bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of the skin microbiome in wound healing
Authors: Yang Yuyan , Huang Jiuzuo , Zeng Ang , Long Xiao , Yu Nanze , Wang Xiaojun
Published: March 2024

The efficient management of skin wounds for rapid and scarless healing represents a major clinical unmet need. Nonhealing skin wounds and undesired scar formation impair quality of life and result in high healthcare expenditure worldwide. The skin-colonizing microbiota contributes to maintaining an intact skin barrier in homeostasis, but it also participates in the pathogenesis of many skin disorders, including aberrant wound healing, in many respects. This review focuses on the composition of the skin microbiome in cutaneous wounds of different types (i.e. acute and chronic) and with different outcomes (i.e. nonhealing and hypertrophic scarring), mainly based on next-generation sequencing analyses; furthermore, we discuss the mechanistic insights into host–microbe and microbe–microbe interactions during wound healing. Finally, we highlight potential therapeutic strategies that target the skin microbiome to improve healing outcomes.
Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2024 Update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)
Authors: Miller J Michael , Binnicker Matthew J , Campbell Sheldon , Carroll Karen C , Chapin Kimberle C , Gonzalez Mark D , Harrington Amanda , Jerris Robert C , Kehl Sue C , Leal Sixto M , Patel Robin , Pritt Bobbi S , Richter Sandra S , Robinson-Dunn Barbara , Snyder James W , Telford Sam , Theel Elitza S , Thomson Richard B , Weinstein Melvin P , Yao Joseph D
Published: March 2024

The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician and the microbiologists who provide enormous value to the healthcare team. This document, developed by experts in both adult and pediatric laboratory and clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. Sections are divided into anatomic systems, including Bloodstream Infections and Infections of the Cardiovascular System, Central Nervous System Infections, Ocular Infections, Soft Tissue Infections of the Head and Neck, Upper Respiratory Infections, Lower Respiratory Tract Infections, Infections of the Gastrointestinal Tract, Intraabdominal Infections, Bone and Joint Infections, Urinary Tract Infections, Genital Infections, and Skin and Soft Tissue Infections; or into etiologic agent groups, including arboviral Infections, Viral Syndromes, and Blood and Tissue Parasite Infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. In addition, the pediatric needs of specimen management are also addressed. There is redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a reference to guide physicians in choosing tests that will aid them to diagnose infectious diseases in their patients.
Taxonomic, phylogenetic, and functional nestedness of mammal assemblages in the Zhoushan Archipelago, China
Authors: Zhan Chengxiu , Li Bicheng , Chen Chuanwu , Wang Yanping
Published: March 2024

Nestedness is an important part of the theoretical framework of island biogeography and community ecology. However, most previous studies focused on taxonomic dimension and overlooked functional and phylogenetic nestedness. Here, we simultaneously investigated taxonomic, functional, and phylogenetic nestedness of terrestrial mammals on 39 land-bridge islands in the Zhoushan Archipelago, China. As mammals’ response to the environment may depend on their body size, we performed analyses for three mammal assemblages separately: overall species, large and medium-sized species, and small species. The taxonomic nestedness was quantified by organizing the species incidence matrix, while the functional and phylogenetic nestedness were estimated by combining the similarity of their ecological traits and phylogeny. Island characteristics (island area, three isolation indices, land use intensity, and habitat diversity) and species traits (body size, litter size, habitat specificity, geographic range size, and minimum area requirement) were used as predictors of nestedness. Overall and small species were significantly nested in 3 facets of nestedness, and results supported the selective extinction, selective colonization, and habitat nestedness hypotheses. Large and medium-sized species were functionally and phylogenetically nested when matrices were ordered by increasing distance to mainland, supporting the selective colonization hypothesis. Overall, differences in nestedness and its underlying mechanisms were detected not only in 3 facets of nestedness but also in the 3 mammal assemblages. Therefore, frameworks that incorporate taxonomic, phylogenetic, and functional nestedness can contribute to a more comprehensive understanding of nestedness processes. Additionally, it also improves our ability to understand the divergent responses of mammal assemblages to the insular environment.
Atrial secondary tricuspid regurgitation: pathophysiology, definition, diagnosis, and treatment
Authors: Muraru Denisa , Badano Luigi P , Hahn Rebecca T , Lang Roberto M , Delgado Victoria , Wunderlich Nina C , Donal Erwan , Taramasso Maurizio , Duncan Alison , Lurz Philipp , De Potter Tom , Zamorano Gómez José L , Bax Jeroen J , von Bardeleben Ralph Stephan , Enriquez-Sarano Maurice , Maisano Francesco , Praz Fabien , Sitges Marta
Published: March 2024

