bluuebunny/crossref_metadata_2025 huggingface dataset:
Wo der Schwindel herkommt – Hilfestellung für eine schnelle Einordnung
Authors: Zwergal Andreas , Kellerer Silvy , Dassel Alexander
Published: June 2024

Akuter Schwindel kann benigne Ursachen haben, aber auch durch einen Schlaganfall ausgelöst werden. Wichtig ist es daher, mithilfe eines standardisierten diagnostischen Vorgehens zeitnah gefährliche Ursachen zu identifizieren.
From poverty to prosperity: assessing of sustainable poverty reduction effect of “welfare-to-work” in Chinese counties
Authors: Lan Feng , Xu Weichao , Sun Weizeng , Zhao Xiaonan
Published: June 2024

The “welfare-to-work” program is a comprehensive supportive policy in the 14th five-year plan period in China. In this paper, a systematical assessment of the long-run effectiveness of the welfare-to-work policy on poverty reduction is of great significance to stimulate the internal impetus of people who are lifted out of poverty to achieve income growth and prosperity and promote regional economic development. Based on the data at the county (city) level in China from 2000 to 2019 and the sustainable development theory, in this paper, a county-relative poverty evaluation system was constructed. Besides, the double difference method was employed to evaluate the effect of the welfare-to-work policy on poverty reduction and test its action mechanism. The findings are as follows: (1) the welfare-to-work policy has a significant poverty reduction effect and presents an inverted “U” shape. In addition, significant achievements have been made in “maintaining employment stability, ensuring income, strengthening skills, and supporting the economy” ; (2) the welfare-to-work policy boosts poverty reduction in counties through infrastructure construction, fiscal intervention, and financial tools; however, the financial tools play a positive role in poverty reduction in the northwest region and suppressed role in the southwest region, and has an insignificant effect in the central region; and (3) there are differences in the effect of poverty alleviation policies of the counties with different sustainable development levels, and the regions with higher development level have a stronger driving effect.
Design of variable direction wireless power transfer system based on metamaterial
Authors: Xiao Feihang , Wang Zhenfan , Qiang Hao
Published: June 2024

In complex environments, such as mines, ports, and pipelines, wireless power transfer technology is a convenient and safe power supply method. However, the offset and change in direction of the receiving coil greatly weaken the power transfer performance. To address this issue, this paper proposes a variable direction wireless power transfer device for mining based on metamaterials. According to the relationship between incident angle, refracted angle, and permeability, three different metamaterials are selected to fabricate a metamaterial slab arranged in 3 × 3 using printed circuit board technology. Experimental results show that when the transmitting coil and receiving coil are perpendicular to and deviate from each other, the designed power transfer system with the metamaterial slab can effectively increase power transfer by 117.9%. The proposed variable direction transfer system only needs a metamaterial slab without an additional power supply or control structure, and it is convenient for large-scale manufacturing and application.
Research on fractional symmetry based on Riesz derivative
Authors: Wang Cai , Song Chuan-Jing
Published: June 2024

The variational problem, Noether symmetry and conserved quantity, and Lie symmetry and conserved quantity of singular systems are investigated on the basis of Riesz derivatives. First, based on Riesz derivatives, the variational problem of Lagrangian systems is studied, the fractional Lagrange equation is established, and the primary constraint problem of the system is discussed when the Lagrangian is singular. Second, the constrained Hamilton equation is established and the compatibility condition is provided. Third, the Noether symmetry and conserved quantity and the Lie symmetry and conserved quantity of the constrained Hamiltonian system are studied. In the end, an example is provided for illustration.
Influence of extracellular ATP on mammalian sperm physiology
Authors: López-González I. , Oseguera-López I. , Castillo R. , Darszon A.
Published: June 2024

In addition to its central role in cellular metabolism, adenosine 5′-triphosphate (ATP) is an important extracellular signalling molecule involved in various physiological processes. In reproduction, extracellular ATP participates in both autocrine and paracrine paths regulating gametogenesis, gamete maturation and fertilisation. This review focusses on how extracellular ATP modulates sperm physiology with emphasis on the mammalian acrosome reaction. The presence of extracellular ATP in the reproductive tract is primarily determined by the ion channels and transporters that influence its movement within the cells comprising the tract. The main targets of extracellular ATP in spermatozoa are its own transporters, particularly species-specific sperm purinergic receptors. We also discuss notable phenotypes from knock-out mouse models and human Mendelian inheritance related to ATP release mechanisms, along with immunological, proteomic, and functional observations regarding sperm purinergic receptors and their involvement in sperm signalling.
‘The benefits of the vaccine outweigh the risks… they say’
Authors: Riccioni Ilaria , Bertolazzi Alessia , Bongelli Ramona
Published: June 2024

This study aims to analyse Italian Internet users’ comments on two posts that appeared on the Facebook page of the
Italian newspaper Il Corriere della Sera during a particularly critical phase of the COVID-19 pandemic
(specifically, March 2021). At that time, the AstraZeneca vaccine had been temporarily suspended in some European countries due to
confirmed reports of blood clots but subsequently declared “safe and effective” by the European Medicines Agency. Two datasets of
comments were collected and analysed by combining automatic and manual, as well as quantitative and qualitative, methods. The main
findings shed light on the orientation (agreement vs disagreement), construction of consensus and dissent, and epistemic
positioning of Facebook users when they are confronted and engaged in dialogue with uncertain news about public health issues.
New features in Franck–Hertz experiment with argon: experiment and Monte Carlo simulation
Authors: Dong Tianzuo , Wang Yanqi , Zhang Yi , Shi Qingtian , Dai Rucheng , Sun Xiaoyu , Wang Zhongping , Zhang Zengming , Sun Lazhen
Published: June 2024

