bluuebunny/crossref_metadata_2025 huggingface dataset:
A new approach to small area estimation: improving forest management unit estimates with advanced preprocessing in a multivariate Fay–Herriot model
Authors: Georgakis Aristeidis , Papageorgiou Vasileios E , Stamatellos Georgios
Published: December 2024

Forest inventories are essential for informing sustainable forest management decisions, and small area estimation (SAE) techniques aim to enhance the precision of these inventories, particularly when sample sizes are limited. This study presents a novel approach to SAE by integrating trivariate empirical best linear unbiased prediction Fay–Herriot (FH) models with advanced preprocessing techniques. By employing multivariate Fay–Herriot (MFH) models, the methodology utilizes clustering analysis, variable selection, and outlier treatment to improve the precision of estimates for small areas. A comparative analysis with traditional univariate Fay–Herriot (UFH) models demonstrates that MFH outperforms UFH in estimating key forest attributes such as forest growing stock volume, basal area, and Lorey’s mean tree Height, even in areas with limited sample sizes. The use of auxiliary variables derived from remote sensing data and past censuses proved critical, with remote sensing playing a dual role: aiding in clustering forest management units into larger small areas of interest and serving as covariates in the FH models. The results highlight the effectiveness of MFH1 (assuming independent and identically distributed random effects), which consistently produced estimates with <5% coefficient of variation, indicating high precision. Across all response variables, MFH1 led to reductions in standard errors compared to UFH, with median percentage gains in precision of 17.22% for volume, 13.91% for basal area, and 3.95% for mean height. Mean precision gains were even higher, at 18.27%, 16.51%, and 10.87%, respectively. This study advances SAE methodologies by providing a robust framework for accurately estimating critical forest attributes in challenging scenarios, including geolocation errors, limited sample sizes, and the smallest applicable small areas for area-level models. It highlights the contribution of the correlation between multiple response variables to improving the precision of estimates. The proposed methodology has significant implications for enhancing the accuracy of forest inventories and supporting informed forest management decisions.
De Novo Genome Assembly and Annotation for the Synanthropic Webbing Clothes Moth (Tineola bisselliella): A Globally Distributed, Economically Important Pest
Authors: Alqassar Jasmine D , Aichelman Hannah E , Novick Isabel A , Mullen Sean P
Published: December 2024

Tineola bisselliella, the webbing clothes moth, is an economically important, globally distributed synanthropic pest species and member of the basal moth lineage Tineidae. These moths are facultatively keratinophagous, and their larvae can cause extensive damage, particularly to clothing, textiles, and museum specimens. Despite the economic and phylogenetic importance of T. bisselliella, there is a lack of quality genomic resources for this, or for other species within the Tineidae family. The T. bisselliella genome assembly presented here consists of 30 pseudochromosomes (29 autosomes and 1 Z chromosome) produced using synteny alignment of a preliminary contig-level assembly (256 contigs) to a closely related species, Tinea pellionella. The resulting final pseudochromosome-level assembly is 243.630 Mb and has an N50 length of 8.708 Mb. The assembly is highly contiguous and has similar or improved quality compared to other available Tineidae genomes, with 93.1% (91.8% single copy and 1.3% duplicated) of lepidopteran orthologs complete and present. Annotation of the pseudochromosome-level genome assembly with the transcriptome we produced ultimately yielded 11,259 annotated genes. Synteny alignments between the T. bisselliella genome assembly and other Tineidae genomes revealed evidence for numerous small rearrangements with high synteny conservation. In contrast, a synteny alignment performed between T. bisselliella and Melitaea cinxia, which is thought to have retained the ancestral karyotype (n = 31), revealed a fusion of the ancestral autosome 30 and Z chromosome that led to a reduction in T. bisselliella karyotype size. The reference quality annotated genome for T. bisselliella presented here will advance our understanding of the evolution of the lepidopteran karyotype by providing a chromosome-level genome for this basal moth lineage and provide future insights into the mechanisms underlying keratin digestion in T. bisselliella.
Complex dynamics in peace negotiations: insiders' views on the Colombian experience
Authors: Arévalo Julián
Published: December 2024

The study of peace negotiations has traditionally emphasized the conditions leading to peace talks and the effect of external variables on negotiation outcomes. This article draws from the recent experience of Colombia, where peace negotiations took place between the government and the two main guerrilla groups, to investigate the internal dynamics of peace negotiations and the outcomes they produce. In doing so, it connects the fields of conflict resolution and the study of complex systems. The article investigates the elements that help us to understand the different dynamics of the parallel peace talks conducted by the Colombian government with the Revolutionary Armed Forces of Colombia (FARC) and the National Liberation Army (ELN) in the period between 2010 and 2018, and to draw lessons from Colombia's experience. The comparative qualitative research underpinning the article is based on 23 interviews conducted in 2022 with participants in the peace negotiations, representatives of the international community and experts closely involved in the negotiation processes. The study's main finding is the recognition of negotiation spaces as having the power to transform the relationship between the parties. This contributes to the study of other conflict scenarios, where much emphasis is placed on military variables, as opposed to the potential of negotiation spaces.
Seal-fishery interactions in the Falkland Islands—operational and environmental factors drive resource competition
Authors: Riaz Javed , Büring Tobias , van der Grient Jesse , Winter Andreas , Lee Brendon , Brickle Paul , Baylis Alastair M M
Published: December 2024

