bluuebunny/crossref_metadata_2025 huggingface dataset:
Hearing, β-Amyloid Deposition and Cognitive Test Performance in Black and White Older Adults: The ARIC-PET Study
Authors: Deal Jennifer A , Jiang Kening , Rawlings Andreea , Sharrett A Richey , Reed Nicholas S , Knopman David , Mosley Thomas , Wong Dean , Zhou Yun , Lin Frank R , Gottesman Rebecca F
Published: July 2023

Background

Hearing loss is a risk factor for dementia; whether the association is causal or due to a shared pathology is unknown. We estimated the association of brain β-amyloid with hearing, hypothesizing no association. As a positive control, we quantified the association of hearing loss with neurocognitive test performance.

Methods

Cross-sectional analysis of Atherosclerosis Risk in Communities-Positron Emission Tomography study data. Amyloid was measured using global cortical and temporal lobe standardized uptake value ratios (SUVRs) calculated from florbetapir-positron emission tomography scans. Composite global and domain-specific cognitive scores were created from 10 neurocognitive tests. Hearing was measured using an average of better-ear air conduction thresholds (0.5–4 kHz). Multivariable-adjusted linear regression estimated mean differences in hearing by amyloid and mean differences in cognitive scores by hearing, stratified by race.

Results

In 252 dementia-free adults (72–92 years, 37% Black race, and 61% female participants), cortical or temporal lobe SUVR was not associated with hearing (models adjusted for age, sex, education, and APOE ε4). Each 10 dB HL increase in hearing loss was associated with a 0.134 standard deviation lower mean global cognitive factor score (95% CI: −0.248, −0.019), after adjustment for demographic and cardiovascular factors. Observed hearing-cognition associations were stronger in Black versus White participants.

Conclusions

Amyloid is not associated with hearing, suggesting that pathways linking hearing and cognition are independent of this pathognomonic Alzheimer’s-related brain change. This is the first study to show that the impact of hearing loss on cognition may be stronger in Black versus White adults.
Claims-Based Frailty Index as a Measure of Dementia Severity in Medicare Claims Data
Authors: Park Chan Mi , Sison Stephanie Denise M , McCarthy Ellen P , Shi Sandra , Gouskova Natalia , Lin Kueiyu Joshua , Kim Dae Hyun
Published: July 2023

Background

Dementia severity is unavailable in administrative claims data. We examined whether a claims-based frailty index (CFI) can measure dementia severity in Medicare claims.

Methods

This cross-sectional study included the National Health and Aging Trends Study Round 5 participants with possible or probable dementia whose Medicare claims were available. We estimated the Functional Assessment Staging Test (FAST) scale (range: 3 [mild cognitive impairment] to 7 [severe dementia]) using information from the survey. We calculated CFI (range: 0–1, higher scores indicating greater frailty) using Medicare claims 12 months prior to the participants’ interview date. We examined C-statistics to evaluate the ability of the CFI in identifying moderate-to-severe dementia (FAST stage 5–7) and determined the optimal CFI cut-point that maximized both sensitivity and specificity.

Results

Of the 814 participants with possible or probable dementia and measurable CFI, 686 (72.2%) patients were ≥75 years old, 448 (50.8%) were female, and 244 (25.9%) had FAST stage 5–7. The C-statistic of CFI to identify FAST stage 5–7 was 0.78 (95% confidence interval: 0.72–0.83), with a CFI cut-point of 0.280, achieving the maximum sensitivity of 76.9% and specificity of 62.8%. Participants with CFI ≥0.280 had a higher prevalence of disability (19.4% vs 58.3%) and dementia medication use (6.0% vs 22.8%) and higher risk of mortality (10.7% vs 26.3%) and nursing home admission (4.5% vs 10.6%) over 2 years than those with CFI <0.280.