In this work, a homemade apparatus was built to perform the Franck–Hertz experiment with argon. The lowest energy state and the higher energy state of argon can be excited by the Franck–Hertz experiment. The excitation energies of the argon atom are measured by using the setup. The obtained higher excitation energy of argon atoms is 13.73 ± 0.28 eV, for the mixture of higher energy states 3s
23p
53d and 3s
23p
54p. A plate capacitor model was constructed to simulate the inelastic collisions between electrons and argon atoms using the Monte Carlo method. The simulated current curve and electron energy distribution agrees with that of Franck–Hertz experiments, especially the features of higher excited state. The Monte Carlo simulation indicates the deformed electron energy distribution results from the change in excitation proportion of energy levels during the collisions of electrons and argon atoms. Moreover, the new features in Franck–Hertz curve are ascribed to the higher excitation states of argon atoms. The experimental setup has been applied to undergraduate physics experiment teaching in college. Students can perform the Franck–Hertz curve measurement of not only the lowest excited state, but also the higher excited states of argon. In addition, students can do the Monte Carlo simulations for the experimental Franck–Hertz curves and gain a better understanding of electron-argon atom collisions in the experiment. The new designed experiment will make students more familiar with the quantum behavior in atomic physics and quantum mechanics course.
GaN-based E-mode p-FETs with polarization-doped p-type graded AlGaN channels
Authors: Xing Zhanyong , Zhang Haochen , Ye Yankai , Liang Fangzhou , Yang Lei , Huang Zhe , Liang Kun , Wang Hu , Zhang Mingshuo , Li Jiayao , Zuo Chengjie , Sun Haiding
Published: June 2024

Herein, a novel enhancement-mode (E-mode) GaN-based p-channel FETs (p-FETs) with a linearly graded AlGaN (LGA) p-channel is proposed and numerically studied by Silvaco TCAD. Thanks to strong polarization-induced doping, three-dimensional hole gas (3DHG) can be uniformly generated in LGA to form a continuous p-channel with a hole concentration over 1018 cm–3. Combined with an optimized recessed gate structure, the LGA p-FET can simultaneously achieve a large threshold voltage (|V
TH|) > 2 V and a high current density (|J
DS|) of ∼10 mA mm−1 at V
DS = −10 V. Additionally, two critical parameters of the LGA p-FETs, i.e. the depth of recessed gate and initial Al composition of LGA, are specifically studied to reveal the unique carrier behavior of 3DHG in the devices. Importantly, the LGA structure is further optimized and implemented as the p-type cap layer to construct an E-mode GaN n-FET. Thereby, based on the same LGA configuration, a GaN-based inverter with the matched complementary n- and p-FETs is monolithically constructed, showing sharp voltage transition. The reported novel LGA structure and its availability in both GaN-based E-mode n- and p-FETs provides valuable insights and guidance to construct highly efficient GaN p-type devices and All-GaN-based integrated circuits for compact power electronic systems.
Tunable metamaterials with carrier-induced effective permittivity for active control of electromagnetic fields in semiconductor manufacturing device
Authors: Lee Minyeul , Yoon Sungyoung , Lim Meehyun , Kim Sungyeol , Shin Jonghwa
Published: June 2024

Precise control of electromagnetic fields is critical in many advanced manufacturing processes, such as those used in the semiconductor industry, where device performance relies on precision and uniformity. Here, we introduce a solution to control electromagnetic fields via permittivity modulation without the limitations of resonance-based approaches, through a patterned semiconductor enabling permittivity tuning via carrier-density modulation. This carrier-responsive metamaterial (CRM) exhibits frequency-independent performance over a broad frequency spectrum and significant permittivity tunability through controlled semiconductor conductivity. Furthermore, the conductivity response and the tuning range can be easily modulated through the variation of semiconductor materials and geometrical parameters. We present an intuitive model that explains the relationship between the CRM’s structure and properties, including its effective permittivity and loss tangent. Supported by comprehensive simulations and experimental validations, our findings show that the effective permittivity can be increased by over 3.5 times with low dielectric loss across a wide frequency range. As an application, we explore the CRM’s potential in plasma control, revealing its ability to influence plasma density nearly 30% by modulating its effective permittivity, exhibiting CRM’s versatile functionality and potential impact across diverse technological domains.
Efficacy of barium and calcium additives in lithium silicate glasses for nuclear shielding applications
Authors: Yilmaz Alan Hatice
Published: June 2024