Direct interactions between marine mammals and commercial fisheries are a worldwide conservation challenge. Observer programmes remain the most effective and reliable method for collecting data on these interactions. In the Falkland Islands—home to globally significant seal populations and commercial squid fisheries, seal-fishery interactions have escalated in recent years, prompting management concerns. Complete observer coverage within the squid fishery presents a valuable opportunity to investigate the nature, extent, and drivers of these interactions. Integrating multi-year observer records with extensive ancillary (i.e. vessel logbook and oceanographic) datasets, we examine the operational and environmental factors influencing the occurrence of seal-fishery interactions. Our findings show interactions most frequently occur in the main squid fishing grounds during trawls associated with high catch quantities. Assessment of long-term catch data (both finfish and squid) also suggests the increase in seal-fishery interactions may be caused by collapses in dominant finfish stocks over the past 20 years, constricting foraging resources available to seals. Taken together, our findings indicate resource competition may be a mechanism of interactions. To help mitigate this issue, we advocate for the development of ecosystem-based fisheries management, which considers the trophic effects of fishing practices and the energetic requirements of local marine predator populations.
Prohibited artificial intelligence practices according to Article 5 of the European Union’s regulation on AI—between the ‘too late’ and the ‘not enough’
Authors: Ćemalović Uroš
Published: December 2024

In June 2024, the European Union adopted the AI Act (AIA), its first comprehensive legal instrument in this field. Notwithstanding the undoubted importance of the very adoption of this act, it is much less certain whether it will significantly contribute to more trustworthy and human-centric AI tools and systems. Focusing on a critical examination of the provisions of AIA dedicated to the prohibited AI practices, this paper argues that the answer is no, mainly because of the AIA’s late adoption, as well as due to the fact that it did not go far enough in regulating AI.
Parvovirus B19 and Human Herpes Virus 6B and 7 Are Frequently Found DNA Viruses in the Human Thymus But Show No Definitive Link With Myasthenia Gravis
Authors: Nowlan Kirsten , Hannolainen Leo , Assimakopoulou Irini M , Dürnsteiner Pia , Sarkkinen Joona , Suokas Santeri , Hedman Lea , Tienari Pentti J , Hedman Klaus , Niku Mikael , Aaltonen Leena-Maija , Huuskonen Antti , Räsänen Jari V , Ilonen Ilkka K , Mäyränpää Mikko I , Dunkel Johannes , Laakso Sini M , Söderlund-Venermo Maria , Perdomo Maria F , Kekäläinen Eliisa
Published: December 2024

Myasthenia gravis (MG) is a rare autoimmune disorder characterized by muscle weakness resulting from autoantibody-mediated disruption of the neuromuscular junction. Notably, it is also frequently associated with thymic pathology. This study explores the relationship between MG and DNA viruses in the thymus, employing targeted next-generation sequencing and quantitative polymerase chain reaction to analyze thymic tissue samples from both patients with MG and healthy controls. We detected human herpes virus 6B and 7, Epstein-Barr virus, and parvovirus B19 (B19V) across various tissue groups. However, no significant enrichment of these viruses was observed in the thymic tissue of patients with MG.
Bayesian analysis of non-communicable diseases risk factors: a focus on the lower-educated population in Bangladesh
Authors: Hossain Md Ismail , Gupta Moumita Datta , Ohi Tahsina Fariha , Rahman Md Mahfuzur
Published: December 2024

Background

This study investigates non-communicable disease (NCD) risk factors, specifically hypertension and diabetes, among Bangladeshi adults with lower educational attainment. With an increasing global burden of NCDs, understanding the dynamics in lower-educated populations becomes crucial for targeted interventions and achieving Sustainable Development Goal 3.4–curtailing premature mortality from non-communicable diseases by one-third by 2030 through prevention and treatment.

Methods

Utilizing data from the Bangladesh Demographic and Health Survey (2017–2018), a two-stage stratified sampling design identified 7287 lower-educated individuals. Bayesian logistic regression was applied for risk factor analysis.

Results

The prevalence of hypertension and diabetes among lower-educated people was 31% and 9.3%, respectively. NCD prevalence (37.3%) underscored a significant health burden. Factors such as gender, age, wealth status, working status, residence and region showed significant associations with NCDs. Bayesian analysis revealed that females were 1.30 times more likely to develop NCDs, while older age groups demonstrated 4.30 times greater likelihood. Employed individuals exhibited a 43% lower risk. Wealthier households showed higher NCD likelihood and residence in the central region was associated with an 11% lower risk.

Conclusions

This study highlights the high risk of developing NCDs among lower-educated females, particularly those ≥35 y of age in Bangladesh. Therefore, targeted interventions for this group are critical to reducing NCD risks, supporting national health objectives and advancing progress toward the Sustainable Development Goals.
Host-specific viral predation network on coral reefs
Authors: Varona Natascha S , Hesketh-Best Poppy J , Coutinho Felipe H , Stiffler Alexandra K , Wallace Bailey A , Garcia Sofia L , Scholten Yun , Haas Andreas F , Little Mark , Vermeij Mark , Luque Antoni , Silveira Cynthia
Published: December 2024