Atrial secondary tricuspid regurgitation (A-STR) is a distinct phenotype of secondary tricuspid regurgitation with predominant dilation of the right atrium and normal right and left ventricular function. Atrial secondary tricuspid regurgitation occurs most commonly in elderly women with atrial fibrillation and in heart failure with preserved ejection fraction in sinus rhythm. In A-STR, the main mechanism of leaflet malcoaptation is related to the presence of a significant dilation of the tricuspid annulus secondary to right atrial enlargement. In addition, there is an insufficient adaptive growth of tricuspid valve leaflets that become unable to cover the enlarged annular area. As opposed to the ventricular phenotype, in A-STR, the tricuspid valve leaflet tethering is typically trivial. The A-STR phenotype accounts for 10%–15% of clinically relevant tricuspid regurgitation and has better outcomes compared with the more prevalent ventricular phenotype. Recent data suggest that patients with A-STR may benefit from more aggressive rhythm control and timely valve interventions. However, little is mentioned in current guidelines on how to identify, evaluate, and manage these patients due to the lack of consistent evidence and variable definitions of this entity in recent investigations. This interdisciplinary expert opinion document focusing on A-STR is intended to help physicians understand this complex and rapidly evolving topic by reviewing its distinct pathophysiology, diagnosis, and multi-modality imaging characteristics. It first defines A-STR by proposing specific quantitative criteria for defining the atrial phenotype and for discriminating it from the ventricular phenotype, in order to facilitate standardization and consistency in research.
Genomic Resources and Annotations for a Colonial Ascidian, the Light-Bulb Sea Squirt Clavelina lepadiformis
Authors: Daric Vladimir , Lanoizelet Maxence , Mayeur Hélène , Leblond Cécile , Darras Sébastien
Published: March 2024

Ascidian embryos have been studied since the birth of experimental embryology at the end of the 19th century. They represent textbook examples of mosaic development characterized by a fast development with very few cells and invariant cleavage patterns and lineages. Ascidians belong to tunicates, the vertebrate sister group, and their study is essential to shed light on the emergence of vertebrates. Importantly, deciphering developmental gene regulatory networks has been carried out mostly in two of the three ascidian orders, Phlebobranchia and Stolidobranchia. To infer ancestral developmental programs in ascidians, it is thus essential to carry out molecular embryology in the third ascidian order, the Aplousobranchia. Here, we present genomic resources for the colonial aplousobranch Clavelina lepadiformis: a transcriptome produced from various embryonic stages, and an annotated genome. The assembly consists of 184 contigs making a total of 233.6 Mb with a N50 of 8.5 Mb and a L50 of 11. The 32,318 predicted genes capture 96.3% of BUSCO orthologs. We further show that these resources are suitable to study developmental gene expression and regulation in a comparative framework within ascidians. Additionally, they will prove valuable for evolutionary and ecological studies.
Aging, Race, and Health Disparities: Recommendations From the Research Centers Collaborative Network
Authors: Jain Snigdha , Bey Ganga S , Forrester Sarah N , Rahman-Filipiak Annalise , Thompson Gonzalez Nicole , Petrovsky Darina V , Kritchevsky Stephen B , Brinkley Tina E
Published: March 2024

Racial disparities in adverse health outcomes with aging have been well described. Yet, much of the research focuses on racial comparisons, with relatively less attention to the identification of underlying mechanisms. To address these gaps, the Research Centers Collaborative Network held a workshop on aging, race, and health disparities to identify research priorities and inform the investigation, implementation, and dissemination of strategies to mitigate disparities in healthy aging. This article provides a summary of the key recommendations and highlights the need for research that builds a strong evidence base with both clinical and policy implications. Successful execution of these recommendations will require a concerted effort to increase participation of underrepresented groups in research through community engagement and partnerships. In addition, resources to support and promote the training and development of health disparities researchers will be critical in making health equity a shared responsibility for all major stakeholders.
Leveraging citizen science for monitoring urban forageable plants
Authors: Soares Filipi Miranda , Ferreira Pires Luís , Garcia Maria Carolina , Bouzembrak Yamine , Coradin Lidio , Ghilardi-Lopes Natalia Pirani , Silva Rubens Rangel , de Carvalho Aline Martins , Maculan Benildes Coura Moreira dos Santos , Koffler Sheina , Montedo Uiara Bandineli , Drucker Debora Pignatari , Santiago Raquel , Gavai Anand , de Carvalho Maria Clara Peres , Lima Ana Carolina da Silva , Gabriel Hillary Dandara Elias , de França Stephanie Gabriele Mendonça , de Almeida Karoline Reis , dos Santos Bárbara Junqueira , Saraiva Antonio Mauro
Published: March 2024

Urbanization brings forth social challenges in emerging countries such as Brazil, encompassing food scarcity, health deterioration, air pollution, and biodiversity loss. Despite this, urban areas like the city of São Paulo still boast ample green spaces, offering opportunities for nature appreciation and conservation, enhancing city resilience and livability. Citizen science is a collaborative endeavor between professional scientists and nonprofessional scientists in scientific research that may help to understand the dynamics of urban ecosystems. We believe citizen science has the potential to promote human and nature connection in urban areas and provide useful data on urban biodiversity.
Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship
Authors: Ngoma Maty Tsumbu , Sitali Doreen , Mudenda Steward , Mukuma Mercy , Bumbangi Flavien Nsoni , Bunuma Emmanuel , Skjerve Eystein , Muma John Bwalya
Published: March 2024

Introduction

Antimicrobial resistance (AMR) is a global public health crisis. This study assessed the general public’s consumption of antibiotics and associated factors in the Lusaka district of Zambia.