This study presents a detailed investigation into the nuclear radiation shielding capabilities of lithium silicate (Li2O-SiO2) glass systems, specifically examining the impact of doping with barium oxide (BaO) and calcium oxide (CaO). Utilizing advanced simulation tools, including PAGEX and SRIM for charged particle interactions, and Phy-X/PSD for gamma-ray attenuation analysis, the radiation shielding effectiveness of BaO-based and CaO-based lithium silicate glasses were systematically compared. The gamma attenuation parameters (LAC, MAC, TVL, HVL, EBF, EABF, MFP, Zeff, Neff, FNRCS, and Zeq) of investigated glass samples were computed via the Phy-X/PSD program (15 keV-15 MeV energy). The HVL values vary between 0.007–14.203 cm, and the TVL values vary between 0.054–47.182 cm for all samples in the selected energy range. The highest and lowest values of FNRCS were observed for samples BaO20 and CaO5, with the values 0.093 and 0.1 cm−1, respectively. KERMAs were calculated using PAGEX software between the 1.5 keV and 20 MeV energy range, with the highest KERMA obtained for the BaO20 sample at 0.05 MeV and the lowest KERMA obtained for the CaO5 sample at the lowest density. The mass stopping power quantities were computed between 1 keV-10 GeV energy with PAGEX. The projected range values were calculated with SRIM codes. The lowest projected range values for both alpha particles and protons were obtained for the BaO20 sample with maximum density (3.391 g cm−3). The sample with BaO20 code showed better shielding potential for alpha and proton particles with lower values of projected range and mass stopping power. Findings reveal that the Li2O-BaO-SiO2 glass composition exhibits superior gamma-ray attenuation properties compared to its CaO-doped counterpart, with the BaO20 sample demonstrating particularly enhanced performance.
The hyperbolic sine chaotification model and its applications
Authors: Li Binglun , Sun Kehui , Wang Huihai , Liu Wenhao
Published: June 2024

Some existing chaotic systems suffer from issues such as period windows, discontinuous parameter ranges, and dynamical degradation, which seriously limit their application. Therefore, designing high-performance anti-degradation chaotic systems is of great significance. In this paper, a novel hyperbolic sine chaotification model (HSCM) is proposed. It allows for the use of any chaotic maps or linear functions as the seed maps, and employs a closed-loop modulation coupling (CMC) method to extend it to high-dimensional (HD) chaotic maps. Theoretical and experimental results show that this model can effectively improve the Lyapunov exponent (LE) of the seed chaotic map and expand the parameter ranges. In addition, it can also resist the dynamical degradation under finite computational precision. Based on the HSCM, a novel eight-dimensional (8D) HSCM is designed, and implemented through field-programmable gate array (FPGA) in both serial and parallel modes, respectively. Furthermore, the novel chaotic maps are applied to pseudo-random sequence generator (PRNG) and image compression under finite computing precision. Experimental results indicate that the novel chaotification model has greatly broad application prospects.
Dynamics of holographic images of scalar-tensor-vector gravity-AdS black holes*
Authors: Hu 胡 Xin-Yun 馨匀 , Aslam M. Israr , Saleem Rabia , Zeng 曾 Xiao-Xiong 晓雄
Published: June 2024

Using AdS/CFT correspondence, we analyze the holographic Einstein images via the response function of the complex scalar field as a probe wave on an AdS Schwarzschild scalar-tensor-vector gravity (STVG) black hole (BH). We find that the amplitude of the response function

decreases with increasing values of coupling parameter α and increases with decreasing temperature T. The frequency ω of the wave source also plays a significant role in wave periods; as we increase the values of ω, the periods of waves decrease, indicating that the total response function closely depends on the wave source. Further, we investigate the optical appearance of the holographic images of the BH in bulk. We found that the holographic ring always appears with surrounding concentric stripes when the observer is located at the north pole, and an extremely bright ring appears when the observer is at the position of the photon sphere of the BH. This ring changes into a luminosity-deformed ring or a bright light spot as the observational angle changes. The corresponding brightness profiles show that the luminosity of the ring decreases and the shadow radius increases with increasing values of α. The relation between temperature T and the inverse of the horizon

is discussed; T is small at the beginning of the horizon

and then increases as the horizon radius increases. This effect can be used to distinguish the STVG BH solution from other BH solutions. Moreover, these significant features are also reflected in the Einstein ring and corresponding brightness profiles. In addition, we compare the results obtained by wave optics and geometric optics, which align well, implying that the holographic scheme adopted in this study is valid.
Reflexive Modules on Normal Gorenstein Stein Surfaces, Their Deformations and Moduli
Authors: Fernández de Bobadilla Javier , Romano Velazquez Agustín
Published: June 2024

In this paper we generalize Artin-Verdier, Esnault and Wunram construction of McKay correspondence to arbitrary Gorenstein surface singularities. The key idea is the definition and a systematic use of a degeneracy module, which is an enhancement of the first Chern class construction via a degeneracy locus. We study also deformation and moduli questions. Among our main result we quote: a full classification of special reflexive MCM modules on normal Gorenstein surface singularities in terms of divisorial valuations centered at the singularity, a first Chern class determination at an adequate resolution of singularities, construction of moduli spaces of special reflexive modules, a complete classification of Gorenstein normal surface singularities in representation types, and a study on the deformation theory of MCM modules and its interaction with their pullbacks at resolutions. For the proof of these theorems it is crucial to establish several isomorphisms between different deformation functors, that we expect that will be useful in further work as well.
A geometric classification of rod complements in the 3-torus
Authors: Hui Connie On Yu
Published: June 2024

Rod packings are used in crystallography to describe crystal structures with linear or zigzag chains of particles, and each rod packing can be topologically viewed as a collection of disjoint geodesics in the

3
3

-torus. Hui and Purcell developed a method to study the complements of rods in the