Viral infections are major modulators of marine microbial community assembly and biogeochemical cycling. In coral reefs, viral lysis controls bacterial overgrowth that is detrimental to coral health. However, methodological limitations have prevented the identification of viral hosts and quantification of their interaction frequencies. Here, we reconstructed an abundance-resolved virus–bacteria interaction network in the oligotrophic coral reef waters of Curaçao by integrating direct microscopy counts with virus-host links obtained from proximity-ligation, prophage integration, and CRISPR spacers. This network of 3013 individual links (97 unique species-level interactions) revealed that the abundance of free viral particles was weakly related to host abundance and viral production, as indicated by the cell-associated virus-to-host ratio (VHR). The viruses with the highest free and cell-associated VHR, interpreted here as highly productive viruses, formed links with intermediate-to-low abundance hosts belonging to Gammaproteobacteria, Bacteroidia, and Planctomycetia. In contrast, low-production viruses interacted with abundant members of Alphaproteobacteria and Gammaproteobacteria enriched in prophages. These findings highlight the decoupling between viral abundance and production and identify potentially active viruses. We propose that differential decay rates and burst sizes may explain the decoupling between free viral abundance and production and that lysogenic infections play an important role in the ecology of high-abundance hosts.
When Generalized Trust Matters? Impact of Industrial Tertiarization on Trade Preference Formation
Authors: Fujita Masafumi
Published: December 2024

Generalized trust has attracted attention as a non-material disposition that affects risk perception in political and economic international cooperation. However, its effect on public support for free trade or trade agreements has been debated. This debate centers on whether the economic impacts of trade are evident or uncertain to ordinary citizens because generalized trust operates only when trade impacts are uncertain and risk perception is crucial. However, the visibility of trade impacts varies significantly depending on the economic environment. This study explores the role of industrial tertiarization, the shift from agriculture and manufacturing to services, in altering the visibility of trade impacts. It hypothesizes that generalized trust shapes trade preferences primarily in highly tertiarized local economies. Using data from the 2016 American National Election Studies and World Values Survey Wave 7, this hypothesis was tested and confirmed. This study contributes to the literature by demonstrating that the influence of generalized trust on trade preferences varies with the level of local tertiarization. It also proposes new causal mechanisms for understanding anti-globalism in developed countries and suggests that the influence of economic impacts on trade preferences may similarly depend on local tertiarization levels.
Knowledge graph-based multi-granularity tacit design knowledge reuse for product design
Authors: Jia Jia , Zhang Yingzhong , Saad Mohamed
Published: December 2024

Decomposing product design into multiple granularities is an effective strategy to implement complex product design. Tacit design knowledge (TDK), adhering to designers’ experience and intuition, plays an essential role in the product design at various granularities, but it is difficult to acquire and reuse due to its implicity. Aiming at this issue, a knowledge graph-based multi-granularity TDK reuse framework for product design is presented. First, the design issue-solving oriented knowledge graph (DSKG) model is employed to indirectly capture TDK, where the design result data are represented as design solution nodes and the design issues that refine design solution are represented as relation edges. An improved ontological concept model is designed as the schema of the DSKG to represent the multi-granularity design knowledge on functions, behaviours, and structures of products. Afterwards, the framework supports two design modes, i.e., top–down design and bottom–up design, where the captured TDK is reused to create the design context and predict design solutions. DSKG embedding is employed for design solution prediction in both design modes, while the design context creation is achieved distinctively. In top–down design, the design issue-solving process starts from the design requirements and then gradually downward refines the design solutions at different granularities with breadth-first strategy, which naturally creates the continuous design context, until moving to the detailed design. In bottom–up design, the target design solution is commonly isolated at specific fine-grained granularity. This paper presents a novel approach to constructing design context based on path-ranking algorithm. Path-ranking algorithm can identify the design solution influence paths to build connections between the design requirements and the isolated design solution and thus construct the design context. Finally, a case study for stamping die design is implemented, which illustrates the feasibility and effectiveness of the framework. The comparisons with the state-of-the-art design methods are also made to demonstrate the merits of the presented framework.
A new nondestructive method for monitoring red imported fire ant (Hymenoptera: Formicidae) populations in the field
Authors: Taravati Siavash , Ma Jung , Campbell Kathleen , Choe Dong-Hwan
Published: December 2024

Solenopsis invicta Buren (Hymenoptera: Formicidae), also known as the red imported fire ant (RIFA), is currently established in many Southern and Central Californian regions. RIFA can be managed using various insecticides, but in recent decades, granular baits have become a standard and effective management tool. To improve and maintain effective RIFA management programs, researchers and pest control experts need to perform careful population monitoring before and after treatments. Despite the availability of various RIFA monitoring methods, many are challenging to perform and are extremely time-consuming. Counting mounds is an easier-to-perform method but may not be reliable in certain places and for detecting low-density populations. Other methods of field sampling and laboratory counting can be cumbersome, destructive, and highly time-consuming. In this article, we are providing research data on a new, fast, and nondestructive field technique for RIFA monitoring using density (ants/ml) measurements. These measurements can be converted into counts and eventually to indices. On average, the density of RIFAs inside our measuring cylinder was 130.8 ± 2.3 ants/ml (Mean ± S.E.). A strong positive and statistically significant correlation was found between the volume of RIFA workers and the number of ants (r = 0.92, P < 0.001).
Evidence of extensive home range sharing among mother–daughter bobcat pairs in the wildland–urban interface of the Tucson Mountains
Authors: Payne Natalie , Andersen Desiree , Davis Robert , Mollohan Cheryl , Baldwin Kerry , LeCount Albert L , Culver Melanie
Published: December 2024