Conclusions

Our study suggests that CFI can be useful in identifying moderate-to-severe dementia from administrative claims among older adults with dementia.
Technology Affordance in an Information and Communication Technology Delivered Group Psychotherapy and Exercise Program for Older People With Depressive Symptoms: A Multiple Triangulation Qualitative Study
Authors: Leung Dara Kiu Yi , Wong Frankie Ho Chun , Wong Edwin Lok Yan , Sze Lesley , Chan Melissa , Liu Tianyin , Fong Annabelle Pui Chi , Kwok Wai Wai , Shum Angie Kwan Yu , Wong Gloria Hoi Yan , Lum Terry Yat Sang
Published: July 2023

Background and Objectives

Health and mental health interventions, such as psychotherapy and exercise programs, delivered via information and communication technology (ICT) may improve service access. However, adjustment among older people and in synchronous group interventions is more challenging. Technology affordance concerns the possibilities engendered by technology for various users and purposes and can help understand challenges in ICT-delivered groups and identify possible solutions.

Research Design and Methods

Adopting a multiple triangulation approach, we observed ICT-delivered groups of acceptance and commitment therapy and exercise for older people with depressive symptoms, conducted focus groups with older people who had received group psychotherapy with or without an exercise component, and obtained clinical notes from interventionists. We conducted a thematic analysis of the observation notes, focus group transcriptions, and clinical notes.

Results

Four focus groups were conducted with 22 participants (mean age = 72.6 years, standard deviation = 7.2, 86% female). We identified 3 challenges: (1) seeing–be seen dilemma, (2) speaking–hearing dilemma, and (3) blurred therapy–home boundary, and 2 solutions: (1) maneuvering layouts and collaborative tools, and (2) cross-platform mediated strategies. Participants struggled to observe the interventionist while simultaneously demonstrating their posture in front of a camera. Remaining silent and moderated turn-taking allowed for clearer hearing but limited interactions. Interruptions from the background environment and intersections of family living spaces disrupted audio-visual communication and jeopardized the sense of security. As a solution, interventionists maneuvered layouts and collaborative tools on teleconferencing applications to achieve intervention goals and provided support through different media.

Discussion and Implications

The identified challenges and potential solutions can be understood from interactivity, portability, temporality, persistence, and multimediality. Technology affordance can guide ICT-delivered group design by matching the affordance of various technologies and communication media with the characteristics of the intervention and users to enhance efficacy and avoid an unnecessary digital divide.
Gender Differences in the Relationship Between Financial Capability and Health in Later Life: Evidence From Hong Kong
Authors: Chen Yu-Chih , Sun Sicong
Published: July 2023

Background and Objectives

Financial capability, comprising financial literacy, access, and behavior, can influence an individual’s ability to effectively use financial resources, thus affecting their health and well-being. However, studies have predominantly focused on financial literacy and overlooked a more comprehensive measure of financial capability and its health impacts. Furthermore, although financial capability is shaped profoundly by gender, there is limited knowledge of the role of gender in these associations.

Research Design and Methods

This study investigated how gender may moderate the links between financial capability and health. The study recruited 1,109 community-dwelling adults (aged 45+) in Hong Kong to take part in an online survey employing multivariate linear and logistic regression to examine the gender differences in the associations between financial capability and physical (perceived health and mobility limitations), mental (life satisfaction and depression), and financial (retirement worry and financial satisfaction) health.

Results

The results showed that financial access and behavior had a more significant influence on health outcomes than financial literacy. Gender differences in financial capability were identified through simple slope analyses. Financial literacy was more important for men’s self-rated health and life satisfaction, whereas financial behavior was more critical for women. Additionally, although financial access was not related to retirement worry among men, it was significantly associated with lower retirement worry among women.

Discussion and Implications

The findings suggest that gender-specific pathways to financial capability may lead to health disparities. Policies and programs to improve population health and well-being, particularly for women, should target financial literacy, strengthen financial inclusion, and encourage responsible financial behavior.
From Sheltered in Place to Thriving in Place: Pandemic Places of Aging
Authors: Greer Valerie Chang , Hong Andy , Canham Sarah L , Agutter James , Garcia Ivis , Van Natter Jess M , Caylor Natalie
Published: July 2023

Background and Objectives

Response to the coronavirus disease 2019 pandemic required rapid changes to physical, social, and technological environments. There is a need to understand how independent-living older adults are adapting to pandemic-borne transformations of place and how environmental factors may shape experiences of aging well in the context of a public health emergency response.