3
3

-torus with the use of

3
3

-dimensional geometry and tools from the

3
3

-sphere, and they partially classified the geometry of some families of rod complements in the

3
3

-torus. In this paper, we provide a complete classification of the geometry of all rod complements in the

3
3

-torus using topological arguments.
Gulistan in Black and White
Authors: Pourtavaf Leila
Published: June 2024

This paper takes the late Qajar court and harem as a historically specific site through which we can examine the complex and diverse histories of slavery within the region in the nineteenth century, as well as the ways in which hierarchies of race, gender, and sex functioned as constitutive elements of this institution. I examine a particular albeit very elite site, Nasir al-Din Shah’s harem, occupied by a variety of enslaved and formerly enslaved constituents who were a product of the evolving slave trade. The essay ends by zooming in on the lives (and afterlives) of two eunuchs, Aziz Khan and Agha Bahram, who were part of the servant class of Gulistan Palace during Nasir al-Din Shah’s reign, and whose life trajectories offer us some insight into the racial and gendered legacies of late nineteenth-century slavery in Iran.
The MATH test. A three-phase assay?
Authors: Salas-Tovar Jesús A , Escobedo-García Sarai , Olivas Guadalupe I , Acosta-Muñiz Carlos H , Harte Federico , Sepulveda David R
Published: June 2024

This study aimed to investigating the possible interference caused by glass test tubes on the quantification of bacterial adhesion to hydrocarbons by the MATH test. The adhesion of four bacteria to hexadecane and to glass test tubes was evaluated employing different suspending polar phases. The role of the ionic strength of the polar phase regarding adhesion to glassware was investigated. Within the conditions studied, Gram-positive bacteria adhered to both the test tube and the hydrocarbon regardless of the polar phase employed; meanwhile, Escherichia coli ATCC 25922 did not attach to either one. The capacity of the studied microorganisms to adhere to glassware was associated with their electron-donor properties. The ionic strength of the suspending media altered the patterns of adhesion to glass in a strain-specific manner by defining the magnitude of electrostatic repulsion observed between bacteria and the glass surface. This research demonstrated that glass test tubes may interact with suspended bacterial cells during the MATH test under specific conditions, which may lead to overestimating the percentage of adhesion to hydrocarbons and, thus, to erroneous values of cell surface hydrophobicity.
Selection Shapes the Genomic Landscape of Introgressed Ancestry in a Pair of Sympatric Sea Urchin Species
Authors: Glasenapp Matthew R , Pogson Grant H
Published: June 2024

A growing number of recent studies have demonstrated that introgression is common across the tree of life. However, we still have a limited understanding of the fate and fitness consequence of introgressed variation at the whole-genome scale across diverse taxonomic groups. Here, we implemented a phylogenetic hidden Markov model to identify and characterize introgressed genomic regions in a pair of well-diverged, nonsister sea urchin species: Strongylocentrotus pallidus and Strongylocentrotus droebachiensis. Despite the old age of introgression, a sizable fraction of the genome (1% to 5%) exhibited introgressed ancestry, including numerous genes showing signals of historical positive selection that may represent cases of adaptive introgression. One striking result was the overrepresentation of hyalin genes in the identified introgressed regions despite observing considerable overall evidence of selection against introgression. There was a negative correlation between introgression and chromosome gene density, and two chromosomes were observed with considerably reduced introgression. Relative to the nonintrogressed genome-wide background, introgressed regions had significantly reduced nucleotide divergence (dXY) and overlapped fewer protein-coding genes, coding bases, and genes with a history of positive selection. Additionally, genes residing within introgressed regions showed slower rates of evolution (dN, dS, dN/dS) than random samples of genes without introgressed ancestry. Overall, our findings are consistent with widespread selection against introgressed ancestry across the genome and suggest that slowly evolving, low-divergence genomic regions are more likely to move between species and avoid negative selection following hybridization and introgression.
GWAS Identifies DPP6 as Risk Gene of Cognitive Decline in Parkinson’s Disease
Authors: Li Chunyu , Hou Yanbing , Ou Ruwei , Wei Qianqian , Zhang Lingyu , Liu Kuncheng , Lin Junyu , Chen Xueping , Song Wei , Zhao Bi , Wu Ying , Shang Huifang
Published: June 2024

Background

Cognitive decline is among the most common non-motor symptoms in Parkinson’s disease (PD), while its physiological mechanisms remain poorly understood. Genetic factors constituted a fundamental determinant in the heterogeneity of cognitive decline among PD patients. However, the underlying genetic background was still less studied.

Methods

To explore the genetic determinants contributing to cognitive decline in PD, we performed genome-wide survival analysis using a Cox proportional hazards model in a longitudinal cohort of 450 Chinese patients with PD, and further explored the functional effect of the target variant. Additionally, we built a clinical-genetic model by incorporating clinical characteristics and polygenic risk score (PRS) to predict cognitive decline in PD.

Results

The cohort was followed up for an average of 5.25 (SE = 2.46) years, with 95 incidents of cognitive impairment. We identified significant association between locus rs75819919 (DPP6) and accelerated cognitive decline (p = 8.63E-09, beta = 1.74, SE = 0.30). Dual-luciferase reporter assay suggested this locus might be involved in the regulation of DPP6 expression. Using data set from the UK Biobank, we identified rs75819919 was associated with cognitive performance in the general population. Incorporation of PRS increased the model’s predictability, achieving an average AUC of 75.6% through fivefold cross-validation in 1 000 iterations.