Urbanization impacts the structure and viability of wildlife populations. Some habitat generalists, such as bobcats (Lynx rufus), maintain populations at the intersection of wild and urban habitats (wildland–urban interface), but the impacts of urbanization on bobcat social structure are not well understood. Although commonly thought to establish exclusive home ranges among females, instances of mother–daughter home range sharing have been documented. We combined Global Positioning System (GPS) localities with genomic relatedness inferences from double-digest restriction site associated DNA sequencing to investigate mother–daughter home range sharing in bobcats (n = 38) at the wildland–urban interface in the Tucson Mountains, Arizona, USA. We found the highest relatedness among females, which showed stronger isolation by distance than males and the population as a whole. Using mother–daughter relationships inferred from pedigree reconstruction, we found extensive mother–daughter home range sharing, compared with other females. Every mother identified as having at least one daughter, shared home ranges with one daughter, while other confirmed daughters established adjacent home ranges. Our results provide substantial support for the mother–daughter home range sharing hypothesis, as well as evidence of spatiotemporal overlap between mothers and daughters, adding to the body of research complicating the solitary felid paradigm. These results additionally challenge the notion of home range partitioning by prior-rights land tenure, suggesting a role of matrilineal land tenure in the home range establishment of daughters. Habitat fragmentation due to human population growth and urbanization thus has the potential to alter landscape genetic structure and social dynamics in bobcats.
Race and clinical outcomes in hormone receptor-positive, HER2-negative, node-positive breast cancer in the randomized RxPONDER trial
Authors: Abdou Yara , Barlow William E , Gralow Julie R , Meric-Bernstam Funda , Albain Kathy S , Hayes Daniel F , Lin Nancy U , Perez Edith A , Goldstein Lori J , Chia Stephen K L , Dhesy-Thind Sukhbinder , Rastogi Priya , Alba Emilio , Delaloge Suzette , Schott Anne F , Shak Steven , Sharma Priyanka , Lew Danika L , Miao Jieling , Unger Joseph M , Tripathy Debasish , Hortobagyi Gabriel N , Pusztai Lajos , Kalinsky Kevin
Published: December 2024

Background

The phase III RxPONDER trial has affected treatment for node-positive (1-3), hormone receptor-positive, HER2-negative breast cancer with a 21-gene recurrence score (RS) less than 26. We investigated how these findings apply to different racial and ethnic groups within the trial.

Methods

The trial randomly assigned women to endocrine therapy (ET) or to chemotherapy plus ET. The primary clinical outcome was invasive disease-free survival (IDFS), with distant relapse-free survival (DRFS) as a secondary outcome. Multivariable Cox models were used to evaluate the association between race/ethnicity and survival outcomes, adjusting for clinicopathological characteristics, RS, and treatment.

Results

A total of 4048 women with self-reported race/ethnicity were included: Hispanic (15.1%), non-Hispanic Black (NHB) (6.1%), Native American/Pacific Islander (0.8%), Asian (8.0%), and non-Hispanic White (NHW) (70%). No differences in RS distribution, tumor size, or number of positive nodes were observed by race/ethnicity. Relative to NHWs, IDFS was worse for NHB participants (5-year IDFS 91.6% vs 87.1%, HR = 1.37; 95% CI = 1.03 to 1.81) and better for Asians (91.6% vs 93.9%, HR = 0.64; 95% CI = 0.46 to 0.91). Relative to NHW, DRFS was worse for NHB participants (5-year DRFS 95.8% vs 91.0%, HR = 1.65; 95% CI = 1.17 to 2.32) and better for Asians (95.8% vs 96.7%, HR = 0.59; 95% CI = 0.37 to 0.95). Adjusting for clinical characteristics, particularly body mass index, diminished the effect of race on outcomes. Chemotherapy treatment efficacy did not differ by race/ethnicity.

Conclusions

NHB women had worse clinical outcomes compared with NHWs in the RxPONDER trial despite similar RS and comparable treatment. Our study emphasizes the persistent racial disparities in breast cancer outcomes while highlighting complex interactions among contributing factors.

Trial Registration

ClinicalTrials.gov: NCT01272037.
Systematic measurement and calibration approach for mechanical properties of polymer thin film materials
Authors: Lin Yan-Ting , Liao Shao-Hong , Tsai Yi-Chian , Chao Yen-Chu , Zhu Jing-Ting , Huang Jung-Ren , Wang Chien-Kai , Juang Jia-Yang
Published: December 2024

This study investigates the mechanical properties of pressure-sensitive adhesive (PSA) and PSA blended with polyethylene terephthalate (PET) film (PBP) through a series of mechanical tests. The combination of a linear-elastic and viscoelastic material model was employed and calibrated to accurately characterize their mechanical behavior. The tensile test and dynamic mechanical analysis (DMA) yielded contrasting results regarding the elastic properties of the two polymer thin films. The experimental data revealed that Young's modulus of PBP is significantly higher than that of PSA, whereas the shear modulus of PBP is notably lower than PSA. This behavior can be attributed to the sandwich structure of the PBP composite, where the PSA and PET components interact in different configurations either in parallel or in series during the tensile test and DMA, respectively. This paper presents a systematic approach for the precise and efficient application of material models for PSA and PBP, providing valuable insights for future use in various composite polymer film adhesives. Comprehensive calibration and finite element analysis were conducted for both PSA and PBP materials. Based on these experimental findings, we propose a systematic method for measuring and calibrating the mechanical properties of thin film composite materials. This method offers a reliable reference for future engineering applications, as it can be applied to other material systems to expedite the development process.
Prevalence and disposal of unused medicines: a systematic review of cross-sectional studies
Authors: Wang Leong Seng , Aziz Zoriah , Wang Hong Jing , Chik Zamri
Published: December 2024

Objectives

We aimed to systematically review cross-sectional studies of unused medicines that described the prevalence, types of unused medicine, disposal practices and factors associated with unused medicines.