Methods

This cross-sectional study was conducted among 2038 participants between December 2022 and January 2023. Data were analysed using Stata 13.0. Multivariable regression techniques were used to determine the factors that influenced antibiotic consumption.

Results

Of the 2038 participants, 53.4% were female, and 51.5% had attended at least secondary school. Antibiotic use was 99.2%, of which 40.9% were appropriately used. Overall, 79.1% of antibiotics were prescribed in hospitals, while 20.9% were used from leftovers and accessed without prescriptions. This study found that the appropriate use of antibiotics was associated with being female, being aged 35 years and above, attaining secondary school or tertiary education, having a monthly expenditure of 195 USD and above, being aware that antibiotics were not the same as painkillers, and being confident that when someone was hospitalized, they would get well.

Conclusions

This study found that the appropriate use of antibiotics was low, and this is an urgent public health issue requiring community engagement in tackling AMR and adherence to treatment guidelines in healthcare facilities. Additionally, there is a need to implement and strengthen antimicrobial stewardship programmes in healthcare facilities to promote the rational use of antibiotics in Zambia. There is also a need to heighten community awareness campaigns and educational activities on the appropriate use of antibiotics.
A comprehensive approach for evaluating the virucidal performance of domestic laundry detergents under practical conditions
Authors: Konkol Justyna E , Becker Britta , Paulmann Dajana , Steinmann Eike , Todt Daniel , Meister Toni L , Evers Stefan , Weide Mirko , Dotzauer Andreas , Brill Florian H H
Published: March 2024

Aims

We aimed to develop a method to assess the virucidal performance of domestic laundry in a lab-scale washing machine (Rotawash) based on EN 17658.

Methods and results

For method development, virus recovery was investigated after drying on cotton carriers for three test viruses murine norovirus (MNV), modified vaccinia virus Ankara (MVA), and bovine coronavirus (BCoV), followed by washing simulations in flasks and Rotawash. MNV and MVA demonstrated sufficient recovery from carriers after drying and washing (up to 40°C and 60 min). BCoV exhibited lower recovery, indicating less relevance as a test virus. Rotawash efficacy tests conducted with MNV, a resistant, non-enveloped virus, showed limited efficacy of a bleach-free detergent, aligning with results from a domestic washing machine. Rotawash washes achieved higher reductions in infectious virus titers than suspension tests, indicating the role of washing mechanics in virus removal.

Conclusions

This study established a practical method to test the virucidal efficacy of laundry detergents in Rotawash, simulating domestic washing.
Effects of photoperiod and temperature on the developmental duration and diapause in Dolycoris baccarum (Heteroptera: Pentatomidae) from Hohhot, Inner Mongolia, China
Authors: Tian Ruilin , Hou Zhanming , Li Song , Chai Hua
Published: March 2024

The shield bug, Dolycoris baccarum (L.) (Heteroptera: Pentatomidae), is widely distributed across Asia and Europe. At high latitudes, it overwinters, as adult in diapause, which then becomes the insect source for the following year. To fully understand the developmental duration and diapause characteristics of D. baccarum, the effects of photoperiod and temperature were studied in a population from Hohhot, Inner Mongolia, China. The results indicated that the developmental duration was significantly prolonged at temperatures of 20 or 25 °C, with a prolonged light period; however, when the light period was prolonged to 16L:8D and 18L:6D, the developmental duration was shortened significantly. Furthermore, the developmental duration was also shortened significantly with increasing temperature, when the photoperiod was 12L:12D for short days and 16L:8D for long days. All individuals entered diapause under short-day conditions of 10L:14D and 12L:12D at a temperature of 20 °C; however, the diapause rate decreased significantly under 14L:10D and 16L:8D photoperiods, and the diapause rate decreased significantly at a temperature of 25 °C with prolonged photoperiod. Interestingly, when the photoperiod was fixed at 12L:12D, the diapause rates at different temperatures (20, 25, 28, and 30 °C) exceeded 95%; while the effect of temperature on diapauses was nonsignificant under this photoperiod, it was still sensitive to the photoperiod; at a photoperiod of 16L:8D, the effect of temperature on the diapause rate was noticeable, and the diapause rate decreased significantly with increasing temperature.
Therapeutic Singing and Semi-Occluded Vocal Tract Exercises for Individuals with Parkinson’s Disease: A Randomized Controlled Trial of a Single Session Intervention
Authors: Lee Sun Joo , Dvorak Abbey L , Manternach Jeremy N
Published: March 2024

