bluuebunny/crossref_metadata_2025 huggingface dataset:
(127) Is Artificial Intelligence Ready to Help Urologists?
Authors: Van De Walle G , Morgantini L , Donaldson H , Smith J , Mima M
Published: March 2024

Introduction

ChatGPT is a language model developed by OpenAI. It's a variant of the GPT (Generative Pretrained Transformer) architecture, a transformer-based neural network used for natural language processing tasks. The model has been trained on a massive corpus of text data and can generate human-like responses to topics and questions. ChatGPT can be used for chatbots, conversation agents, and language translation. The integration of AI into urology has the potential to improve patient outcomes, increase efficiency, and reduce costs, ultimately leading to a better healthcare experience for patients.

Objective

The objective of this study is to assess the current state of artificial intelligence (AI) when it comes to urologic problems and to determine whether it is sufficiently developed and prepared to provide useful assistance to urologists in their clinical practice. This study aims to assess the accuracy, reliability, and potential benefits of one AI language model (ChatGPT) in efficiently answering common patient questions, providing patients with accurate educational information, minimizing patient harm, and guiding patients towards appropriate management. By exhibiting ChatGPT's capabilities and limitations in the context of urology, the study aims to demonstrate how AI can be helpful in everyday urological practices.

Methods

ChatGPT (chat.openai.com) was presented with typical clinical scenarios and patient questions.

Results

AI wrote the introduction answering “What is ChatGPT?” and “How can AI help urologists?”. For the conclusion, AI was prompted with “Is artificial intelligence ready to help urologists?”. Figures summarize the answers to common patient questions given by ChatGPT.

Conclusions

The use of AI in the field of urology is still in its early stages and more research is needed to determine its full potential. However, there have already been some promising developments and successful applications. For example, AI algorithms have been used to accurately diagnose prostate cancer, predict patient outcomes, and improve surgical planning. While AI has the potential to revolutionize the field of urology, it is important to note that AI is not a substitute for human expertise and judgment. AI algorithms can provide valuable insights and assistance, but the ultimate decision making and treatment planning should still be done by experienced urologists. Additionally, it is important to ensure that AI systems are developed and used in a way that respects patient privacy and data security, and that the outcomes of AI-assisted decision making are transparent and explainable. In summary, AI has the potential to greatly benefit the field of urology. Still, it is important to approach its use with caution and continue evaluating its impact as more research is conducted.

Disclosure

No.
(146) Sex Education and Pattern of Sexual Behavior among Adolescents in a Sub-Urban High School
Authors: Idowu O C , Adedeji O , Oyerogba O P , Osundara O
Published: March 2024

Introduction

Adolescence being the transition from childhood to adulthood may be associated with risky sexual behavior with consequences that may last a lifetime. Sex education for teenagers to encourage safe sexual practices is necessary to build a society of adults with healthy sexual lifestyle. The details of the source of information, level of knowledge and actual sexual practices among these adolescents will inform the approach to supplying adequate information.

Objective

The objective of the study is to demonstrate the level of knowledge of adolescents about safe sexual practices, contraceptives and their pattern of behavior.

Methods

Data regarding knowledge and sexual behavior was obtained from adolescents in a Sub-Urban high school with the aid of pre-tested self-administered questionnaire. The data was imputed and analyzed with the IBM SPSS software.

Results

A total of 107 adolescents aged 13 to 19years (mean - 16.078years) with average weight of 47.931Kg; 53(49.5%) were males and 54(50.5%) were females. About half (51.4%) practice Christianity and 48.6% practice Islamic religion and majority (96.3%) were in their penultimate class in high school. Majority of respondents (87.7%) reported having formal sex education, the commonest source of sex education was school in 76.9%, other sources of information were parents (11.0%), friends and peers (8.7%), mass media (4.4%) and siblings (2.2%). The quality of knowledge of these adolescents may be poor, as many as 25% of respondents think that casual sex does not predispose to infections and only 21.8% had any knowledge of modern contraceptives. Nearly one-quarter (23.36%) of respondents have commenced sexual activities with the mean age at coitarche being 12.38±2.38years; majority in this category (92%) being males. The commonest form of sexual practice is peno-vagina intercourse which is seen in 21.7% of respondents, 13.3% practice masturbation, 5.8% of respondents have had homosexual activities, 6.7% practice oral sex and 1.9% practice peno-anal sex. Among the sexually active respondents, 72% have had multiple sexual partners, 32% practice casual sex. Majority (92%) have used male condoms before but only 32% of sexually active respondents regularly use condoms. Majority (98%) of sexually naïve were contented with their status and 13% of sexually active respondents wished they had delayed sexual activities.

Conclusions

Although, intervention at adolescence with sex and reproductive health services offers the opportunity to form societies with healthy sexual lifestyle, the level of knowledge of sex education among adolescents in Sub-Urban communities remain poor yet a significant proportion of these Adolescents have commenced sexual activities with some practicing risky sexual behavior.