Research Design and Methods

We conducted a photovoice study to examine the characteristics associated with aging in place. Our study investigated how independent-living older adults characterized aging in a “right” place approximately 1 year after the onset of the pandemic.

Results

Six themes categorized into 2 groups capture how older adults describe a “right” place to age. The first category, “places as enactors of identity and belonging,” describes the significance of places contributing to intimate relationships, social connections, and a sense of personal continuity. The second category, “places as facilitators of activities and values,” recognizes environments that promote health, hobbies, goals, and belief systems. Participants reported modifying their daily living environments with increased use of technology and more time outdoors.

Discussion and Implications

Our findings emphasize older adults’ active engagement with place and strategies used to maintain healthy aging despite public health restrictions. The results also identify place-based characteristics that may help overcome stressful circumstances from older adults’ perspectives. These findings inform pathways to pursue to facilitate resiliency for aging in place.
A Bayesian inverse approach to identify and quantify organisms from fisheries acoustic data
Authors: Urmy Samuel S , De Robertis Alex , Bassett Christopher
Published: July 2023

Identifying sound-scattering organisms is a perennial challenge in fisheries acoustics. Most practitioners classify backscatter based on direct sampling, frequency-difference thresholds, and expert judgement, then echo-integrate at a single frequency. However, this approach struggles with species mixtures, and discards multi-frequency information when integrating. Inversion methods do not have these limitations, but are not widely used because species identifications are often ambiguous and the algorithms are complicated to implement. We address these shortcomings using a probabilistic, Bayesian inversion method. Like other inversion methods, it handles species mixtures, uses all available frequencies, and extends naturally to broadband signals. Unlike previous approaches, it leverages Bayesian priors to rigorously incorporate information from direct sampling and biological knowledge, constraining the inversion and reducing ambiguity in species identification. Because it is probabilistic, a well-specified model should not produce solutions that are both wrong and confident. The model is based on physical scattering processes, so its output is fully interpretable, unlike some machine learning methods. Finally, the approach can be implemented using existing Bayesian libraries and is easily parallelized for large datasets. We present examples using simulations and field data from the Gulf of Alaska, and discuss possible applications and extensions of the method.
CFD and statistical analysis of flow mass ratios on temperature and pressure drops of double pipe heat exchanger
Authors: Evran Savaş , Kurt Mustafa
Published: July 2023

In this numerical and statistical study, the effect of mass flow rates for shell and fluid temperature for tube on temperature and pressure drops was analyzed in double pipe heat exchanger under counterflow. Numerical calculations were performed using computational fluid dynamics (CFD) in ANSYS Fluent. Calculations were carried out according to the L8 orthogonal array with two control factors in accordance with Taguchi method. Although the different mass flow rates of the fluid passing through the shell were chosen as the first control factor, different fluid temperatures of the fluid passing through the tube were selected for the second control factor. Signal-to-noise ratio analysis was used to decide the impacts and optimum levels of the mass flow rates and fluid temperatures on temperature and pressure drop. The significance levels and contribution percentages of each variable on the temperature and pressure change occurring in the heat exchanger were calculated using analysis of variance. The accuracy of the analyses was compared numerically and statistically by comparing the obtained optimum CFD results with the estimated Taguchi results. This study can be used as a guiding research in the project and cost calculations of heat exchangers to be produced experimentally.
(109) CONFIRMING ANTI-FIBROTIC EFFECT OF TERFENADINE, EBASTINE, AND SOLIFENACIN IN IN VITRO MODELS OF PEYRONIE’S DISEASE
Authors: Dr. Marcus M Ilg , Dr. Alice R Lapthorn , Prof. David J Ralph , Prof. Selim Cellek
Published: July 2023