Individuals with Parkinson’s disease (PD) experience speech and voice-related symptoms that diminish communication and quality of life. Semi-occluded vocal tract (SOVT) exercises are targeted interventions that, when combined with the positive psychosocial benefits of therapeutic group singing (TGS), may affect outcomes. The purpose of this study was to explore the effectiveness of SOVT exercises, specifically straw phonation combined with TGS, to improve voice quality and mood for individuals with PD. We used a true experimental pretest–posttest between-subjects design (i.e., randomized controlled trial) facilitated by a board-certified music therapist. All participants (N = 27) were randomly assigned to one of three groups (a) straw phonation combined with TGS (SP + TGS, n = 10), (b) TGS (n = 10), and (c) speaking-only control group (n = 7). Participants completed voice recordings for acoustic measures and the Visual Analogue Mood Scale for mood analysis before and after a 30-min intervention. The results demonstrated significant improvement in voice quality evidenced by decreasing Acoustic Voice Quality Index scores following a single session for both SP + TGS and TGS intervention groups when compared to the control. Happiness scores improved in the experimental groups when compared to control. Although not statistically significant, participants in the experimental groups (SP + TGS, TGS) demonstrated better mean mood scores on happiness, anxiety, and angry when compared to control, indicating a positive psychological response to the singing interventions. Overall, this study indicated the effectiveness of SP + TGS and TGS as promising therapeutic interventions for voice quality and mood in individuals with PD.
(007) Impact of Non-Invasive Oestrus Synchronization on Sexual Behavior in Intact Sprague Dawley Rats
Authors: Seijas G , Comerma Steffensen S G , Gomez Del Val A , Wegener G , Simonsen U
Published: March 2024

Introduction

Female sexual behavior animal translation data do not translate to acute results and neither current synchronization invasive models (ovariectomy+Estrogen “E2”+Progesterone “P4”) guarantee hormonal physiological values.

Objective

Therefore, our study investigated the effect of non-invasive oestrus synchronization on sexual behavior.

Methods

Methods: Twelve week old Sprague Dawley intact rats were synchronized and randomly divided into three groups each of n=8-10. Each group received a dose of prostaglandin F2α “PGF2α” (75, 125 and 250 μg) at days 0 and 3, and 1 mg of progesterone at day four. Vaginal cytology was performed to determine the point of the cycle and the animals underwent an incentive test. To investigate the sexual behavior, the synchronized female rats were paired with trained male rats, and behavior recorded. The videos were quantified by trained operators. Sexual behavior was quantified as paracopulatory (hops, darts, ear wiggling, sniffing from male and from female) or copulatory (male mounting female, thrusting from male, intromission, ejaculation, female for sniffing position, lordosis, orgasm, female mounting on male, female rotation in her axis and female licking itself), E2 and Follicle Stimulating hormone (FSH) in plasma and E2 in vaginal fluid were quantified by immune assay.

Results

Based on the vaginal cytology, the proportion of animals in proestrus (p), estrus (e) or metestrus (m) was calculated with values of 0.5 (p), 0.25 (e) and 0.25 (m) for the group which received 0.75 μg PGF2α; 0.4 (p), and 0.6 (e) for the group which received 0.125 μg PGF2α; 0.2 (p), 0.5 (e), and 0.3 (m) for the group which received 250 μg PGF2α. The numbers of hops was higher in the proestrus compared to the metestrus, and of mounts higher in the estrus compared to the metestrus phase. The sexual encounter profile and E2 levels were unchanged with the different PGF2α doses, but in the high-dose group no hops were observed. The levels of sexual behavior was comparable to previous studies of hormone substituted ovariectomized rats, but E2 and FSH plasma levels were in a physiological range.

Conclusions

In summary, the non-invasive synchronization protocol could substitute the state-of-the-art used ovariectomized+hormone (E2) model. Our findings suggest the largest part of rats were synchronized in the oestrus phase with 125 μg PGF2α. but the 250 μg had also a positive profile.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Initiator Pharma A/S.
(009) Erogenous Zones of the Vagina and Vulva: An Anatomic Map-Based Study
Authors: Stelmar J , Zaliznyak M , Isaacson D , Duralde E , Sandhu S , Mallavarapu S , Smith S , Gaither T , Topp K , Garcia M
Published: March 2024

Introduction

Erogenous sensation zones (ESZs) of the body elicit sexual arousal in response to touch. Prior studies have established general maps of external ESZs, but they did not assess internal surfaces or focus on individual structures of the genitalia.

Objective

To develop a topographic map of the ESZs of the vulva and vagina.

Methods

A sample of n=451 sexually active cisgender women (mean age 48.9 ± 15.5 years) were administered an anonymous, online questionnaire via Qualtrics. Respondents selected predefined areas from anatomic illustrations of the vulva and vagina that bring them pleasure when touched during sex. Respondents then rated the importance of each zone to their sexual pleasure on a 10-point Likert scale.

Results

More respondents selected at least one area of the vulva as an ESZ (82%), as compared to the vagina (59.4%). Of the vulva (Figure 1), the clitoris, peri urethra, and vaginal introitus were the three most frequently selected and highest rated structures. The five ESZs of the vagina (Figure 2) revealed a preference for the superficial anterior region of the vaginal canal. The cervix and posterior areas were selected and rated lower than the superficial aspects.