Conclusions

These findings improve the current understanding of the genetic etiology of cognitive impairment in PD, and provide a novel target DPP6 to explore therapeutic options. Our results also demonstrate the potential to develop clinical-genetic model to identify patients susceptible to cognitive impairment and thus provide personalized clinical guidance.
Dolutegravir- Versus Efavirenz-Based Treatment in Pregnancy: Impact on Red Blood Cell Folate Concentrations in Pregnant Women and Their Infants
Authors: Jacobson Denise L , Crider Krista S , DeMarrais Patricia , Brummel Sean , Zhang Mindy , Pfeiffer Christine M , Moore Cynthia A , McCarthy Katie , Johnston Benjamin , Mohammed Terence , Vhembo Tichaona , Kabugho Enid , Muzorah Gerald Agaba , Cassim Haseena , Fairlie Lee , Machado Elizabeth S , Ngocho James S , Shapiro Roger L , Serghides Lena , Chakhtoura Nahida , Chinula Lameck , Lockman Shahin
Published: June 2024

Background

In the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) 2010/VESTED study, pregnant women were randomized to initiate dolutegravir (DTG) + emtricitabine (FTC)/tenofovir alafenamide (TAF), DTG + FTC/tenofovir disoproxil fumarate (TDF), or efavirenz (EFV)/FTC/TDF.

Methods

We assessed red blood cell (RBC) folate concentrations at maternal study entry and delivery, and infant birth. RBC folate outcomes were (1) maternal change entry to delivery (trajectory), (2) infant, and (3) ratio of infant-to-maternal delivery. Generalized estimating equation models for each log(folate) outcome were fit to estimate adjusted geometric mean ratio (Adj-GMR)/GMR trajectories (Adj-GMRTs) of each arm comparison in 340 mothers and 310 infants.

Results

Overall, 90% of mothers received folic acid supplements and 78% lived in Africa. At entry, median maternal age was 25 years, gestational age was 22 weeks, CD4 count was 482 cells/μL, and log10 HIV RNA was 3 copies/mL. Entry RBC folate was similar across arms. Adj-GMRT of maternal folate was 3% higher in the DTG + FTC/TAF versus EFV/FTC/TDF arm (1.03 [95% confidence interval {CI}, 1.00–1.06]). The DTG + FTC/TAF arm had an 8% lower infant-maternal folate ratio (0.92 [95% CI, .78–1.09]) versus EFV/FTC/TDF.

Conclusions

Results are consistent, with no clinically meaningful differences between arms for all RBC folate outcomes, and they suggest that cellular uptake of folate and folate transport to the infant do not differ in pregnant women starting DTG- versus EFV-based antiretroviral therapy.

Clinical Trials Registration

NCT03048422.
Digital Confessions: The Willingness to Disclose Intimate Information to a Chatbot and its Impact on Emotional Well-Being
Authors: Croes Emmelyn A J , Antheunis Marjolijn L , van der Lee Chris , de Wit Jan M S
Published: June 2024

Chatbots have several features that may stimulate self-disclosure, such as accessibility, anonymity, convenience and their perceived non-judgmental nature. The aim of this study is to investigate if people disclose (more) intimate information to a chatbot, compared to a human, and to what extent this enhances their emotional well-being through feelings of relief. An experiment with a 2 (human vs. chatbot) by 2 (low empathetic vs. high empathetic) design was conducted (N = 286). Results showed that there was no difference in the self-reported intimacy of self-disclosure between the human and chatbot conditions. Furthermore, people perceived less fear of judgment in the chatbot condition, but more trust in the human interactant compared to the chatbot interactant. Perceived anonymity was the only variable to directly impact self-disclosure intimacy. The finding that humans disclose equally intimate information to chatbots and humans is in line with the CASA paradigm, which states that people can react in a social manner to both computers and humans.
(163) IS THE ENDOGENOUS VASOACTIVE PEPTIDE OXYTOCIN A PHYSIOLOGICAL MEDIATOR OF PENILE ERECTION IN THE ADULT MALE?
Authors: Ückert Prof Stefan , Becker Prof Armin J , Bannowsky Priv-Doz Andreas , Tsikas Prof Dimitrios , Kuczyk Prof Markus A
Published: June 2024

Objectives

It is has been established that the pro-erectile effects of the activation of dopaminergic receptors (D1/D2), for example, by the receptor agonist apomorphine, involves oxytocinergic pathways descending from the hypothalamus to spinal autonomic centers. Although it has been demonstrated that, in rats, the injection of oxytocin into the paraventricular nucleus or the hippocampus induced penile erection, the significance of the peptide in the control of sexual arousal and penile erection in men still is only poorly understood. The present study was undertaken to determine as to whether oxytocin (OT) plasma levels alter in the systemic and cavernous blood of healthy males under different conditions of sexual arousal, as exemplified by the penile conditions flaccidity, tumescence, rigidity and detumescence.

Methods

Twenty-five (25) healthy adult males were exposed to visual and tactile erotic stimuli in order to elicit penile tumescence and rigid erection. Blood was taken from the corpus cavernosum (CC) and a cubital vein (CV) at the penile conditions flaccidity, tumescence, rigidity and detumescence. Following extraction from the plasma by applying an octadecasilyl silica matrix, oxytocin was measured by means of a radioimmunoassay (RIA).