Objectives

Peyronie’s disease (PD) is characterised by formation of a fibrotic plaque in the tunica albuginea which is caused by excessive myofibroblast presence and activity. A previous phenotypic screening campaign that tested 1,954 FDA-approved drugs for their ability to inhibit myofibroblast transformation in PD-derived fibroblasts revealed 26 hits. Of these, we investigated the following hits further; terfenadine (H1-receptor antagonist), ebastine (H3-receptor antagonist) and solifenacin (muscarinic receptor antagonist).

Methods

Tunica albuginea of PD patients was used to isolate primary fibroblasts. The cells were treated with the drugs and co-incubated with transforming growth factor beta 1 (TGF-β1). Full concentration response curves ranging from 0.03 μM to 100 μM were constructed and myofibroblast transformation was quantified by measuring α-smooth muscle actin (α-SMA) using the In-Cell ELIA (ICE) method. A modified ICE was used to quantify total extracellular matrix (ECM) production. ICE results were further supported by Western blots and immunocytochemistry (ICC).

Results

Terfenadine (IC50 of 1.7 μM), ebastine (IC50 of 4.3 μM), and solifenacin (IC50 of 3.5 μM) showed a concentration-dependent inhibition of α-SMA in ICE which was confirmed by Western blot. ICC revealed that stress fibre formation was inhibited by all three drugs. The modified ICE confirmed concentration-dependent inhibition of ECM formation. Western blot analysis showed that terfenadine and ebastine but not solifenacin reduced fibronectin expression.

Conclusions

This is the first study to demonstrate that modulating H1-receptor, H3-receptor or muscarinic receptor signalling can affect myofibroblast transformation in PD-derived cells. These drugs have potential for repurposing for treatment of PD but need to be confirmed by in vivo studies.

Conflicts of Interest

None
(150) COMPLIANCE TO ORAL TREATMENT FOR PREMATURE EJACULATION – DATA FROM A SINGLE ACADEMIC CENTER
Authors: Dr. Paolo Capogrosso , Dr. Edoardo Pozzi , Dr. Federico Belladelli , Dr. Fallara Giuseppe , Dr. Simone Cilio , Dr. Massimiliano Raffo , Fausto Negri , Ludovica Cella , Margherita Fanton , Dr. Alessandro Bertini , Dr. Luca Boeri , Dr. Francesco Lanzaro , Dr. Christian Corsini , Dr. Luigi Candela , Dr. D'arma Alessia , Prof. Federico Dehò , Prof. Francesco Montorsi , Prof. Andrea Salonia
Published: July 2023

Objectives

Oral therapy for premature ejaculation (PE) has been associated with high drop-out rates due to side effects and poor results. We compared patients compliance to dapoxetine prn vs. paroxetine OaD in men with PE in a real-life setting

Methods

Data from 4105 patients with sexual dysfunctions prospectively collected at a single Sexual Medicine clinic in 2005-2022 were analysed. Overall, 342(8.3%) patients complained of PE and were treated either with dapoxetine 30-60mg prn or paroxetine 20mg OaD according to patients’ profile and preference. All completed the Premature Ejaculation Diagnostic Tool (PEDT) and the IIEF before and over the treatment course. Patients were re-assessed at 3 months from treatment start and thereafter every 6 months or as needed. Kaplan-Meier estimated treatment drop-out rates over time. Cox regression analysis assessed predictors of treatment discontinuation.