Disclosure

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(167) Shaeer’s Corporal Rotation IV: Length and Girth Preserving Technique for Correction of Severe Congenital Ventral Penile Curvature
Authors: Kamal O
Published: March 2024

Introduction

For cases with severe penile curvature, the loss in length with shortening techniques, or the loss in rigidity with incision-grafting can compromise the results, hence the advent of Shaeer’s Corporal Rotation III technique which corrects the most severe degrees of ventral penile curvature without loss in length, though with a certain degree of narrowing.

Objective

To describe Shaeer’s Corporal Rotation IV, aiming at correction of moderate to severe ventral penile curvature with minimal shortening, minimal narrowing, minimal mobilization of the neurovascular bundle, among other improvements such as using thicker suture material to decease recurrence while inverting the surgical knots.

Methods

Forty-two patients with congenital ventral penile curvature were selected for the study with the curve ranging from 60 to 90 degrees. Patients were randomized into one of the two groups: Shaeer’s Corporal Rotation III (SCR-III) and Shaeer’s Corporal Rotation IV (SCR-IV). In SCR-IV, rotation is used to correct the main brunt of curvature, up to 70–80% of the curve. Plication is used to correct the residual curvature up to 100% straightness. This keeps the rotation points fewer and closer to the midline, thereby minimizing narrowing and mobilization of the neurovascular bundle. Both groups were compared as regards intra-operative erection angle, length and girth, before and after rotation, as well as subjectively-reported post-operative recurrence, penile sensitivity, satisfaction and IIEF.

Results

Post-correction angle was zero for all cases in the two groups. Dorsal length decreased by 3% in SCR-IV, compared to 0.5% in SCR-III (2.5% difference). The difference in circumference between narrowest and widest points was 2% in SCR-IV versus 9.3% in SCR-III (7.3% difference). Average operative time was 19.2% shorter with SCR-IV. Girth asymmetry was reported in 1/21 patients in SCR-IV (4.8%), compared to 15/21 in SCR-III (71.4%). Partial hyposensitivity of the penis was reported in 9.5% among SCR-IV compared to 19% in SCR-III.

Conclusions

Shaeer’s Corporal Rotation IV technique corrects moderate and severe degrees of congenital ventral penile curvature, with little or no compromise in penile length, girth or sensitivity.

Disclosure

No.
(184) The Prevalence of Sexual Dysfunction in Women Seeking Infertility Treatment in Vietnam
Authors: Phan Thi Bich T , Nguyen Thi Huyen T , Pham Thi My H , Nguyen Anh T , Le Thi Thu H
Published: March 2024

Introduction

Sexual function plays a crucial role in women's psychosocial and overall well-being, significantly impacting their quality of life. Any decline in sexual function can have detrimental effects on the affected individuals' quality of life

Objective

(i) To describe the prevalence of sexual dysfunction in women seeking infertility treatment at the Andrology and Fertility Hospital of Hanoi, Viet Nam, and (ii) to analyze the factors associated with sexual dysfunction in the study population.

Methods

This was a cross-sectional descriptive study. All women (1.039) seeking infertility treatment at the Andrology and Fertility Hospital from December 30, 2022, to March 30, 2023 participate in the study. They were invited to scan a QR code and complete the research questionnaire. Female sexual dysfunction is assessed based on the FSFI scale included six domains: sexual desire, arousal, lubrication, orgasm, satisfaction, and pain (comprising 19 questions). The data were extracted into Excel, cleaned, and analyzed using STATA 17.0 software. The analysis of factors associated with female sexual dysfunction was conducted using logistic regression models.

Results

Among the 1039 participants in the study, the mean age was 30.9±5.3 years. The overall score for female sexual dysfunction was 25.09 ± 6.20, with individual component scores. The prevalence of female sexual dysfunction was 49.7%. There is a positive correlation among the six components of female sexual dysfunction, p<0.01. In the multivariate regression model, the risk of female sexual dysfunction is higher among individuals who work away from home, have an underweight body mass index, have a poor relationship with their partner, have had no sexual intercourse in the past 4 weeks, experience fear of pain, anxiety, and body image concerns during sexual activity, have infrequent or no discussions with their partner regarding sexual desires, preferred positions, and stimulation, and are dissatisfied with their sexual life.

Conclusions

Half of the women seeking infertility in late-stage medical care experience sexual dysfunction. Factors that increase the risk of sexual dysfunction include having a job far from home, being underweight based on body mass index, having a poor overall relationship with a partner, not engaging in sexual activity in the past four weeks, fear of pain, anxiety, body image concerns during sexual intercourse, and limited or lack of communication with a partner about sexual issues such as desires, preferred positions, and stimulation. Additionally, dissatisfaction with one's sexual life contributes to the occurrence of sexual dysfunction. Therefore, early screening and timely intervention are necessary for this group of individuals.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Andrology and Fertility Hospital of Hanoi.
(195) Penile Implants: Restoring Erectile Function Regardless of Age. A Mini–Case Series
Authors: Khalaf Alla K , Slovacek H , Wang R
Published: March 2024

Introduction

Given the overall aging of the population, erectile dysfunction has become an increasingly relevant issue among the elderly. When elective surgery is offered, the patient's age is often taken into consideration as a potential limiting factor. Moreover, the importance of addressing the quality of life and sexual satisfaction of older men tends to be overlooked in the management of erectile dysfunction.

