such.

Conclusions

PCa survivors are at high risk of DR. Virtual care does not seem to impact DR. However, the degree of pre-treatment understanding of treatment options and their functional impact does. Survivors are motivated to learn about their condition, requesting more information on treatments, side effects, and local support groups. Apart from PCa diagnosis and management, it is equally as important to discuss functional aspects.

Disclosure

No.
(099) UNDER PRESSURE: STRESS IS NEGATIVELY ASSOCIATED WITH LIBIDO AND INTERCOURSE FREQUENCY
Authors: Seyer A , Nolte D , Kenfield S , Belarmino A , Civello D , Smith J , Helo S
Published: December 2024

Introduction

Undergoing fertility testing can be a stressful event in a couple's life. This can impact multiple aspects of life, including sex.

Objective

To evaluate the relationship between stress and sexual function in men undergoing fertility testing.

Methods

We performed a review of a prospectively maintained database of men utilizing a mail-in semen analysis test system developed by Fellow Health, Inc. Those included consented to participate in research, were 18 or older, and completed survey questionnaires on both their quality of life and sexual function. Stress level (low, moderate, or high stress) was determined using the validated Perceived Stress Scale (PSS) 10-question survey. The sexual function survey assessed libido, orgasmic and ejaculatory dysfunction, intercourse frequency, Erection Hardness Score, and IIEF-5 score. Descriptive statistics were reported and chi-squared and t-tests were used to determine statistical significance at the 0.05 alpha level.

Results

A total of 2077 men undergoing fertility testing were included in this study. 50.2% reported moderate stress levels and 2.6% reported high stress levels. Those with low stress were older than those with moderate or high stress (average 35.4 vs. 34.3 and 34.0 years, respectively; p < 0.01). Men with high stress levels were more likely to report a “poor” or “terrible” libido (31.4%) compared to those with moderate or low stress, 17.2% and 9.5%, respectively (p < 0.01). Stress was highly associated with weekly intercourse frequency (p < 0.01): among men with high levels of stress, 25.5% reported having sex less than once a week compared to 6.0% of men with low stress. Likewise, no highly stressed men reported having sex more than six times per week compared to 2.8% of men with low stress. Whereas 80.4% of men with low stress were evaluated to have “No signs of ED” by the IIEF-5, the same was true for only 62.3% of moderately stressed men and 56.0% of highly stressed men (p < 0.01).

Conclusions

More than half of men undergoing fertility testing report increased levels of stress, which is negatively associated with libido and erectile function. In men seeking fertility evaluation, lifestyle factors such as stress levels should be assessed to identify patients who may benefit from stress management strategies.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Fellow Health.
(109) CONTEMPORARY HIGH-LEVEL RADIATION THERAPY PROSTATE CANCER TRIALS MAY UNDERESTIMATE THE RISK OF BIOCHEMICAL RECURRENCE
Authors: Mulhall J , West M , Flores J
Published: December 2024

Introduction

Prostate specific antigen (PSA) is an important tool for the diagnosis of prostate cancer and detection of biochemical recurrence (BCR) after treatment. Secretion of PSA is a testosterone (T) dependent process. When T levels are below saturation point, PSA levels may be artificially low. T recovery rates after ADT cessation are variable and often fail to normalize. Recent data suggest that PSA levels should be indexed to T levels. The Radiation Therapy Oncology Group (RTOG, now NRG) has performed numerous clinical trials of radiotherapy (RT) with androgen deprivation therapy (ADT) in this population.

Objective

We explored whether the RTOG trials have indexed post-treatment PSA to T levels.

Methods

The clinicaltrials.gov (CTG) website was reviewed for RT/ADT clinical trials run by the RTOG/NRG over the past decade. For studies with results, manuscripts were reviewed; for the others the CTG protocol was reviewed. Demographic, oncologic, and treatment characteristics such as age, baseline PSA, Gleason grade, and length of treatment were collected if available. Data were reviewed assessing for mention of T measurement at time of post-treatment PSA checking, as well as assay suggested and time of day adherence for T measurement.

Results

15 clinical trials that met the study criteria were identified (Table). 14 029 patients have been enrolled. Median age was 64 (IQR [interquartile range] 2.5) years, median PSA was 0.5 (IQR 3.8), median Gleason grade group was 2 (IQR 1). 6/15 (40%) made no mention of T measurement whatsoever. None of the manuscripts published to date reported any T levels. One study had T recovery after ADT in the CTG results. Only 4/10 (40%) protocols stipulated that T should be measured concurrently with PSA, for an overall 27% T measurement performance rate. Only 1 protocol stipulated the type of assay and time of day (morning) measurement. 9/15 (60%) did not require regular follow up testosterone measurements for patients on ADT, while only 2/15 (13%) studies required a baseline T level to be measured.

Conclusions

Routinely indexing testosterone to PSA levels after high level RT/ADT trials is uncommon. This renders the BCR data unreliable, potentially underestimating BCR rates in these trials.