Results

An increase was observed in median OT plasma levels (given in pg/ml) in the systemic and cavernous blood when the flaccid penis became tumescent (CV: from 71 ± 41 to 79 ± 49.5, CC: from 66.7 ± 34 to 75 ± 44). From tumescence to rigidity, OT further rose in the cavernous blood (to 81 ± 58), whereas it remained unaltered in the systemic circulation. During detumescence, oxytocin plasma levels dropped in the cavernous blood but again increased in the systemic blood (to 94 ± 49).

Conclusions

Based on the results, it seems likely that there is a role of OT in the mechanism of male sexual arousal and penile erection.

Conflicts of Interest

The authors have no conflcts of interest to declare.
(186) ERECTILE DYSFUNCTION AND ARTERIAL HYPERTENSION- A PROSPECTIVE STUDY IN GEORGIA
Authors: Khalvashi Dr Shorena , Marshania Zurab , Samteladze Mariam
Published: June 2024

Objectives

Arterial hypertension is the main risk factor for cardiovascular disease, which also affects erectile function and is considered one of the most common causes of erectile dysfunction. ED can also be caused by drugs used to treat arterial hypertension, namely: diuretics and beta-blockers, often used to treat arterial hypertension. The aim of our study was to find a correlation between the presence of arterial hypertension and the success of treatment with ED.

Methods

During the last 1 year, 240 male patients (aged 40 to 70 years) were treated with arterial hypertension. In 97 cases patients had ED, the following studies were conducted: blood pressure monitoring, electrocardiogram, heart ultrasound, 24-hour Holter monitoring, stress tests, and determination of lipid spectrum in blood. After the above-mentioned examinations, the patients were prescribed the appropriate group and dose of erectile dysfunction drugs (including PDE-5 inhibitors) together with the arterial hypertension drugs.

Results

Individuals who did not treat their hypertension and received only ED medications had a significantly lower erectile response rate than those who received ED medications along with antihypertensive medications.

Conclusions

The involvement of a cardiologist along with a sexologist in the process of timely diagnosis and relevant treatment of patients with ED has crucial importance for the successful management of ED.

Conflicts of Interest

There are no conflicts of Interest.
(366) EFFICACY OF NUTRACEUTICALS IN THE TREATMENT OF ERECTILE DYSFUNCTION: A NETWORK META-ANALYSIS
Authors: Tienforti Dr Daniele , Di Giulio Dr Francesca , Spagnolo Dr Luca , D'Alessandro Dr Francesco , Antolini Dr Federica , Palazzi Dr Sara , Castellini Chiara , Barbonetti Prof Arcangelo
Published: June 2024

Objectives

We evaluated the effects of different nutraceutical formulations widely available worldwide as alternative treatment strategies in improving erectile function in men with erectile dysfunction (ED) using a network meta-analysis (NMA) approach.

Methods

A search of PubMed, Scopus, Cinahl, and Cochrane Library was performed, limited to studies using IIEF-score, published through September 2023. To facilitate the efficacy rating for individual nutraceutical treatments, we excluded studies in which more than three different molecules were used in combination in the same group. We performed direct pairwise meta-analyses and then a frequentist random-effects NMA to incorporate estimates from direct and indirect comparisons. The surface area under the cumulative classification curve (SUCRA) expresses the percentage of effectiveness of each treatment relative to an “ideal” treatment, using values range from 0 to 100%.

Results

The included 16 RCTs investigated 13 nutraceutical preparations. At the NMA forest plot (Figure 1), when compared with placebo, significant improvements in IIEF score were induced by L-arginine, acetil L-carnitine (ALC) + propionil L-carnitine (PLC), L-arginine + Tadalafil, ALC + PLC + Sildenafil. Among the different nutraceutics, the association between ALC, PLC and sildenafil was associated to the highest SUCRA (0.96), followed by the association between L-arginine and Tadalafil (0.84), ALC + PLC (0.79) and L-arginine (0.55).

Conclusions

In the context of the widespread ineffectiveness of most nutraceutical preparations, this NMA of available RTCs has identified a small group of compounds that are potentially useful in ED, particularly when used in combination with PDE5 inhibitors. The combination of ALC and PLC, especially in the presence of Sildenafil, and L-Arginine, especially in combination with Tadalafil, produced higher IIEF score improvements. These findings should be interpreted with caution, but are of value in narrowing the field to a small number of compounds whose actual efficacy needs to be confirmed through targeted prospective studies in patients of ED of different etiologies.

Conflicts of Interest

We have no conflicts of interest to disclose.
(153) PENILE REHABILITATION AFTER NERVE-SPARING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY: PRELIMINARY DATA OF A PROSPECTIVE FEASIBILITY STUDY
Authors: Cox Inge L , van Leeuwen Pim J , van Muilekom Henricus A , van der Poel Prof Henk G , Nicolai Melianthe P
Published: June 2024

Objectives

Over the past decade, only 35% of patients experienced good erectile function two years after a nerve-sparing radical prostatectomy (nsRP), likely due to damaged neurovascular bundles and cavernosal tissue fibrosis during neuronal recovery. Given the limited prospective data, the ideal multimodal rehabilitation for enhancing erectile function following nsRP remains unclear. This study examined the feasibility and effectiveness of a multimodal penile rehabilitation program, involving daily sildenafil (100mg) and vacuum pump (VED) therapy (5 days a week, generating 5 erections per day).