Methods

We searched Medline, EMBASE, CINAHL, Web of Science, Scopus, and Google Scholar. We identified and selected cross-sectional studies published between database inception and June 2023 examining the prevalence of unused medicines and factors associated with their disposal.

Key findings

We included 57 studies in the review. The prevalence of unused medicines ranged from 21.4% to 98.0% (mean = 63.8%). The top reason people had unused medicines was because their conditions improved (40.0%). The most common method to dispose of unused medicines was in the environment (66.9%), while a smaller percentage (12.9%) returned them to medicine take-back facilities. We found that there was a positive correlation between returning unused medicines and knowing how to dispose of them properly [(r(29) = 0.50, P = .006)]. However, actual disposal practice did not correlate with knowing about environmental risks [r(31) = −0.17, P = .4] or willingness to return the unused medicines [r(13) = 0.40, P = .20].

Conclusions

The prevalence of unused medicines and their disposal methods vary between countries. Improper medicines cannot solely attributed to consumer knowledge about the risks and attitudes of consumers. More research is needed to understand the impact of legislation and the availability of medicine take-back facilities.
Pharmaceutical expenditure during the financial crisis: a decomposition analysis
Authors: Loupou Chrysoula , Karampli Eleftheria , Athanasakis Kostas
Published: December 2024

Objectives

The pharmaceutical sector is extremely important as it is one of the cost drivers in the wider health sector. The scope of this paper is to explore the drivers of pharmaceutical expenditure in Greece by decomposing pharmaceutical spending into the impact of prices, volume, and substitution effects.

Methods

We use a statistical approach to decompose the growth of pharmaceutical expenditure during 2009–2019 into three elements: (i) the substitution effect; (ii) the price effect; and (iii) the consumption effect.

Key findings

Pharmaceutical expenditure decreased by 37.81% and the volume of medicines increased by 4.51%. Prices decreased by 18% and the therapeutic mix index decreased by 27.43%, indicating that—on average—Greece experienced a switch to lower-priced medicines. This was enhanced by electronic prescribing, guidelines, monitoring of prescribing behaviour, and generic substitution.

Conclusion

Decomposition analysis can provide important information on the driving forces shaping the trend in pharmaceutical expenditure. To take full advantage of its potential, detailed data on consumption and expenditure need to be available to the research community.
Intrathoracic ectopic kidney with pulmonary sequestration: clinical and surgical insights: a case report
Authors: Taha Isam Ahmed Abdeljaleel , Ibrahim Mohamed Y , Helali Mohamed , Taha Sami Mohamed Elamin , Alshareif Baha Aldeen , Altayeib Hala , Idriss Razan , Abdalgadir Esra S
Published: December 2024

Intrathoracic ectopic kidney is an extremely rare congenital defect that is frequently identified by accident because it is asymptomatic. Even more unusual is its link to pulmonary sequestration alone. This case report describes the clinical presentation of a 7-month-old child with a history of recurrent respiratory distress and chest infections since birth, who had shortness of breath, failure to thrive, and delayed developmental milestones. The clinical examination and imaging revealed an ectopic right kidney in the thoracic cavity, as well as a probable sequestered lung lobe. Thoracotomy revealed a healthy right lung with a collapsed lower lobe connected to the ectopic kidney. The right lower third lobe was released to be in its normal appearance and the sequestration vessels were ligated. The patient recovered smoothly after surgery, with the exception of a brief episode of pneumonia that was treated. The patients follow up confirmed complete recovery without complications.
Failure to thrive in infant secondary to congenital colonic stenosis: a case report
Authors: Garcia Daniel Jose , Hamade Mohamad , Lin Li , Matias Matias , Sobhan Armaan , Zaritsky Mario , Thorson Chad
Published: December 2024

Congenital colonic stenosis (CCS) is a rare cause of intestinal obstruction, most commonly presenting in the neonatal period. We present a case of delayed CCS and describe the diagnostic challenges experienced. A 16-week-old female patient presented with persistent failure to thrive associated with signs of intestinal obstruction. Prior encounters included investigation for pyloric stenosis, gastrointestinal pathogens, acid reflux, and cow milk allergy, with no to little improvement in symptoms. Abdominal imaging showed bowel dilation with possible colonic obstruction while excluding malrotation. Exploratory laparotomy revealed abrupt reduction in caliber of the mid/distal transverse colon and extreme luminal narrowing, consistent with colonic stenosis. Extended right hemicolectomy and anastomosis resulted in returned bowel function and appropriate weight gain in follow-up. Though rare, CCS should be considered in cases of partial or subacute intestinal obstruction throughout the first year of life. Inconclusive clinical and imaging results may support exploratory laparotomy after excluding differential diagnoses.
Inferring a Population Composition From Survey Data With Nonignorable Nonresponse: Borrowing Information From External Sources
Authors: Ballerini Veronica , Liseo Brunero
Published: December 2024