Conclusions

The vulva and vagina were associated with enhanced erogenous sensation not only at (but also in regions immediately peripheral to) the clitoris. These ESZs were also rated as "highly important" to sexual pleasure. Notwithstanding these trends, the wide range of selection-frequency and pleasure-importance ratings emphasizes the subjective and varying experience of sexual arousal between individuals. These ESZ maps may enhance patient education, particularly among individuals who suffer from sexual dysfunction or other factors that lend to diminished sexual arousal.

Disclosure

No.
(010) Assessment of Cannabis Use Before Partnered Sex on Women who Experience Orgasm Difficulty
Authors: Mulvehill S , Tishler J
Published: March 2024

Introduction

Up to 41% of women experience female orgasm disorder/difficulty (FOD), a statistic unchanged for 50 years. Despite this, there is a paucity of validated treatments. Research has suggested cannabis as a treatment for female sexual disorders for more than 50 years. Yet a literature review revealed no studies evaluating cannabis as a treatment specifically for FOD and no studies comparing women with and without FOD. This study is the first to evaluate cannabis as a treatment for FOD specifically in women with and without FOD.

Objective

Evaluate the effect of cannabis use before partnered sex on women with and without FOD.

Methods

This IRB-approved observational study conducted between March 24, 2022, and November 18, 2022, evaluated baseline demographics, sexual behavior, mental health, cannabis use, and the orgasm subscale questions of the Female Sexual Function Index (FSFI), evaluating orgasm frequency, orgasm satisfaction, and orgasm ease, with and without cannabis before partnered sex.

Results

Of 1,037 survey responses, the researchers received 410 valid, completed surveys; failure to meet the study’s criteria required excluding 23 (5.6%) surveys. Among the 387 valid survey participants, the majority of women, 52% (n = 202) reported orgasm difficulty, were between the ages of 25–34 (45%, n = 91), reported their race as white (75%, n = 152), and were married or in a relationship (82%, n = 165). Among respondents reporting orgasm difficulty (n = 202), cannabis use before partnered sex increased orgasm frequency (72.8%, n = 147/202, p < .001), improved orgasm satisfaction (67%, n = 136/202, p < .001) or made orgasm easier (71%, n = 143/202, p < .001). Frequency of cannabis use before partnered sex correlated with increased orgasm frequency for women with FOD (n = 202, p< .001). Orgasm response to cannabis depended on the reasons for use (n = 202, p = .022). Women with FOD reported 24% more mental health issues, 52.6% more PTSD, 29% more depressive disorders, 13% more anxiety disorders, and 22% more prescription drug use than women without FOD. Women with FOD were more likely to report sexual abuse history than women without FOD (38.6%, n=74/202).

Conclusions

Fifty years of sexuality research support use of cannabis for sexual difficulties. This is the first study to look at FOD specifically, demonstrating significant benefit. Randomized controlled studies are needed to evaluate cannabis’ efficacy on FOD sub-types, mental health and physical health conditions and other clinical implications; evaluating dosage, strain, timing, and method of intake. References Laumann et al., 2005 Kontula & Miettinen, 2016 Keiman & Meston, 1997 Dawley et al., 1979 Gorzalka et al., 2010 Klein et al., 2012 Lewis, 1970 Moser et al., 2023.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: inhaleMD.
(012) Sexual Dysfunction in Men After Failed Hypospadias Repair
Authors: Shatylko T , Gamidov S , Dusmukhamedov R
Published: March 2024

Introduction

Hypospadias is commonly treated in childhood, and future sexual function of such patients is sometimes overlooked. Some published reports reveal excellent sexual function following hypospadias repair at long term, while other authors state high prevalence of sexual dysfunction which depends on original position of urethral meatus. Patients with complications of primary hypospadias repair are one of the most difficult subpopulations to evaluate. This is a unique subset of patients who should be described separately from men who underwent successful hypospadias repair.

Objective

To describe the spectrum of sexual dysfunction in patients with sequelae of failed hypospadias repair and our experience in its management.

Methods

We evaluated 112 patients with a history of failed hypospadias repair, defined as presence of voiding symptoms or cosmetic problems remaining despite previous surgery or caused by it. Patients’ median age was 29.5 years (range: 18–62). There were no intersex cases. Only 9.8% (11/112) underwent single attempt at surgical reconstruction, the median number of attempts was 3.5 (range: 1–9). Patients with IIEF-EF score ≤ 25 were considered to have erectile dysfunction; those with IIEF-EF ≤ 16 underwent penile doppler ultrasound, penile electromyography and endocrine assessment.

Results

64.2% of patients (72/112) were dissatisfied with penile appearance, 40.2% (45/112) had ED, 71.4% (80/112) had ejaculation disorders. Psychogenic ED was diagnosed in 21 patients with preserved non-coital erections and no evidence of organic ED. Median IIEF-EF in ED patients was 20 (range: 8–25). Asthenic ejaculation, delayed ejaculation and anejaculation were present in 63.4% (71/112), 7.1% (8/112) and 3.5% (4/112) patients, respectively. Premature ejaculation was present in 28.6% (32/112) patients, but its association with hypospadias or previous surgery is unlikely. On univariate analysis only the number of previous attempts at surgical repair was a significant predictor of sexual dysfunction following definitive surgery (p = 0.033). Rate of normal sexual function was 37.5%, 23.5% and 9.1% among patients with history of ≤ 3, 4–6 and ≥ 7 procedures, respectively.