Objective

The aim of this study is to investigate the safety of implanting penile prostheses (PP) in patients aged 90 years and older, as well as the potential complications associated with this age group.

Methods

The database of patients was screened between the years 2003 and 2023, to identify patients at least 90 years and older who underwent the implantation of penile prosthesis by a single surgeon at two large volume centers. We collected demographic information for the patients, including their past medical and surgical history, medication list, anesthesia perioperative assessment and recommendations, details of the surgical procedure, intraoperative and postoperative recovery period, as well as clinic follow-up.

Results

Between 2003 and 2023, a total of 2000 men underwent PP surgery at the two centers. Out of the total number of patients, only two were 90 years or older at the time of implantation. One patient was a first timer, while the other had two previous PP surgeries over the span of 15 years for mechanical failure reasons. Both surgeries were performed using different device types, without any intraoperative or postoperative complications. At their three and six months follow up visits, both patients demonstrated the ability to cycle the implant smoothly, reported satisfactory penetrative intercourse with their partners, and improved sexual intimacy through Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. They were followed for a total of 1 year with no long-term negative effects.

Conclusions

Despite reporting only two cases in this specific cohort, it demonstrates that implantation of PP is a safe and effective treatment for elderly men with ED. Maintaining satisfactory sexual activity in this age group is vital and achievable through inflatable penile prosthesis (IPP) insertion. There are several complex factors that must be considered prior to operating on an older patient due to medical comorbidities and age. However, with proper patient selection, pre-operative counseling and optimization, this operation can be effectively performed in patients who are at least 90 years old. Simply, age is not a limitation to undergo penile implant.

Disclosure

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(209) Investigating if Polygamy is Associated with Higher Levels of Testosterone or Not
Authors: Habous M , Bittocchi C , Ralph D
Published: March 2024

Introduction

Introduction: in middle east countries polygamy is legal and common. While the majority of married men have only one wife, some of them have more than one wife.

Objective

Objectives: Its a common hypothesis among public that a man who has more than one wife at a time is hypersexual and has higher levels of testosterone. We ran this study to check if this hypothesis is true or not.

Methods

We prospectively enrolled men who attended the andrology clinic for different reasons in this study in one-year duration. Exclusion criteria were: being single, age >45, body mass index (BMI) >30 or <20, diabetics, dyslipidaemia, pituitary dysfunction, thyroid dysfunction, cryptorchidism, history of primary infertility or azoospermia and testosterone supplementation. All patients had thorough medical history and marital status. Number of children of each participant was also recorded. All patients had blood sample for total testosterone between 9–11 am. Statistical analysis was performed using the T- Student test. Serum testosterone was compared in a multivariate analysis to martial history and number of children.

Results

214 men were included in this analysis. The mean age was 28(19–45).98 patients had one wife (46%),43 had two wives (20%),37 had 3 wives (17.2%), and 36 had 4 wives (16.8%) at the time of presentation. The average number of children for each man was 4(1–17). The mean serum total testosterone was 4.6 ng/ml (3.2–7.6). The number of children was correlated with the number of wives (r=0.522, P<0.01). The number of children was negatively correlated with the testosterone level (r=-0.170, P<0.05). The number of wives was negatively correlated with the testosterone level (r=-0.180, P<0.01), see table 1.Once age has been controlled for, the correlation disappeard, see table 2.

Conclusions

Increasing numbers of both wives and children are not associated with higher levels of testosterone.

Disclosure

No.
(223) Specific Training Needs of Student Midwives in Sexual Health and Clinical Sexology
Authors: Kaabia O , Souai M
Published: March 2024

Introduction

According to the WHO, sexuality is an integral part of human life, encompassing all dimensions of human beings: physical, emotional, mental, and social well-being associated with sexuality, involving a positive and respectful approach. It is essential to educate and train health professionals such as midwives to address sexual problems and provide the necessary information to their clients, in order to ensure comprehensive and quality care. There is still a lack of specific sexual health training programs in the midwifery curriculum in several countries worldwide.

Objective

This study aims to assess the student midwives’ training needs in sexual health and clinical sexology.

Methods

It is a knowledge, attitudes, and practices cross-sectional online study that took place over 5 weeks starting March 1st, 2023. All enrolled student midwives in public and private midwifery schools in the country were contacted through the schools’ social media groups. The online questionnaire was a 29-item Google form elaborated in concertation with the Frequency, Gravity Problem (FGP) grid of questions.

Results

The study included 206 student midwives (answer rate: 87%). The participants were representative of the population of student midwives (31% 1st, 33% 2nd, and 36% 3rd year and 31% from the North, 38% from the center, and 31% from the South of the country). The participants’ mean age was 22,1± 1,04 years and 96% were single. When asked about their experience with sexual interviews, 60.7% felt uncomfortable. The reasons for that feeling were the absence of previous learning simulations and experiences (84%), the lack of confidence in their knowledge (70%), the fear of a potential lack of interest of the clients about sexual health (59%), sexuality is taboo (28%). Regarding their training and education in sexual health and clinical sexology, 94% declared that it was only theoretical, 47% considered it as unorganized and 68,5% thought that there was a lack of correlation between the time allowed and the content of the sessions. The instructors were judged as qualified by 36% of the participants. The resources were considered useful by 19%. And 23.3% of the students enrolled in other non-academic training in sexology during the previous year. The expressed need for specific sexology training was expressed in 94%. The needs were regarding knowledge in 55%, Attitudes in 80%, and practices in 55%.