Disclosure

No.
(111) PROSTATE SPECIFIC ANTIGEN LEVELS IN TRANSGENDER WOMEN ARE LOWER THAN CISGENDER MEN
Authors: Nguyen V , Morris S , Meagher M , Burke L , Freedland S , Nik-Ahd F , Rose B , Patel D , Salmasi A , Anger J , Jamieson C
Published: December 2024

Introduction

Little is known about incidence and screening patterns of prostate cancer, a hormone-sensitive malignancy, among transgender and nonbinary (TGNB) individuals assigned male at birth.

Objective

We sought to evaluate prostate specific antigen (PSA) levels in this population compared to cisgender men and to investigate effect of gender affirming hormonal therapy.

Methods

We identified TGNB HIV-negative individuals age > 40 from the California Collaborative Treatment Group 603 study aimed at evaluating pre-exposure prophylaxis. We then assembled a 3:1 comparison group of cisgender men age > 40 followed by Urology for a diagnosis other than elevated PSA. Data abstracted included age, sex assigned at birth, gender identity, race/ethnicity, PSA, testosterone and estradiol levels, and use of hormone therapy.

Results

We identified 31 TGNB individuals (median age 47 years, 77% on estrogen, 48% on antiandrogen) and 94 cisgender men (median age 57 years, 25% on testosterone; Table 1). PSA was significantly lower in TGNB individuals (0.23 vs 0.93 ng/ml, p < 0.01); this remained true after stratifying by age (Table 2). Age and testosterone were significant predictors of increased PSA (p < 0.01) in both cohorts. Estradiol levels significantly predicted decreased PSA (p < 0.01) in both cohorts, whereas antiandrogen and estrogen therapy were predictors of decreased PSA in TGNB individuals (p < 0.01, Table 3). On multivariate analysis, testosterone level remained the only significant predictor of PSA (p < 0.01).

Conclusions

PSA levels are lower among TGNB individuals assigned male at birth with a retained prostate. Testosterone level is a key determinant of PSA and use of gender affirming hormones is associated with lower PSA. Further studies are needed to establish prostate cancer screening cutoffs in this population.

Disclosure

No.
(145) TRANSDERMAL APPLICATION OF H100™ GEL TO THE PENILE SHAFT IN PATIENTS WITH PEYRONIE’S DISEASE INFILTRATES THE TUNICA ALBUGINEA
Authors: Twidwell J , Tortorelis D , Mahon J , Levine L
Published: December 2024

Introduction

Noninvasive treatment options for Peyronie’s disease (PD) remain limited. Topical H100™ gel (Hybrid Medical, Edina, USA) which contains nicardipine, super oxide dismutase and emu oil showed safety and efficacy in a previous small double-blind, placebo- controlled pilot study.

Objective

The present study evaluates if topically applied H100™ gel applied to the penile shaft infiltrates the tunica albuginea. Nicardipine is a key active ingredient in H100™ and serves as a surrogate marker.

Methods

3 men already scheduled to undergo a planned surgical procedure for PD applied commercially available H100™ gel twice daily to the penile shaft for up to 30 days prior to the procedure. Tunica albuginea samples were obtained at surgery. Nicardipine evaluation was performed using isotope dilution technique via liquid- chromatograph-mass spectrometry (LCMS).

Results

All 3 patients tolerated H100™ gel application without side effects. All 3 tunica albuginea specimens showed detectable nicardipine in the tunica tissue.

Conclusions

Transdermal application of commercially available H100™ gel is able to penetrate the tunica albuginea tissue and is detectable in men with acute and chronic PD. This finding may support the encouraging results found in the prior H100™ pilot study.

Disclosure

Yes, this is sponsored by industry/sponsor: Hybrid Medical.

Clarification: Industry initiated, executed and funded study.

Any of the authors act as a consultant, employee or shareholder of an industry for: Hybrid Medical.
A detailed investigation of particle energization mechanisms in models of collapsing magnetic traps
Authors: Mowbray Kate , Neukirch Thomas , Threlfall James
Published: December 2024

In this paper, we provide a detailed investigation of the energization processes in two-dimensional, two and a half-dimensional, and three-dimensional collapsing magnetic trap models. Using kinematic magnetohydrodynamic models of collapsing magnetic traps, we examine the importance of Fermi acceleration in comparison with betatron acceleration in these models. We extend previous work by investigating particle orbits in two-dimensional models without and with a guide field component and from full three-dimensional models. We compare the outcomes for the different models and how they depend on the chosen initial conditions. While in the literature betatron acceleration has been emphasized as the major mechanism for particle energization in collapsing magnetic traps, we find that Fermi acceleration can play a significant role as well for particle orbits with suitable initial conditions.
Observations of the 3.4 mm line of HCN in C/2020 T2 (Palomar)
Authors: Wang Zhen
Published: December 2024