Conclusions

Failed hypospadias repair may lead to a wide spectrum of sexual dysfunction, involving sexual desire, erection and ejaculation. Repeated surgery leads to increased risk of sexual dysfunction which may be devastating for patient’s quality of life.

Disclosure

No.
(028) Intracavernosal Injection of Platelet-Rich Plasma for the Treatment of Erectile Dysfunction: A Meta-Analysis of Randomized Placebo-Controlled Trials
Authors: Atmoko W , Savira M
Published: March 2024

Introduction

Erectile dysfunction (ED) affects 3 to 76.5% of men globally. Appropriate treatments for ED patients are vital to ensure their quality of life. However, the present conservative ED treatments cannot reverse the underlying pathology and often lead to discontinuation due to the lack of efficacy. Regenerative therapies, including platelet-rich plasma (PRP), have been gaining increasing interest for the last few years. Preclinical studies suggest that growth factors in PRP may be beneficial in ED. With the increasing evidence of PRP, a meta-analysis has yet to be conducted to determine its efficacy and safety compared to a placebo.

Objective

To systematically evaluate PRP's efficacy and safety for treating ED based on randomized placebo-controlled trials (RCTs) results.

Methods

A comprehensive search on PubMed, Scopus, and EMBASE databases was conducted on June 2023 to find relevant articles following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RCTs in English evaluating PRP's efficacy and safety in treating ED were included. The primary outcomes were the International Index of Erectile Function-Erectile Function (IIEF-EF) score at 1-, 3-, and 6-months post-treatment. The secondary analysis includes the proportion of patients who met the minimal clinically important difference (MCID) of IIEF-EF score, IIEF score for sexual satisfaction and overall satisfaction, peak systolic velocity (PSV) in the cavernousal artery, and the complication rate after treatment. Quality of included studies was assessed using JADAD Score and Cochrane RoB2 tools. Meta-analysis with a random or fixed effects model based on the heterogeneity was performed using Revman 5.4.

Results

From 183 articles in initial research, three RCTs with low risk of bias were reviewed. We included 103 patients in the PRP group and 106 in the placebo group. The baseline of the evaluated score from both groups was comparable despite variable PRP protocol being used. The pooled analysis showed that PRP is associated with higher IIEF-EF scores at 1, 3, and 6 months follow up compared to placebo with a mean difference (MD) of 2.85 (95% CI, 1.68 – 4.03, p: <0.00001), 2.81 (95% CI, 1.57 – 4.05, p: <0.00001), 3.11 (95% CI, 1.96 – 4.27, p: <0.00001). Similarly, the proportion of patients who met MCID and PSV at follow-up also favoured the PRP group. On contrary, the IIEF score for sexual satisfaction and overall satisfaction domain, as well as VAS score post-injection were comparable between groups. No significant adverse event was reported in any study during follow-up.

Conclusions

The present meta-analysis suggests that PRP is effective and tolerable as a restorative therapy for managing ED patients compared to a placebo. Nevertheless, additional RCTs with more robust data from larger sample sizes and longer-term follow-ups are required to corroborate the findings.

Disclosure

No.
(038) Development of a Vaginal Dilator and Home Insemination Device for Cis-And Transgender People, Based on Actual Pelvic Anatomy
Authors: Sandhu S , Mallavarapu S , Stelmar J , Garcia M
Published: March 2024

Introduction

Genital gender-affirming surgery (gGAS) is a rapidly evolving surgical field. Specific to feminizing gGAS, one surgical option pertains to vaginoplasty with creation of a neovaginal canal. Given this canal is commonly lined with skin, peritoneum, or colon, women who undergo these procedures as part of their gender affirmation must commit to life-long self-dilation and douching to maintain canal patency and hygiene. Current commercially available dilators and douches are designed for cisgender anatomy, and are either straight, or, have an abrupt upward curve at the tip, inconsistent with neovaginal canal anatomy, which also lacks the elasticity of a cisgender woman’s vagina, making it sensitive to dilator shape, and douche nozzle length. In addition, many LGBTQ+ individuals with a uterus seek pregnancy without a male sexual partner, but few devices exist which cater to this specific population.

Objective

1) To design a vaginal dilator which more accurately reflects pelvic and vaginal canal anatomy, 2) Design a novel dilator which combines dilation, douching, and depth measurement functions, and 3) Modify our new dilator-douche device for use with semen for home insemination by both cis- and transgender women, and, transgender men seeking to become pregnant.

Methods

A radio-opaque catheter was placed into the neovaginal canal of 12 transgender women who underwent vaginoplasty with canal creation. C-Arm fluoroscopy delineated canal curvature based on the catheter. In addition, gynecologic texts and instruments were examined to ascertain the shape of a cisgender woman’s vaginal canal. Based on these findings, a novel dilator was designed and 3-D printed.