Conclusions

A specific academic curriculum in sexual health and clinical sexology is a necessity within the student midwives' training. This educational program needs to reinforce some knowledge and practices and mainly address the attitudes of healthcare professionals toward clients asking for information and/or help regarding their sexual health. Prevention has also to be integrated into this program. Role-playing and simulations in small groups seem the most adapted pedagogical techniques to re-enforce attitudes within students.

Disclosure

No.
(237) Patient Reported Outcomes in Men Received Focal Therapy for Prostate Cancer
Authors: Raheem O A , Maricano O , Paruthi M
Published: March 2024

Introduction

Although focal therapy as a definite treatment modality for prostate cancer patients has been increasing in the United States, there has been paucity of patient reported outcome measures (PROM) specific to urinary, erectile, and sexual function

Objective

We aim to evaluate the long-term PROM in men undergone focal therapy for prostate cancer since 2019.

Methods

Web search was performed on the PubMed database. The search was limited to articles published in the English language and reporting focal therapy outcomes between 2019 and 2023, including randomized controlled trials, prospective and retrospective studies. The following data were extracted from each study: year, type of focal therapy, design, participants, demographic, IIEF, ED proportion, IPSS, EPIC, pad incontinence use, fistula rate, urinary retention rate, hematuria, Gleason scores, time to oncologic follow-up, recurrence, and presence of cancer after treatment.

Results

Twenty-three studies, consisting of cryotherapy, HIFU, TULSA, focal and microwave ablation where met the inclusion criteria and reviewed. Oncologic outcomes were reported in 17 of 23 studies. Median follow-up ranged from 3 to 42 months. Main oncologic outcomes analyzed were in-field/out-of-field recurrence and presence of prostate cancer after treatment. The two largest HIFU studies (n=90, n=101) had 9% and 24% respectively for clinically significant recurrence. The two focal microwave ablation studies (n=55, n=5) had 9% and 20% recurrence rates respectively. Functional outcomes were assessed by IPSS and IIEF. IPSS scores were consistent, with most studies reporting only minimal changes in IPSS after treatment. IIEF scores were generally consistent before and 6 months after procedure for all studies, with some reporting only marginal declines in erectile function. Complication rates among studies were low. Nine studies reported UTI rates ranging from 0% (n=6, n=41) to 30% (n=10) in a TULSA prospective study. Urinary retention rates were reported in 14 studies, with a range from 0% (n=41) to 30% (n=10).

Conclusions

This review suggests that focal therapies remain safe and effective treatment modality for patients with low-intermediate risk prostate cancer. PROM pertaining to urinary and erectile functions in men undergone focal therapy modality seems to be adequate without worse oncological or complication outcomes. Larger data with oncological and functional outcomes is warranted to further validate its safety and efficacy over longer follow up period.

Disclosure

No.
(250) A Case Study with an Egyptian Transgender Woman's Transitioning Phases
Authors: Elkot N
Published: March 2024

Introduction

Transgender individuals face numerous challenges in their journey to affirm their gender identity. In Egypt, transgender individuals face additional challenges due to social and legal constraints. This case study aims to provide an in-depth look at the transitioning phases of an Egyptian transgender woman, including the challenges she faced and the support she received.

Objective

The objective of this study is to investigate the transitioning phases of an Egyptian transgender woman in her thirties, including demographic history, social and legal constraints, past traumas, psychiatric management, medical and surgical procedures, and outcome.

Methods

This study will use a case study approach, focusing on a single Egyptian transgender woman. Data will be collected from interviews with the participant, as well as with her family members, friends, and healthcare providers. The interviews will cover topics such as demographic history, social and legal constraints, traumas, psychiatric management, medical and surgical procedures, and outcome. Written consent was acquired from the participant, her family and all involved parties. Conflict of Interest: the author declares that he was the psychotherapist for the participant before, during and after the transition, the psychotherapy was ended 4 years ago

Results

The data collected from the interviews will be analyzed using thematic analysis to identify common themes and patterns related to the participant’s transitioning phases. The analysis will focus on the challenges faced by the participant, as well as the support she received from her family, friends, and healthcare providers.

Conclusions

This case study aims to provide valuable insights into the transitioning phases of an Egyptian transgender woman. By identifying the challenges faced by the participant and the support she received, this research can inform the development of strategies for improving the health and well-being of transgender individuals in Egypt.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: rakhawy hospital for mental health.
(253) Use of Online Pharmacy Tools May Lead to Significantly Reduced National Expenditures on Vaginal Estrogen
Authors: Hammad M A M , Loeb C A , Miller J A , Nguyen M , Azad B , Yafi F A
Published: March 2024

Introduction

High medication costs for vaginal estrogen may create a barrier for patients seeking treatment for numerous urinary and vaginal symptoms and lead to poor medication adherence. The Mark Cuban Cost Plus Drug Company (CPD) and GoodRx tools offer patients a method to purchase prescription medications at a discount, which may lead to improved medication adherence and decreased national expenditures on such medications.