Results

Median (IQR) age was 47(36, 61) years. Median baseline PEDT score was 15 (10,17.5). Of all, 151(44%) and 191(56%) patients were treated with dapoxetine and paroxetine respectively. Patients receiving dapoxetine were younger (40(30,48) vs. 56(41,67);p<0.0001) and depicted worse baseline PEDT (16(14,18) vs. 8(3,14); p<0.0001) as compared with those receiving paroxetine. Overall, 329(96%) discontinued the drugs at some point throughout the treatment course, showing only a slight mean improvement of PEDT from baseline of -0.4(95%CI:-0.8,1.7) and -0.8(95%CI:-0.7,1.3) with dapoxetine and paroxetine, respectively. At Kaplan-Meier (Figure-1) the two groups did not differ in terms of treatment dropout over time (p=0.3), with estimated discontinuation rates of 27%(15,45) and 55%(37,75) at 12 and 24 months for dapoxetine and 13%(7,24) and 47%(32,65) for paroxetine. Younger patients were at higher risk of treatment drop-out (HR:0.95,95%CI:0.91,0.99;p=0.03) after accounting for PEDT, IIEF-EF and type of treatment.

Conclusions

PE still represents a therapeutic challenge with high treatment drop-out rates and only minor improvements. Younger patients appear at higher risk of oral therapies discontinuation and maybe better candidates for a multimodal treatment.

Conflicts of Interest

NA
(282) CONSEQUENCES OF ANABOLIC-ANDROGENIC STEROID ABUSE IN MALES: RESULTS FROM A META-ANALYSIS STUDY
Authors: Dr. Walter Vena , Dr. Nicola Bianchi , Dr. Francesca Frizza , Prof. Giulia Rastrelli , Dr. Sara Marchiani , Dr. Sandra Filippi , Dr. Annamaria Morelli , Dr. Elena Sarchelli , Dr. Mario Dicuio , Dr. Alessandra Sforza , Dr. Alessandro Brunetti , Dr. Alessandro Pizzocaro , Prof. Mario Maggi , Dr. Giovanni Corona
Published: July 2023

Objectives

The real epidemiology and the possible consequences of anabolic-androgenic steroids (AAS) use still represent a very tricky task due to the difficulties in the quantification and detection of these drugs. The aim of the present study is to systematically meta-analyze and discuss the available evidence regarding the impact of Anabolic Androgenic Steroids (AAS) on the male reproductive system.

Methods

A comprehensive Medline, Embase and Cochrane search was performed.

All studies investigating the impact of AAS on several andrological outcomes without any restriction were included.

Results

Out of 738 studies, 24 specifically analyzed the andrological consequences of AAS in males. These trials included 2411 patients with a mean age of 29.7 years and a mean follow-up of 148.7 weeks. The trials differ in basal characteristics and type of AAS used. In particular, 13 studies compared the effects of AAS to controls whereas 11 reported only side effects in the active group. Body builders or weightlifters were the most common athletes considered, the list of which included also soccer players, other professional athletes as well as recreational exercisers. In the vast majority of the cases, control groups were made up of non-abuser athletes but also of normal sedentary groups.

Conclusions

Available data clearly indicated that AAS negatively affect endogenous T production. In addition, increased T and estradiol circulating levels were also observed according to the type of preparations used. The latter leads to an impairment of sperm production and to the development of side effects such as acne, hair loss and gynecomastia. Furthermore, a worse metabolic profile, characterized by reduced high density lipoprotein and increased low density lipoprotein cholesterol levels along with an increased risk of hypertension has been also detected. Finally sexual dysfunctions, often observed upon doping, represent one the most probable unfavorable effects of AAS abuse.

Conflicts of Interest

No conflict of interest to declare.
(122) FEMALE SEXUAL FUNCTION AFTER PELVIC EXENTERATION FOR LOCALLY ADVANCED OR RECURRENT COLORECTAL CANCER: A SYSTEMATIC REVIEW
Authors: Elke Platteau , Andreas Denys , Prof. Marlon Buncamper , Prof. Gabriëlle van Ramshorst
Published: July 2023

Objectives

Our objective was to analyze the impact of pelvic exenteration (PE) and vaginal flap reconstruction on the sexual functioning of women with locally advanced or recurrent colorectal cancer.