Results

A smooth “S-shape” was found in the vaginal canal of both cis- and transgender women, consistent with the shape of cervical dilators. In cisgender women, the vaginal vault, which is elastic, is closer to the introitus than that of transgender women. The cervix is typically anteriorly located between 0.5 to 4cm proximal to the posterior fornix. Our vaginal dilators (Figure 1a) (five, each 8–12cm circumference) and insemination device (Figure 1b-c) (9cm circumference) reflect the same smooth S-shaped design. Our dilators have depth markings, side-wall grooves to allow air and liquid to pass, and, can be fitted with a douche-bulb to maintain hygiene. Our insemination device can accommodate a 10cc syringe and has a recessed anterior wall 0.5–4cm from the tip to deposit semen around the cervix for conception.

Conclusions

The design improvements shown with respect to this dilator-douche device should make dilation and douching more comfortable, improve hygiene, and, decrease the incidence of granulation tissue. Our inseminator offers a private, at-home means of achieving fertilization for both cisgender and transgender individuals. (U.S. Patent 11638808; Neovaginal and vaginal health devices)

Disclosure

No.
(040) Anterolateral Thigh Flap Phalloplasty: Outcomes Following Genital Gender Affirmation Surgery
Authors: Adasonla K , Christopher N , Ralph D , Lee W G
Published: March 2024

Introduction

Genital gender affirmation surgery (gGAS) is a key part of the management of patients with gender dysphoria. The anterolateral thigh (ALT) free flap was proposed as an alternative to the more common radial forearm free flap (RFFP) phalloplasty due to the twin advantages of a more easily hidden scar and improved flexibility in the length of the flap. A pedicled variant of the ALT flap offers greater security of vascular supply for suitable patients, and if suitable and desired the flap can be formed with an integrated urethra, facilitating voiding while standing.

Objective

The aim of the study is to report the contemporary surgical and functional outcomes of ALT phalloplasty.

Methods

All individuals undergoing ALT flap phalloplasty for genital gender affirmation surgery (GAS) between 2009 and 2023 nationwide were included. Individuals were managed in accordance with the World Professional Association for Transgender Health (WPATH) Standards of Care version 7. Data were extracted from a prospectively collected single surgeon database and medical records. Functional outcomes were assessed by non-validated questionnaire. Statistical analysis included Mann-Whitney, chi-squared, Fisher’s exact and unpaired T tests.

Results

Surgical outcomes: A total of 87 patients were included in the study. More than half (45, 51.7%) had an integrated urethra. The median length of stay following surgery was six days (IQR 6-7). Eleven patients (12.6%) had a 30-day Clavien-Dindo 3b complication or greater. Three patients (3.4%) experienced total flap loss. A further three patients (3.4%) had partial flap loss. Three patients (3.4%) required a salvage phalloplasty later. Thirteen patients (out of 42, 31.0%) without an integrated urethra went onto have a free flap urethroplasty. Functional outcomes: Thirty-nine individuals (44.8%) completed the patient reported outcomes questionnaire. Most patients (77%) were generally satisfied with their phalloplasty. More than half (56%) with an erectile device used their phallus for penetrative intercourse, while one in five reported experiencing orgasm using their phallus alone. Following urethral lengthening, all respondents were able to void standing. There was no significant difference in mean satisfaction scores for those with an integrated urethra compared to those without (4.18/5 vs 3.82/5, p=.45), as well as between those with or without an erectile device, respectively (3.78/5 vs 4.10/5, p=.26).

Conclusions

This study is one of the largest single centre cohorts of ALT flap phalloplasty reported to date. It further supports the use of the ALT flap as one of the main genital GAS options for transmen. Over half of the patients studied had an integrated urethra, the gold standard for urethral lengthening. Patient reported functional outcomes were promising, with similar scores regardless of urethral lengthening or erectile device insertion.

Disclosure

No.
(058) Evaluation of Pathway Expression Following Down-Regulation of NELL1, a Potential Gene of Interest in Peyronie’s Disease
Authors: Christensen B , Tulona R , Weston J , Stover J , Bowles R , Pastuszak A
Published: March 2024

Introduction

Peyronie’s Disease (PD) is a superficial fibrosing disorder characterized by inelastic fibrous plaques within the tunica albuginea. We previously performed high-resolution array comparative genomic hybridization analysis of genomic DNA from men with both PD and Dupuytren’s Disease (DD), yielding candidate genes, including NELL1, with potential involvement in these conditions. NELL1 is a secreted growth factor that enhances osteoblastic differentiation and chondrogenesis and may contribute to calcification and inflammation in fibrotic plaques via its interaction with bone morphogenetic protein (BMP) within the TGF-β signaling pathway. Here, we report on pathway analysis following up- and down-regulation of NELL1 using CRISPR modification in an in vitro setting.