Objective

To compare the pricing of vaginal estrogen as advertised by retail pharmacies, Medicare, and discount listings through CPD and GoodRx.

Methods

A review of publicly available data from CPD and GoodRx was performed to obtain listed retail and discounted prices for Estrace (topical), Vagifem (tablet), and Premarin (topical). GoodRx prices were obtained using prices from Costco, CVS, Walgreens, and Walmart pharmacies in the most from populous zip code from each of the 3 most populous U.S. states: California, New York, and Texas. Prices were adjusted to account for dosage and prescribed quantity to estimate an average cost per dosage unit ($/adu). The Medicare Part D Drug Spending and Utilization data from 2021 were used to report the average spending per dosage unit and total expenditure for each of the listed medications. These data were compared to create an estimate of average national savings after use of CPD and/or GoodRx.

Results

Average spending per dosage unit for Estrace, Vagifem, and Premarin was lesser when discount tools were used (0.50 $/adu, 3.75 $/adu, and 4.30 $/adu respectively), compared to Medicare pricing (6.14 $/adu, 20.95 $/adu, and 10.10 $/adu respectively) or retail pricing (3.14 $/adu, 10.19 $/adu, and 5.43 $/adu respectively). When adjusted for total dosage units, use of CPD over Medicare pricing for the three medications would result in a combined annual national saving of $64.2M. Use of either CPD or GoodRx compared to retail pricing would similarly result in a combined annual national saving of $39.2M.

Conclusions

The utilization of CPD and GoodRx in the prescription of vaginal estrogen led to a substantial national average cost savings when compared to retail and Medicare pricing. CPD and GoodRx may offer a way to decrease the cost burden for patients seeking treatment for urinary and vaginal symptoms and significantly reduce national expenditures on medications.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: The utilization of CPD and GoodRx in the prescription of vaginal estrogen led to a substantial national average cost savings when compared to retail and Medicare pricing. CPD and GoodRx may offer a way to decrease the cost burden for patients seeking treatment for urinary and vaginal symptoms and significantly reduce national expenditures on medications.
(264) Outcome of Intra-Cytoplasmic Sperm Injection ICSI with Testicular Sperm Aspiration (TESA) In Patients with High Sperm DNA fragmentation, Hospital Experience
Authors: Alhathal N , Almalki A
Published: March 2024

Introduction

Sperm DNA fragmentation (SDF) is considered as an important biomarker in the assessment of male fertility potential with contradictory results regarding its effect on ICSI. In our study we focus on the outcomes of Intra-Cytoplasmic Sperm Injection (ICSI) in male patients with high SDF using testicular spermatozoa (TESA).

Objective

To evaluate intra- cytoplasmic sperm injection (ICSI) outcomes in male patients with high SDF using testicular spermatozoa and analysis of the cofactors (Age, Smoking, Chemical Exposure and usage of Anti-oxidants agents)

Methods

Retrospective study, institutional experience.

Results

In our study, we evaluated 41 men with high-SDF levels who had a previous ICSI cycle from their ejaculates. A subsequent ICSI cycle was performed using spermatozoa retrieved through testicular sperm aspiration. The mean (SD) SDF level is 33.7%. live birth rate was 29.2% (12 out of 41) In addition of that, we analyzed the cofactors of men such as Age, Smoking, Chemical Exposure and usage of Anti-oxidants agents. The mean age is 33 %. Men received anti oxidants agent prior to TESA were 9 out of 12 (75%)

Conclusions

Intra-cytoplasmic sperm injection (ICSI) outcomes in male patients with high SDF using testicular spermatozoa has higher clinical pregnancy and higher chance of live-birth. The rate is higher with those who received anti-oxidant supplements for at least 6 moths.

Disclosure

No.
(268) Intracavernous Prostaglandin Injection as a Predictor and Effectiveness Measure for LISWT Sessions in ED Patients: A Single Urologist's Experience
Authors: Feghali J
Published: March 2024

Introduction

In recent years, therapeutic approaches for treating vasculogenic Erectile Dysfunction (ED) have evolved, with Low Intensity Shock Wave Therapy (LISWT) emerging as a promising modality.

Objective

To objectively evaluate the efficacy of LISWT for ED patients and to predict the required number of sessions, we examined the effects of administering up to 10 mcg of intracavernous alprostadil injections both before and after treatment

Methods

85 vasculogenic ED patients (Average age: 57); 33 with mild to moderate ED and 52 with moderate or severe ED. Intracavernous injection (ICI) of ≤10 mcg of alprostadil was given before LISWT and one month post-treatment. Depending on ICI response, patients underwent either six (Erection Hardness Score (EHS) ≤3) or four (EHS=4) weekly LISWT sessions using PiezoWave2 from Richard WOLF. LISWT Parameters: 0.16mj/mm2 energy flux density, 8 Hz frequency, 10mm wave focus penetration depth, and 6000 shocks per session distributed among the two crura of the penis (2000 shocks), dorsum penis (2000 shocks), and lateral penis (2000 shocks).