We introduce a method for inference on the composition of a heterogeneous population using survey data, accounting for the possibility that capture heterogeneity is related to key survey variables. To deal with nonignorable nonresponse, we combine different data sources and propose the use of Fisher’s noncentral hypergeometric model in a Bayesian framework. To illustrate the potentialities of our methodology, we present a case study aimed at estimating the distribution of occupation status of Italian graduates one year after graduating, cross-classified by gender and degree program. In our case study, we account for a potential dependence between occupation status and survey response, implying the nonignorable nonresponse. Our findings show that employed people are generally more inclined to answer the questionnaire. Neglecting the nonresponse bias in such contexts might lead to overestimating the employment rate.
Optimal Weights for double Many-To-One Generalized Weight Share Method
Authors: Medous Estelle
Published: December 2024

In probabilistic sampling, a sampling frame comprising the target population may not be available. However, indirect sampling can be used when the units on a sampling frame can be linked to the target population, with the values observed in the target population used for estimation. If the target population can only be linked to the sampling frame through an intermediate population, then double indirect sampling is a viable option. In this case, the sampling weights can be obtained with the double generalized weight share method (GWSM). The double GWSM reduces the number of observed links compared to the simple GWSM but can detrimentally affect the precision of the estimator, as in the example of the French postal service (La Poste). In this article, we show the existence of a set of sampling weights that minimize the variance of the double GWSM in specific cases with La Poste as exemplar. These weights ensure that the implementation advantages of the double GWSM are not offset by a loss of precision. When these weights cannot be computed, as is the case in the French postal traffic survey, we propose alternative weights that can be used to improve the precision of the double GWSM estimator. Results are illustrated through Monte Carlo simulations and an application to the French postal traffic survey.
(010) INTERPLAY OF SEMINAL MICROBIOTA AND LEUKOSPERMIA: A ROLE FOR IMMUNOLOGIC TOLERANCE
Authors: Huang J , Hummel G , Stocks B , Oppenheimer A , Allon M , Lipshultz L
Published: December 2024

Introduction

Leukospermia is of poorly understood clinical significance. Culture-based assays have not consistently correlated leukospermia with bacteriospermia. DNA-based microbial detection has revealed a rich microbiome throughout the body, often in areas previously presumed sterile, and certain microbial populations have been linked to impaired fertility.

Objective

We aim to evaluate the relationship of leukospermia and male infertility by conducting a retrospective study in infertile men with high numbers of seminal round cells, using a DNA-based bacterial detection assay and flow cytometry.

Methods

We identified all patients within our semen repository with at least 10 round cells per high-power field (or 2 million cells/mL) from January 2022 to October 2023. Microbiome profiling was performed with real-time PCR using one of the only commercial assays of the genital microbiome, which, although not specific to semen, has significant overlap with seminal microbial communities and the capacity to detect clinically relevant microbial taxa (Applied BiosystemsTM TaqMan® Vaginal Microbiota assay). Seminal leukocyte analysis was performed by flow cytometry. Chart review was performed to abstract demographic and clinical data.

Results

Of 850 patients screened, 17 met inclusion criteria. 7 samples contained detectable bacterial DNA, which did not correlate with round cell count nor motility (P ≥ 0.11). The most common species identified were Lactobacillus iners (4 patients) and Enterococcus faecalis (4 patients), both of which have been linked with impaired fertility. Leukocyte analysis revealed lower frequencies of tolerogenic CD4 T regulatory cells in samples with detectable microbes (10.0%) vs. undetectable (26.9%), although this was not significant (P ≥ 0.18).

Conclusions

We present microbiota data on a relatively large series of patients with seminal round cells. Despite DNA-based testing, our results do not correlate leukospermia with bacteriospermia. This suggests a possible non-microbial, immunological etiology of impaired fertility. Although preliminary, our complementary leukocyte data suggest bacterial colonization may impair immunologic tolerance in the reproductive tract and subsequently impair fertility. Prospective studies of leukospermia samples utilizing 16S rRNA sequencing are needed to comprehensively characterize this subset of the seminal microbiome.

Disclosure

No.
(033) DO PEYRONIE’S DISEASE PATIENTS WITH CONCOMITANT DUPUYTREN’S CONTRACTURES RESPOND BETTER TO INTRALESIONAL INJECTION OF COLLAGENASE CLOSTRIDIUM HISTOLYTICUM?
Authors: Lumbiganon S , A Moukhtar Hammad M , Nakamura H , Abou Chawareb E , Azad B , Yafi F
Published: December 2024

Introduction

Dupuytren's contractures (DC) are prevalent in men with Peyronie's disease (PD). There is, however, limited data regarding the impact of DC on the efficacy of intralesional injection of Collagenase Clostridium Histolyticum (CCH) for the management of PD.

Objective

This study aimed to examine the demographics of patients undergoing CCH therapy for PD and compare the outcomes between DC and non-DC patients.

Methods

We conducted a retrospective chart review of PD patients attending a tertiary care men's health center between October 1, 2017 and September 30, 2023. Demographic information, treatment modalities, and outcomes were systematically collected. A comparative analysis was performed between PD patients with and without DC.