Methods

A protocol was registered in PROSPERO. PubMed, Embase and Cochrane Library were searched using protocolized search strategies. Studies published between January 2000 and October 2021 reporting on sexual function for at least 5 female PE patients were considered eligible. Study selection, data extraction, rating of certainty of evidence (GRADE) and risk of bias (ROBINS-I) were conducted independently by two reviewers.

Results

Seven of 2086 studies were included. The 5 retrospective and 2 cross-sectional studies were of very low quality, with an overall serious risk of bias. Of all 1221 patients, PE was performed in 683 patients. The VRAM-flap was used in 95,3% of 297 women undergoing reconstruction. 393 patients had locally advanced rectal cancer, 217 had recurrent rectal cancer and for the other patients the cancer type was not specified. Six different validated questionnaires were used in 4 different studies to evaluate female quality of life and sexual function, including the EORTC QLQ-CR29, EORTC QLQ-C30, EORTC QLQ-CR38, FSFI, SF-36v2 and SVQ. All studies included data on female sexual activity, with 3 studies reporting on both baseline and postoperative sexual activity. 41,8% (n= 64/153) of preoperative sexual active women, were still sexual active postoperative. The VRAM-flap was proven to be a suitable technique to close perineal and/or vaginal defects, with a low rate of major complications.

Conclusions

This study shows that oncologic resection including pelvic exenteration leads to grave sexual dysfunction despite vaginal reconstruction with the use of a VRAM-flap. Data concerning sexual function after reconstruction for vaginal resection are limited, with lack of a standard protocol to evaluate female sexual function making it difficult to compare treatment results between studies.

Conflicts of Interest

All authors declare that they have no conflicts of interest.
(233) REGULAR DILATION AND SEXUAL ACTIVITY SHOW LESS RISK FOR VAGINAL NARROWING AND SHORTENING AFTER RADIOCHEMOTHERAPY FOR LOCALLY ADVANCED CERVICAL CANCER
Authors: Dr. Kathrin Kirchheiner , Dr. Alexandru Zaharie , Dr. Stéphanie Smet , Dr. Sofia Spampinato , Dr. Richard Pötter , Dr. Christian Kirisits , Dr. Maximilian Schmid , Dr. Kari Tanderup , Dr. Astrid A De Leeuw , Dr. Ina M Jürgenliemk-Schulz , Dr. Remi A Nout
Published: July 2023

Objectives

Radiochemotherapy for cervical cancer has a substantial risk to cause long-term vaginal stenosis (shortening/narrowing), due to irreversible fibrotic changes and can cause dyspareunia in many cancer survivors. Clinical recommendations for aftercare include vaginal dilation with cylinders; sexually active patients with partners are encouraged to engage in intercourse involving penetration. However, the evidence for prevention is limited.

Aim of this report is to evaluate the association between regular vaginal dilation, sexual activity and vaginal stenosis in locally advanced cervical cancer patients after definitive radiochemotherapy and image-guided adaptive brachytherapy from the prospective, international, longitudinal EMBRACE I study (www.embracestudy.dk).

Methods

Physician-assessed vaginal stenosis (CTCAE v.3), vaginal dilation and patient-reported sexual activity (EORTC QLQ CX24) were assessed at baseline, every 3 months in the 1st year, every 6 months in the 2nd and 3rd year and yearly thereafter. For this longitudinal analysis, a subgroup of patients was selected with at least 3 follow-ups with information on vaginal dilation and sexual activity. Regular dilation was defined if reported in ≥50%, irregular/no dilation if reported in <50% of follow-ups. The same method was applied to sexual activity. Actuarial estimates of vaginal stenosis G≥2 were calculated with Kaplan-Meier method; group comparisons evaluated with the log-rank test.

Results

The EMBRACE I study recruited 1416 patients overall (2008-2015); the subgroup of patients for this longitudinal evaluation included 821 patients, with a median follow-up of 61 months. Of those, 296 (36%) reported regular dilation; this was associated with a significantly lower risk of vaginal stenosis G≥2 at 5 years, p=0.023 (figure A). 381 patients (46%) reported regular sexual activity; this was associated with a significantly lower risk of vaginal stenosis G≥2 at 5 years, p≤0.001 (figure B).