Results

33 patients showed a robust response to the 10mcg ICI and were treated with four LISWT sessions. 52 patients exhibited a partial response to the 10mcg ICI, necessitating six LISWT sessions. 78.6% (26 out of 33) of the patients who initially responded well to 10 mcg ICI had a consistent response to 8 mcg ICI; 63.6% (33 out of 52) of those with a partial initial response to 10 mcg ICI demonstrated an improved reaction to the same dosage post-treatment (table 1) (fig. 1). No complications were reported from the ICI.

Conclusions

Intracavernous prostaglandin injection can serve as a predictor for the required number of LISWT sessions and can objectively gauge the treatment's effectiveness in ED patients. Further randomized studies, incorporating parameters such as EHS, IIEF, and the ICI dosage, are recommended to validate this method's feasibility

Disclosure

No.
(275) IGFBP5 Short Hairpin RNA (shRNA) Constructs Improve Erectile Function in a Mouse Model of Cavernous Nerve Injury
Authors: Ock J , Limanjaya A , Kwon M , Yin G N , Suh J , Ryu J
Published: March 2024

Introduction

Radical prostatectomy for prostate cancer not only induces cavernous nerve injury but also causes cavernous angiopathy, which is responsible for poor responsiveness to phosphodiesterase-5 inhibitors. Insulin-like growth factor-binding protein 5 (IGFBP5) promotes cell death and induces apoptosis in various cell types.

Objective

To investigate the effectiveness of IGFBP5 knockdown at improving erectile function in a mouse model of cavernous nerve injury.

Methods

Eight-week-old C57BL/6 mice were used to prepare cavernous nerve injury model. Mice were divided into 4 groups: a sham operation group and three cavernous nerve injury (CNI) groups, which were administered intracavernous injections of phosphate buffered saline, scrambled control shRNA, or shRNA targeting mouse IGFBP5 (shIGFBP5) lentivirus particles. One week later, we measured erectile function by electrically stimulating the bilateral cavernous nerve.

Results

IGFBP5 expression in cavernous tissues were significantly increased in CNI mice compare to sham mice. CNI mice had reduced erectile function, but shIGFBP5 treatment resulted in significant improvements. Furthermore, in CNI mice, numbers of cavernous endothelial cells, pericytes, and neuronal cells were increased by shIGFBP5 treatment.

Conclusions

Knockdown of IGFBP5 improved erectile function in CNI mice by enhancing neurovascular regeneration. Local inhibition of IGFBP5 expression may provide a new treatment strategy for the treatment of neurovascular diseases.

Disclosure

No.
(278) The Loss of Histone Reader Phf7 Leads to Immune Pathways Activation via Endogenous Retroviruses During Spermiogenesis
Authors: Lin H , Jianxing C , Hui J , Hui J , Wenming X
Published: March 2024

Introduction

PHF7 has been identified as playing a crucial role in germline development in animals. However, its correlation with human infertility remains ambiguous.

Objective

To ascertain if a germline mutation in the human PHF7 gene correlates with azoospermic patients and to further determine if this mutation is a potential cause of non-obstructive azoospermia.

Methods

Genetic screening of azoospermic patients for PHF7 mutations. Using Phf7 knockout mice models to simulate the human mutation, aiming to validate if these mutations are directly responsible for male infertility. Investigating the role of endogenous retroviruses related to Phf7 deletion and its link to activating the immune pathway.

Results

A germline mutation of the human PHF7 gene was identified in azoospermic patients. In the Phf7 knockout mice model, male infertility was observed, specifically stemming from an inhibited histone-to-protamine exchange process. The absence of spermatogenesis due to the Phf7 deletion was found to be associated with the activation of the immune pathway, mediated by endogenous retroviruses. PPARα was identified as a significant factor in the testis, which is suppressed by endogenous retroviruses.

Conclusions

PHF7 is an essential gene associated with human infertility, particularly in non-obstructive azoospermic patients. Its role as an epigenetic reader became evident, and the absence of PHF7 leads to immune pathway activation. The study also highlighted that the PPARα agonist, Astaxanthin, holds promise as a therapeutic agent to treat male infertility resulting from PHF7 mutations.

Disclosure

No.
Tuberculosis among children visiting friends & relatives
Authors: Perez-Porcuna Tomas M , Noguera-Julian Antoni , Riera-Bosch Maria Teresa , Macià-Rieradevall Esperança , Santos-Santiago José , Rifà Pujol Maria Àngels , Eril Maria , Aulet-Molist Lídia , Padilla-Esteba Emma , Tórtola Maria Teresa , Gómez i Prat Jordi , Vilamala Bastarras Anna , Rebull-Fatsini Josep Sebastià , Papaleo Andrea , Rius-Gordillo Neus , Gonçalves Alessandra Q , Naranjo-Orihuela Àngels , Urgelles Marta , García-Lerín Mónica G , Jimenez-Lladser Gemma , Lorenzo-Pino Beatriz , Giuliano-Cuello Mónica Adriana , Pascual-Sánchez Maria Teresa , Marco-García Mónica , Abellana Rosa , Espiau Maria , Altet-Gómez Maria Nieves , Orcau-Palau Angels , Caylà Joan A , Soriano-Arandes Antoni
Published: March 2024

Background

Most paediatric tuberculosis (TB) cases in low-TB-incidence countries involve children born to migrant families. This may be partially explained by trips to their countries of origin for visiting friends and relatives (VFR). We aimed to estimate the risk of latent TB infection (LTBI) and TB in children VFR.