Results

Among the 573 patients in this cohort, 43 with history of DC. Two hundred and ninety-two opted for CCH as first line therapy. One hundred eighty-seven patients had at least 4 cycles of treatment. Of those, 17 patients (9.1%) had a history of DC, and 170 (90.9%) did not. Mean ages were 66.7 ± 5.0 (DC) and 57.1 ± 11.3 years (non-DC), P < 0.001 (table 1). The pre-treatment composite degrees of curvature were 47.5 ± 14.4 (DC) and 43.2 ± 13.4 degrees (non-DC), P = 0.210. Number of injection cycles administered were 4.6 ± 0.9 (DC) and 4.6 ± 1.2 (non-DC), P = 0.904. Post-treatment, the composite degree of improvement was significantly higher in the DC group 29.3 + 12.8 degrees, 63.5 + 27.9 % improvement vs 20.8 + 13.9 degrees, 48.1 + 27.9 % improvement in the non-DC group, with a mean difference of 8.6 + 3.7 degrees (95% CI 1.4, 15.8; P = 0.020), and 15.5 + 7.3% improvement (95% CI 1.1, 29.9; P = 0.036).

Conclusions

Our study suggests that the concomitant presence of DC is a predictor of better response to intralesional injection of CCH in men with PD. Despite the limited sample size and the retrospective design, these findings merit further exploration.

Disclosure

No.
(043) IS DAILY PDE5I SUPPLEMENTATION WITH TRIMIX ICI INJECTIONS BENEFICIAL IN POST-PROSTATE CANCER TREATMENT? AN EVALUATION OF EFFICACY AND SAFETY DATA
Authors: Khalaf Alla K , Mahdi M , Majzoub A , Jacob J , Slovacek H , Wang R
Published: December 2024

Introduction

Trimix intracorporeal injections (ICI) are considered a dependable treatment option for men who have undergone radical prostatectomy, often resulting in satisfactory erections suitable for penetration. However, higher doses of Trimix ICI can cause penile pain and are linked to an increased incidence of priapism.

Objective

This study aimed to investigate whether daily use of Phosphodiesterase 5 Inhibitors (PDE5i) can enhance the effectiveness of ICI, enabling patients to achieve the desired response with lower Trimix ICI dosages.

Methods

We performed a retrospective analysis of our institutional database to identify patients experiencing erectile dysfunction following prostate cancer treatment. Data from 233 patients who underwent Ultrasound Penile Doppler (US PD), used Trimix ICI with or without daily PDE5i between 2020 and 2023, and had a follow-up period of at least one year were included. Correlation was drawn between the changes in Trimix dosage required to attain a satisfactory erection and the different variables including demographic data and ultrasound penile doppler readings. Patients were categorized into two groups according to their PDE5i usage: group 1 (no PDE5i intake, n = 128) and group 2 (PDE5i intake, n = 105). To assess the impact of PDE5i on changes in ICI dosage, a chi-squared test was utilized.

Results

In the overall patient cohort, 17.2% had diabetes, 51.9% had hypertension, 71.7% had undergone prostatectomy, 24.5% had a history of radiation treatment, 18.5% had received androgen deprivation therapy, and 15.9% reported using beta blockers. Additionally, 55.8% of the patients used vacuum erection devices. One observation found, most of the patients who took daily PDE5i were from the non-radiation therapy group. (P = 0.03) The correlation between changes in intracorporeal injection dosage and various parameters is detailed in Table 1. Most parameters were not statistically significant, with the exceptions of patient age (P = 0.01) and the initial prescribed Trimix injection dose, which was determined based on the patient's response to initial ICI given during penile Doppler ultrasound. A significantly higher proportion of patients in group 1 reported an increase in Trimix ICI dosage during follow-up compared to group 2 (78.4% vs. 61.9%, p = 0.01). Importantly, no cases of priapism were observed among the 233 patients throughout the follow-up period.

Conclusions

Although additional comprehensive follow-up is warranted, these preliminary findings suggest that regular daily administration of PDE5 inhibitors is both safe and may effectively reduce the necessity for escalating Trimix ICI dosages in this particular patient cohort.

Disclosure

No.
(069) IDENTIFYING PREDICTORS OF BONE DENSITY LOSS IN MEN WITH LOW TESTOSTERONE
Authors: Ljubetic BM , Liso N , Mulhall JP , Flores JM
Published: December 2024

Introduction

Bone density loss (BDL), is associated with low testosterone (T).

Objective

We aimed to identify predictors of BDL in this cohort of patients.

Methods

The sample included (i) men ≥50 years old (ii) with low total T levels (<300 ng/dL using LCMS on 2 early morning blood draws) (iii) who had dual-energy X-ray absorptiometry (DEXA) within 6 months of T measurement. Men with prior T therapy were excluded. On DEXA, osteopenia was defined as a T score -1.1 to -2.5, osteoporosis T score lower than -2.5. Additionally, demographics and comorbidity data, diabetes, sleep apnea, coronary artery disease (CAD), hypertension, dyslipidemia and smoking status were collected. We report rates and attempt to define predictors of any BDL using multivariable analysis (MVA), including age, comorbidities ≥3 (yes), and total T levels ≤100 ng/dL (yes).