The observations of comet C/2020 T2 (Palomar) were carried out using the 3.4 mm wavelength microwave band before perihelion from 2021 January 22 to July 5 and after perihelion on 2021 July 13. During this period, the comet was located at a heliocentric distance of between $r_\text{h}$ = 2.840 and 2.055 au. The consecutive long-term monitoring of outgassing of C/2020 T2 was conducted with Purple Mountain Observatory (PMO) 13.7 m telescope and the Institut de RadioAstronomie Millimétrique (IRAM) 30 m telescope in the atmospheric radio window. The hyperfine triplet components of hydrogen cyanide (HCN (1−0) F = 0−1, F = 2−1, and F = 1−1) of the J = 1−0 vibrational ground-state transitions, as the primary tracer of molecular gas, were unambiguously identified in this comet C/2020 T2. Combining all data, we derived the positive signal of line width corresponds to the coma expansion velocity $v_{\rm exp}$ from $\sim$0.2 to $\sim$0.4 km s$^{-1}$. The mean gas molecular production rates of HCN were derived $Q_{\rm HCN}$ = (2.92 $\pm$ 0.51) $\times$ 10$^{25}$ molecules s$^{-1}$ at PMO 13.7 m, and $Q_{\rm HCN}$ = (6.26 $\pm$ 1.55) $\times$ 10$^{25}$ molecules s$^{-1}$ at IRAM 30 m, respectively. Overall, studying the gas composition of the long-period comet revealed abundant information about the missing link between interstellar molecular clouds and the outer regions of a distant protoplanetary accretion disc, and the relationship between amorphous ice sublimation mechanism and heliocentric distance.
The SARAO MeerKAT Galactic Plane Survey filamentary source catalogue
Authors: Williams G M , Thompson M A , Mutale M , Rigby A J , Bordiu C , Riggi S , Bietenholz M , Anderson L D , Camilo F , Goedhart S , Jaffa S E , Obonyo W O , Trigilio C , Umana G
Published: December 2024

We present a catalogue of filamentary structures identified in the SARAO (South African Radio Astronomy Observatory) MeerKAT 1.3 GHz Galactic Plane Survey (SMGPS). We extract 933 filaments across the survey area, 803 of which (${\sim }86~{{\ \rm per\ cent}}$) are associated with extended radio structures (e.g. supernova remnants and H ii regions), while 130 (${\sim }14~{{\ \rm per\ cent}}$) are largely isolated. We classify filaments as thermal or non-thermal via their associated mid-infrared emission and find that 77/130 (${\sim }59~{{\ \rm per\ cent}}$) of the isolated sources are likely to be non-thermal, and are therefore excellent candidates for the first isolated, non-thermal radio filaments observed outside of the Galactic Centre (GC). Comparing the morphological properties of these non-thermal candidates to the non-thermal filaments observed towards the GC, we find that the GC filaments are on the whole angularly narrower and shorter than those across the SMGPS, potentially an effect of distance. The SMGPS filaments have flux densities similar to those of the GC; however, the distribution of the latter extends to higher flux densities. If the SMGPS filaments were closer than the GC population, it would imply a more energetic population of cosmic ray electrons in the GC. We find that the filament position angles in the SMGPS are uniformly distributed, implying that the local magnetic field traced by the filaments does not follow the large-scale Galactic field. Finally, although we have clearly shown that filaments are not unique to the GC, the GC nevertheless has the highest density of filaments in the Milky Way.
Evolving properties of pits on 67P/C-G due to illumination induced mass-loss – I. Isolated shape morphology
Authors: Rezac L , Zhao Y
Published: December 2024

Our aim is to characterize patterns of evolution of morphological units on the nucleus of 67P-CG such as pits, sink-holes or, more generally, pit-like features. This work focuses on developing suitable metrics to contrast different stages and changes during the time evolution. We adopt a 3D mass-loss evolution model (MONET) assuming water ice sublimation is the primary driver of erosion activity. This paper considers isolated pit-like structures without the process of merging which will be addressed in our subsequent work. The modelling study cases investigate how latitude, obliquity, and initial pit shape converge in defining the final morphology of the pits, for a spherical nucleus as well as shape model of 67P/C-G. Our results corroborate to some extent the previous studies quantifying exes heat retention due to the concavity of these pit features, however, we demonstrate a clear dependence of ‘smoothing’ or ‘deepening’ effects on the orientation and initial shape. Furthermore, it is shown that the diameter evolution of the pits is influenced by a combination of factors such as solar incidence, shadowing, and/or self-heating acting on its walls. Under certain circumstances, we also observe pronounced asymmetry in mass-loss at the pit floors, a weak effect of terracing. Mass-loss-induced evolution may result in the transformation of circular depressions into elongated ones due to specific solar illumination directions. The modelling results presented here represent the first explicit simulators of the deepening, widening, and smoothing processes in the context of 67P-C-G.