Methods

We conducted a prospective multicentric observational study in Catalonia (Spain) from June 2017 to December 2019. We enrolled children aged < 15 years with a negative tuberculin skin test (TST) at baseline and at least one parent from a high-TB-incidence country, and who had travelled to their parent’s birth country for ≥21 days. TST and QuantiFERON-TB Gold Plus (QFT-Plus) were performed within 8–12 weeks post-return. LTBI was defined as a TST ≥5 mm and/or a positive QFT-Plus.

Results

Five hundred children completed the study, equivalent to 78.2 person-years of follow-up (PYFU). Thirteen children (2.6%) were diagnosed with LTBI (16.6/per100 PYFU, 95%CI = 8.8–28.5), including two cases (0.4%) of TB (2.5/per100 PYFU, 95%CI = 0.3–9.3). LTBI incidence rates remained high after excluding BCG-vaccinated children (9.7/per100 PYFU, 95%CI = 3.9–20.0). Household tobacco smoke exposure was associated with LTBI (aOR = 3.9, 95%CI = 1.1–13.3).

Conclusions

The risk of LTBI in children VFR in high-TB-incidence countries may equal, or perhaps even exceed, the infection risk of the native population. The primary associated risk factor was the presence of smokers in the household. Furthermore, the incidence rate of active TB largely surpassed that of the countries visited. Children VFR in high-TB-incidence countries should be targeted for diagnostic and preventive interventions.
Arterio-venous Anastomoses of the Sucquet–Hoyer Type: Complexity and Distribution in the Human Dermis
Authors: Moghaddam Atieh S , Reissig Lukas F , Geyer Stefan H , Weninger Wolfgang J
Published: March 2024

Our study aims at providing detailed information on numbers, form, and spatial distribution of arterio-venous anastomoses of the Sucquet–Hoyer type in the dermis of the nail bed, nail fold corner, thumb pad, arm, nose, glabella, lip, and ear. It further aims at providing a system, which relies on objective morphologic criteria for classifying Sucquet–Hoyer canals (SHCs). Using high-resolution episcopic microscopy (HREM), digital volume data of eight samples of each skin region were produced. Virtual three-dimensional (3D) models of the dermally located SHCs were created, and their 3D tortuosity (τ) values were determined. Dermal SHCs were identified in all 24 finger samples and in 1 lip sample. Beneath a field of 2 × 2 mm2, an average of four were located in the nail bed, three in the dermis of the thumb pad, and one in the dermis of the nail fold corner. Only a single dermal SHC was found in one lip sample. No SHCs were observed in the dermis of the other samples. The τ values of the SHCs ranged from 1.11 to 10. Building on these values, a classification system was designed, which distinguishes four SHC classes. The dermal distribution of the SHCs of different classes was similar in all specimens.
Associations Among Environmental Exposures and Physical and Psychiatric Symptoms in a Care-Seeking Sample of U.S. Military Veterans
Authors: Morse Jessica L , Acheson Dean T , Almklov Erin , Pittman James O E , Lang Ariel J , Lindamer Laurie
Published: March 2024

Introduction

Recent research and policy (e.g., the Sergeant First Class (SFC) Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act) have highlighted the potential health consequences of toxic environmental exposures. The purpose of the current study was to assess the self-reported prevalence of such exposures among a sample of U.S. military veterans seeking care at a Veterans Affairs facility and to examine associations between exposures and physical and psychiatric symptoms.

Materials and Methods

Participants were 4,647 newly enrolling post-9/11 veterans at the VA San Diego Healthcare System who completed standard clinical screening processes between January 2015 and April 2019. Electronic health screening data, including demographic information, military history, environmental exposures, and physical and psychiatric symptoms, were assessed. t-Tests for continuous variables and chi-square tests for categorical variables were used to compare exposed to unexposed veterans on demographic and military characteristics as well as physical and psychiatric symptoms.

Results

A total of 2,028 veterans (43.6%) reported exposure to environmental toxins during their military service. Analyses revealed a disproportionate burden of exposure on older, male, educated, combat veterans as well as Asian and Native American veterans. Exposure to any type of environmental toxin was associated with more physical symptoms, particularly pain, fatigue, and insomnia, as well as psychiatric symptoms, including moderate depressive symptomology, mild to moderate anxiety, and scores approaching the threshold for likely post-traumatic stress disorder and alcohol misuse.