Methods

Between May 2021 and October 2022, the study enrolled patients who had a good preoperative erection, undergone nsRP, and no history of pelvic radiotherapy, contraindications for sildenafil, or systemic neurological disorders. During follow up the adjustment of sildenafil dosage to 75mg to manage any side effects, was allowed. Feasibility was assessed by monitoring dropout rates due to program-related side effects. Furthermore, the assessment of erection rigidity was done every three months up to 18 months postoperatively, using both clinical reports and patient-reported outcome measures.

Results

55 patients were initially enrolled. They had a median start time of 7 weeks post-nsRP. To date, 13 discontinued and 8 adjusted sildenafil to 75mg due to side effects. Among the 32 who completed a year in the program, 13 patients regained spontaneous erections, resulting in the program being deintensified to on-demand use of PDE5i and/or VED. Among the 18 patients who have reached the 18-month follow-up mark, 88% and 50% reported a good assisted and unassisted erection, respectively.

Conclusions

So far, most patients tolerated the multimodal strategy well, with a 24% dropout rate. The majority of patients who completed the rehabilitation program reported having a good assisted erection and half of these patients already reported good unassisted erections after 1.5 year of follow up.

Conflicts of Interest

No conflicts of interest.
(326) LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY IMPROVES PAIN IN PATIENTS WITH PEYRONIE’S DISEASE
Authors: Rubino Dr Matteo , Ricapito Dr Anna , Finati Dr Marco , Falagario Dr Ugo G , Annese Dr Pasquale , Busetto Prof Gian M , Cormio Prof Luigi , Carrieri Prof Giuseppe , Bettocchi Prof Carlo
Published: June 2024

Objectives

Low-intensity extracorporeal shockwave therapy (LI-ESWT) is a recent introduction therapy in the treatment of Peyronie’s disease (PD) with pain during erection that consists of 8 sessions of approximately 20 minutes each and a number of strokes applied varies from 2000 to 3000 for each session which appear to act by stimulating a pro-inflammatory response in the tissues on which it is applied. The key step is the stimulation of the expression of the VEGF (Vascular Endothelial Growth Factor) gene and so the consequent neoangiogenesis and blood overflow would lead to a series of modifications at the level of the plaque in PD that would ultimately lead to the inhibition of the inflammatory process in progress and this would seem to reduce the pain typical of the acute phase and it would also seem effective in reducing the size of the plaque itself and avoiding a worsening of the penile curvature in erection.

Methods

A prospective cohorts of 23 patients with PD presenting with pain during erection was evaluated. Every patient underwent standardized baseline visit at our Department, including physical examination, medical history, International Index of Erectile Dysfunction (IIEF) and pain evaluation. Pain during erection was the indication for treatment that was administered for 8 sessions. After treatment, all patients repeated the pain evaluation and IIEF questionnaire to evaluate the improvement through t-test.

Results

Median age of patients was 52.5 years. After treatment pain was improved in the whole cohort (100%). A significant improvement in the IIEF score was observed after Li-ESWT sessions (p value < 0.001).

Conclusions

This initial study shows that there is a significant improvement of pain after shock wave treatment at in patients affected by Peyronie’s disease. An improved IIEF score after treatment was also observed. Larger cohort is needed to better evaluate Li-ESWT effect of pain and IIEF score in men with Peyronie’s disease.

Conflicts of Interest

This initial study shows that there is a significant improvement of pain after shock wave treatment at in patients affected by Peyronie’s disease. An improved IIEF score after treatment was also observed. Larger cohort is needed to better evaluate Li-ESWT effect of pain and IIEF score in men with Peyronie’s disease.
(385) HYPOTHALAMIC ESTROGEN RECEPTOR ANTAGONISTS MAY HAVE A PROGNOSTIC ROLE IN SUBCLINICAL HYPOGONADISM IN PATIENTS WITH ERECTILE DYSFUNCTION AND INFERTILITY
Authors: Arian Dr Iurii , Dumbraveanu Prof Ion , Ghenciu Dr Victoria , Creciun Dr Mariana , Ceban Prof Emil
Published: June 2024

Objectives

It is already a common clinical practice to not use hypothalamic estrogen receptor antagonists and aromatase inhibitors in hypergonadotropic hypogonadism, as gonadotropins will rise. From clinical observation, normo-gonadotropic hypogonadal males may have elevated gonadotropin levels on hypothalamic estrogen receptor antagonists. The purpose of this study is to evaluate erectile function, hormonal and semen parameters changes in clomiphene-induced high LH and FSH levels.

Methods

A retrospective study was done on 83 normo-gonadotropic hypogonadal males with symptoms of ED and infertility, mean age 35,56±9,09 years, to whom treatment with Clomiphene citrate was recommended, and at follow-up visits, elevated gonadotropins were found. Pre-treatment and on treatment LH (mIU/mL), FSH (mIU/mL), total T (ng/dL), E (pg/mL), and semen parameters were compared. IIEF-5 scoring was used for ED evaluation.