Objective

This study aimed to investigate the influence of NELL1 modification on downstream gene regulation, focusing on pathways that were significantly regulated following NELL1 down-regulation.

Methods

For down-regulation of NELL1, gRNAs were delivered to HEK293 cells with a nuclease deficient (d) dCas9-KRAB system adapted from Streptococcus pyogenes. Gene regulation was assessed using qRT-PCR.

Results

For down-regulation of NELL1, PCR analysis confirmed a 95% reduction in expression. Non-target vectors did not change NELL1 expression levels. RNA sequencing results found over 5,000 differentially expressed genes between, with significant changes in multiple pathways, including the HIF-1α pathway, which promotes keloid development by activating the TGF-β/Smad pathways. Additionally, we identified pathways related to ECM-receptor interaction, inflammation, apoptosis, and cell cycle regulation that are mediated by TGF-β/Smad signaling, which plays a crucial role in fibrosis. Our analysis also demonstrated upregulation of the PI3K-Akt pathway, which is involved in regulating type I collagen expression in response to TGF-β1. These results highlight the significance of NELL1 in fibrotic regulation and suggest its potential involvement in the development of PD.

Conclusions

We have created guides for and successfully down-regulated the expression of NELL1, a gene of interest in Peyronie’s disease. We have also demonstrated, through RNA sequencing, that changes in NELL1 lead to large changes in gene and pathway expression. The identified modified pathways, including HIF-1α-mediated, TGF-β/Smad and PI3K-Akt, provide valuable insights into the potential molecular mechanisms underlying NELL1's role in regulation of fibrosis, and further investigation of these pathways may reveal potential therapeutic targets for fibrosis-related disorders.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Contraline, Techfields Inc, Alto Neurosciences, Curebase.
(092) Mental and Sexual Health Outcomes Associated with Female Genital Mutilation/Cutting in Africa: A Systematic Narrative Synthesis
Authors: Esho T , Kumar M
Published: March 2024

Introduction

There are gaps in evidence regarding mental and sexual outcomes and associated interventions for women with Female Genital Mutilation/Cutting (FGM/C) living in Africa.

Objective

This study's objective was to collate evidence on mental and sexual health outcomes associated with female genital mutilation/cutting in Sub-Saharan Africa

Methods

The study employed a scoping review and narrative synthesis approach and conducted a systematic search of bibliographic databases and websites was performed using appropriate keywords and studies published in English from January 1, 2010 to March 25, 2022. 25 studies were retrieved and reported mental and sexual health complications associated with FGM/C.

Results

Most studies, n = 13 studies reported on sexual health outcomes including sexual pain, orgasm and sexual desire problems at sexual arousal and difficulties in lubrication. Mental health outcomes were reported in four studies including depression which was most prominent followed by somatisation and anxiety, Post Traumatic Stress Disorder (PTSD) and sleep disorder. Studies did not highlight combined mental and sexual health interventions.

Conclusions

The findings of this narrative synthesis reveal the need to prioritise provision of mental and sexual health care services for women with FGM/C. The study recommends strengthening of health systems in Africa through awareness building, training and capacity building of primary health and specialist health workers in offering mental and sexual health care to women with FGM/C.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Amref International University and Aga Khan University Hospital.
(113) Investigating the Prevalence of Erectile Dysfunction in Patients with Non-Alcoholic Fatty Liver and Its Relationship with the Severity of Fatty Liver
Authors: Abdoly M , Taqinejad S
Published: March 2024

Introduction

Today, the relationship between erectile dysfunction in men and the pathogenesis process in the field of metabolic syndrome is of interest. Non-alcoholic fatty liver disease is one of the diseases related to metabolic syndrome, which has a high prevalence. This study was conducted with the aim of evaluating the prevalence of erectile dysfunction in men with non-alcoholic fatty liver disease and investigating the relationship between its severity and the grading of liver complications.

Objective

In this research, the frequency of erectile dysfunction and decreased libido and sexual satisfaction in patients with non-alcoholic fatty liver disease have been investigated and compared with the control group. Also, the relationship between the severity of sexual dysfunction and fatty liver grading has been investigated.

Methods

In this study, 1200 patients with non-alcoholic fatty liver disease were randomly selected and participated in this study between 2019 and 2022. In order to investigate sexual disorders, the standard male sexual performance questionnaire was used along with the demographic questionnaire.

Results

The results of this study showed that the indicators of male sexual dysfunction in patients with non-alcoholic fatty liver have a high prevalence (44.5%). Also, the severity of erectile dysfunction has a significant relationship with the severity of non-alcoholic fatty liver disease (pv=0.002).

Conclusions

A holistic view of the health category requires that in the treatment of medical disorders, the effective factors and consequences of the disorder should be considered. Paying attention to the diagnosis and treatment of sexual disorders in the treatment process will be one of the most important aspects of the patient's health; Because erectile dysfunction in men, apart from the effect on sexual relations, will have destructive consequences on their psychological indicators and quality of life. On the other hand, it is possible to improve the quality of patients' health by modifying the lifestyle and interdisciplinary cooperation.

Disclosure

No.