Conclusions

The high prevalence and detrimental health correlates of environmental exposures underscore the importance of implementing screening for exposures and providing healthcare services that address the multisystemic nature of exposure-related illness.
Preliminary Investigation Into the Effectiveness of Group webSTAIR for Trauma-exposed Veterans in Primary Care
Authors: Kim Jamie S , Prins Annabel , Hirschhorn Elizabeth W , Legrand Alison C , Macia Kathryn S , Yam Sherry S , Cloitre Marylene
Published: March 2024

Introduction

A substantial number of trauma-exposed veterans seen in primary care report significant symptoms of PTSD and depression. While primary care mental health integration (PCMHI) providers have been successful in delivering brief mental health treatments in primary care, few studies have evaluated interventions that combine mobile health resources with PCMHI groups. This pilot study assessed the potential benefits of webSTAIR, a 10-module transdiagnostic treatment for trauma-exposed individuals, supported by 5 biweekly group sessions delivered via telehealth. The transdiagnostic and mobile health nature of the treatment, as well as the therapist and peer support provided through group sessions, may offer an innovative approach to increasing access to patient-centered and trauma-informed treatment in primary care settings.

Materials and Methods

Thirty-nine male and female veterans with trauma-related symptoms (i.e., PTSD and/or depression) participated in group webSTAIR. Mixed effects analyses were conducted to assess changes in PTSD and depression at pre-, mid-, and post-treatment. Baseline symptom severity was assessed as a predictor of module completion and group attendance. The project was part of a VHA quality improvement project, and IRB approval was waived by the affiliated university.

Results

Analyses revealed significant pre-to-post improvement in both PTSD and depression outcomes with a large effect size for PTSD (Hedges’ gav = 0.88) and medium to large for depression (Hedges’ gav = 0.73). Of participants who completed the baseline assessment, 90% began webSTAIR; of those, 71% completed the program. Baseline symptoms of PTSD and depression did not predict group attendance or module completion.

Conclusions

Good outcomes and a satisfactory retention rate suggest that group webSTAIR may provide easily accessible, high-quality, and effective treatment for patients presenting with trauma-related problems without increasing therapist or system burdens. The results suggest the value of conducting a randomized controlled trial to test the effectiveness of group webSTAIR relative to PCMHI usual care or other evidence-based, disorder-specific (e.g., PTSD) treatments for trauma-exposed individuals in PCMHI.
Partial tidal disruption events by intermediate-mass black holes in supermassive and intermediate-mass black hole binaries
Authors: Wu Xiao-Jun , Yuan Ye-Fei , Luo Yan , Lin Wenbin
Published: March 2024

In the centres of galaxies, stars that orbit supermassive black hole binaries (SMBHBs) can undergo tidal disruptions due to the Lidov–Kozai mechanism. Nevertheless, most previous researches have predominantly focused on full tidal disruption events (FTDEs). In this study, we employ N-body simulations to investigate partial tidal disruption events (PTDEs) induced by intermediate-mass black holes (IMBHs) in SMBH–IMBH binaries, taking into account consideration the IMBH’s mass, semimajor axis, and eccentricity of the outer orbit. Our findings indicate that, in comparison to FTDEs, the majority of tidal disruption events are actually PTDEs. Furthermore, we find that a significant number of stars experiencing partial disruption ultimately get captured by the IMBH, potentially leading to repeating flares. By comparing the period of the periodic eruptions observed in ASASSN-14ko, we find that PTDEs in a specific SMBH–IMBH binary system can align with the observed period if the SMBH has a mass of $10^7\rm {\ M_\odot }$, the IMBH has a mass smaller than approximately $10^5\rm {\ M_\odot }$, the eccentricity of the SMBH–IMBH binary exceeds approximately 0.5, and the semimajor axis of the SMBH–IMBH binary is larger than approximately 0.001 pc. Moreover, our model effectively accounts for the observed period derivative for ASASSN-14ko ($\dot{P}=-0.0026\pm 0.0006$), and our results also imply that some quasi-periodic eruptions may be attributed to PTDEs occurring around SMBH–IMBH binaries.
Pregnancy-related issues from the perspective of patients with inflammatory rheumatic diseases – Results from a survey of the members of the National Association for Inflammatory Rheumatic Diseases
Authors: Murashima Atsuko , Kaneko Kayoko , Oguro Hiroshi , Mori Yukiko , Goto Mikako , Mishima Shuko , Anzai Tatsuhiko , Takahashi Kunihiko
Published: March 2024

Objectives

This study aimed to clarify the issues related to pregnancy in patients with inflammatory rheumatic diseases (RDs) and to provide useful information for developing medical services from patients’ perspectives.

Methods

A survey involving approximately 5000 members of the Patients Association for Collagen Vascular Diseases Japan was conducted using a questionnaire that was sent and returned by mail. The questionnaire items included age at the time of the survey, types of RDs, association of RDs with pregnancy/childbirth outcomes, and pregnancy-related supports and hindrances.

Results

We received 491 completed questionnaires. The most common RD was systemic lupus erythematosus (n = 309). Approximately 60% of participants had a history of childbirth. Approximately 60% of participants had previously experienced pregnancy-related challenges due to RDs. These included concerns about the influence of drugs on babies, genetic transmission, and active disease. Patients with active disease at the time of conception were more likely to experience disease exacerbation during pregnancy, but this did not correlate with whether the pregnancy was planned.

Conclusion

This study revealed that many patients with RDs experienced pregnancy-related challenges and needed appropriate support based on appropriate information. The findings here should help rheumatologists, healthcare providers, and public agencies provide counselling and information.