Results

Accordingly, with IIEF-5 scoring, 17.5% reported severe ED, 31.3% with moderate, 21% with mild-moderate, and 31.2% with mild ED. Before treatment hormones and semen mean values: LH (4.04±3.62), FSH (5.43±4.62), total T (208±87.9), E (27.4±15.22), sperm concentration (12.45±8.61), PR motility (27.56±18.13). On treatment 28 (33.73%) male were found with LH only high level with mean value 13.54±6.48. 55 (66.27%) male with Clomiphene induced hypergonadotropic (LH and FSH) hypogonadism was reported with semen and hormonal mean values: LH (12.04±4.98), FSH (15.43±5.62), total T (475.8±244.9), E (48.4±19.22), sperm concentration (18.15±12.87), PR motility (36.56±13.47). In 13 (15.66%) induced high LH and FSH males, semen parameters got worse, with mean values: sperm concentration (7.63±4.91) and PR motility (22.21±7.63).

Conclusions

Follow-up hormonal evaluation during hypothalamic estrogen receptor antagonist treatment should be mandatory, as elevated gonadotropin levels may have a negative impact on semen parameters, gynecomastia, and overall testicular function.

Conflicts of Interest

No conflict of interest to delcare.
(179) SIMULATION OF ERECTILE TISSUE SHOCKWAVE ENERGY ABSORPTION DURING LOW LISWT FOR ERECTILE DYSFUNCTION
Authors: Goldstein Dr Irwin , Theuer Prof Axel E , Hopfenzitz Nikolaus , Warlick John
Published: June 2024

Objectives

Low intensity shockwave therapy (LiSWT) treats ED by inducing mechanotransduction regenerative mechanisms; the greater the shockwave energy absorbed in cavernosal erectile tissue, the greater the opportunity for mechanotransduction. Energy absorption may be improved by erect vs flaccid penile treatment. Compared to flaccid, erect intracavernosal penile pressure is 16-fold higher and erect blood volume >2 times greater, both properties determinants of tissue energy wave velocity. Additionally, energy absorption may be improved using a symmetry-matched secondary reflector. This may reflect shockwave energy back to the erectile tissue that had previously passed through the penis. We performed a simulation of energy absorption during LiSWT in flaccid/erect penis with/without a reflector.

Methods

This energy model used the UroGold100 MTS/Softwave TRT electrohydraulic shockwave device. Sound propagation in tissue can be illustrated via computer simulation by mathematically calculating damping and deflection of the sound wave by different tissue structures. Finite Element Method (FEM) simulation models are suitable for the mathematical description of complex processes of shockwave propagation. Based on results, a “prediction” of propagation of LiSWT in tissue is possible. This patient-specific procedure is based on consideration of individual anatomical structures: corporal lacunar spaces and physical-acoustic laws. For FEM modeling of LiSWT propagation, program systems ANSYS, MATLAB and PZFLEX/ONSCALE were used.

Results

Using the FEM calculation model of the simulation analyses, the shockwave pulse was applied at the bottom edge of the model. This pulse propagated through the erect/flaccid states; there was most energy absorption in the erect state with a reflector. In addition, the simulation model showed that increasing penile pressure during erection with a constant volume increased energy absorption.

Conclusions

More energy is absorbed in cavernosal erectile tissue to achieve mechanotransduction during erection than flaccidity, and with a symmetric reflector. Such strategies should be considered when performing shockwave therapy for ED.

Conflicts of Interest

Erich Theuer is a consultant to MTS.

Nikolaus Hopfenzitz is an employee of MTS.

John Warlick is owner of Softwave/TRT.
(190) META-ANALYTIC PATH ANALYSIS OF THE EFFECTIVENESS OF THE HEALTH BELIEF MODEL IN PREDICTING WOMEN'S SEXUAL HEALTH BEHAVIOR: BREAST CANCER AS AN EXAMPLE
Authors: Liao Chi Hwa , Shih Prof Chun Ming , Chung Peng Chen , Yang Prof Shu Ling
Published: June 2024

Objectives

To use the Health Belief Model to predict women’s sexual health behaviors, with a specific focus on breast cancer.

Methods

Electronic databases were searched between 1974 and 2020 by two independent reviewers using Science Direct Online (SDOL), PubMed, ProQuest, and Google Scholar databases. Search terms included “Health Belief Models”, “breast cancer screening”, “perceived benefit”, “perceived susceptibility”, “perceived severity”, “perceived barrier”, “self- efficacy”, or “cue to action”. Statistical analysis used meta-analytic path analysis approaches.

Results

47 papers were included, and 324 statistical data were analyzed. Meta-analytic path analysis showed that the health belief model had the highest predictive power for mammography (19.30%), followed by breast self-examination, and the lowest predictive power for clinical breast examination. Self-efficacy (β= 0.64, SE =0.02, p < .001) was the strongest positive factor in the health belief model predicting mammography. Perceived severity (β = -0.13, SE =0.02, p < .001) and perceived barrier were negative factors (β = -0.40, SE =0.02, p < .001). In addition, in the survey of moderating variables, subject characteristics such as ages, educational levels, marital status, races, and countries, as well as the publication dates and study designs, had a significant influence on female sexual health behaviors.

Conclusions

Among the common breast cancer screening methods, the Health Belief Model was the strongest predictor of mammography. Perceived barrier was found to be the primary negative predictor of mammography. Subjects experienced greater difficulty in undergoing mammography, possibly because of pain or discomfort associated with the procedure.

Conflicts of Interest

The authors declare no conflicts of interest.