Results

512 men were analyzed, mean age of 65 ± 5 years. Median total T was 223 (175, 262) ng/dL, free T 4.5 (2.8, 7.9) ng/dL, and estradiol 17 (13, 23) pg/mL. 6% had a total T ≤ 100 ng/dL. Median number of comorbidities was 2 (1, 3). 57% hypertension, 57% dyslipidemia, 40% reported OSA, 24% had diabetes, and 8% reported CAD. 34% of the men had ≥3 comorbidities. 44% were former or current smokers. BDL was present in 36% of the patients. 91% had osteopenia, and 9% had osteoporosis. On MVA, significant predictors of BDL were older age, presence of ≥3 comorbidities and the presence of total T ≤ 100 ng/dL (Table 1).

Conclusions

In our cohort of men with low T, one third had BDL, and we have identified key predictors of this occurrence, older age, higher number of comorbidities and profoundly low T.

Disclosure

No.
(090) DELAYED STENOSIS RATE POST VASECTOMY REVERSAL: A MULTICENTER COHORT
Authors: Tyler A , Deebel N , Goldstein M , Lipshultz L , Brannigan R , Kavoussi P , Ramasamy R , Terlecki R , Halpern J , Trost L
Published: December 2024

Introduction

Outcomes with vasectomy reversal procedures for infertility have varied widely in the literature, with limited data available on long-term results. The current study objective was to provide data on long-term outcomes, including delayed stenosis rates using a multicenter dataset.

Objective

To evaluate the rate of long-term stenosis of men undergoing vasectomy reversal.

Methods

A retrospective study was performed of men undergoing vasectomy reversal for infertility by 14 surgeons from nine institutions. Each of the participating institutions had fellowship-trained andrologists specializing in male infertility and provided the data in an anonymous manner to optimize accuracy of reporting. Two institutions provided only limited datasets. The primary objective of the study was to evaluate the rate of long-term patency. Secondary objectives were to describe sperm concentration at various time points and by surgical team. For clinical variability, clinics without at least 10 data points were excluded from those analyses.

Results

A combined total of 3589 cases were included in the cohort, with 2838 having at least one test and 893 with at least one semen analysis available beyond 10 months. The percentage of patients with test results >10 months after surgery by clinic ranged from 1.2 to 47.5%, indicating wide discrepancies in follow-up protocols. Overall median sperm concentrations at <2, 2-4, 4-7, 7-10, 10-13, 13-18, and 18-24+ months were 5.8, 6.7, 5.3, 2.5, 1.3, 0, 1.2 million/ml, respectively. All-comer patency (defined as sperm at any point) rates ranged from 60-97%, with median maximal sperm concentration by clinic (any time point) ranging from 2-21 million/ml. Among men with at least two semen analyses, at least one of which was >10 months, 33.4% who initially had sperm went on to experience azoospermia (clinics varying from 2-48%). Overall patency rates at >10 months were 54% for the full cohort (range by clinic 41-93%). When reviewing data by surgeon, statistically significant differences were noted with all variables assessed, including the ratio of VV vs EV, successful completion rates of both sides, sperm concentrations, and short and long-term rates of azoospermia, suggesting notable differences in results based on surgical technique.

Conclusions

Using data from a combined cohort of 14 surgeons, approximately 54% of men who undergo vasectomy reversal for infertility experience durable patency at 10+ months with results varying significantly by surgeon.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: PathRight Medical.
(092) TESTICULAR CORE EXTRACTION REDUCES NEED FOR MICROSCOPIC TESTICULAR SPERM EXTRACTION BY 75% IN MEN WITH NON-OBSTRUCTIVE AZOOSPERMIA
Authors: Oppenheimer A , Huang J , Stocks B , Lipshultz L
Published: December 2024

Introduction

Current AUA guidelines recommend proceeding to microTESE (mTESE) for patients with non-obstructive azoospermia (NOA). Herein, we propose that that conventional Testicular Sperm Extraction (cTESE) is an effective and preferred first-line technique for sperm retrieval in men with NOA who first undergo a diagnostic testicular core extraction (TCE).

Objective

To comprehensively characterize TCE and cTESE as important diagnostic and therapeutic tools, respectively, we present a large cohort study to confirm our proposed algorithm.

Methods

We identified 187 patients presenting with NOA in our clinic from January 1, 2019 – March 25, 2024. All patients underwent diagnostic TCE that if positive for sperm was followed by cTESE. Chart review was performed, and summary statistics were calculated for tested variables, using chi squared analysis for categorical variables and Kruskal Wallis analysis for non-parametric continuous variables. P < 0.05 deemed significance.

Results

Under current guidelines, all 66 patients who underwent cTESE for NOA would have undergone mTESE. Of these patients, 97.8% had sperm on cTESE sufficient for IVF/ICSI. Those patients who did not have sperm on TCE were offered mTESE. 16 elected to proceed, of which 4 (25%) were found to have sufficient sperm at the time of egg retrieval. In patients with NOA, the only significant predictor of cTESE success was TCE. Other covariates that significantly differed between patients with sperm and those without on TCE included lower FSH (p = 0.001) and LH (p = 0.005). However, these variables were not significant in predicting TCE efficacy for NOA patients.

Conclusions

TCE was the only tested variable statistically associated with cTESE outcome. By pretesting NOA patients with TCE as a method of selection we achieved a 97.8% sensitivity of predicting a positive cTESE outcome in NOA patients and spared 75% of those patients from mTESE. This algorithm for NOA patient management costs significantly less while maintaining efficacy.

Disclosure

No.