Conclusions

These long-term data support clinical recommendations for regular dilation and/or sexual activity after radiotherapy.

Conflicts of Interest

The authors have no conflict of interest to declare.
(99) SEXUALITY, THE ULTIMATE ‘EXPOSURE OR ESCAPE’ FOR PATIENTS WITH BODY DYSMORPHIC DISORDER
Authors: Dr. Rieky Dikmans , Rachel van Loenen , Dr. Staphanie Both , Dr. Maarten van Westen , Dr. Nienke Vulink
Published: July 2023

Objectives

In body dysmorphic disorder (BDD), anxiety for judgement of appearance plays a major role and is especially difficult in contact with others. In sexual engagement this is unavoidable. It is also known that sexuality is an essential part of quality of life and that for both healthcare providers and patients it is still a difficult topic to address. To date, there is no clear insight in how BDD interacts with sexuality. The aim of this study is to get a better understanding on how patients with BDD experience sexuality.

Methods

In the outpatient setting of the psychiatry department of the Amsterdam University Medical Center 15 patients (of mixed gender and sexual preference) underwent a semi-structured interview conducted by two researchers. The analyses took place by open coding and the results were discussed by all researchers involved.

Results

Sexuality is strongly influenced by the presence of BDD. During intercourse patients are trying to navigate on a vulnerable tension field that is created by opposite motives and feelings (such as avoidance versus willingness to engage or arousal versus disgust). Their sexuality is surrounded by rituals where there is little room for spontaneity. The success of the sexual experience depends mainly on the pleasure of the other person and can be immediately interrupted by a tactile or visual confrontation with the respective BDD focus. In the continuous stream of negative thoughts, there is either little contact with the body or it rather serves as a functional instrument that is used to get out of their head. All patients agree that discussing sexuality and using bodily exercises are important.

Conclusions

In this first qualitative study on sexuality in a diverse group of BDD patients, it became clear that sexuality is a topic full of tension. Sexuality should have a part in the treatment of patients with BDD.

Conflicts of Interest

There are no conflicts of interest.
(262) DOES SEXUAL CREATIVITY ENHANCE SEXUAL AND RELATIONSHIP SATISFACTION? EXAMINING THE EFFECT OF WEEKLY CREATIVE SEXUAL TASKS IN MONOGAMOUS LONG-TERM RELATIONSHIPS
Authors: Tabea M Zorn , Lena Feilhauer , Elina Juhola , Ralf Cox , Prof. Peter J de Jong , Charmaine Borg
Published: July 2023

Objectives

Research has only recently started to investigate how sexual passion and satisfaction can be maintained in a monogamous long-term relationship. The challenge lies in the familiarity and comfort that frequently turn into sexual boredom and predictability, leading partners to desire less mechanical and routine sex. Since sexual novelty has been positively related to sexual and relationship satisfaction, we tested the effect of including weekly sexual creativity in couples' sex lives

Methods

As part of the study, we introduced a definition of sexual creativity as sexual activity that is new, pleasurable, and safe for all parties involved. The experimental group had to plan at least one sexually creative activity per week for one month, while the control group planned sex as usual. Both groups received weekly instructions in which the experimental group got a theme with examples to stimulate creativity. There were weekly questionnaires and a follow-up two weeks after the intervention.

Results

In a preliminary analysis, scores of 114 monogamous couples that had been together for at least 1.5 years were analyzed on their development of sexual satisfaction, relationship satisfaction, sexual boredom, sexual novelty, sexual communication, sexual frequency, sexual desire, and importance of sex at baseline, post-intervention, and follow-up. Results showed no differences between the groups. However, sexual satisfaction and sexual novelty significantly increased for both groups over time and remained at the increased level at follow-up.

Conclusions

Our results raise questions about how to effectively manipulate sexual creativity in an experimental setup as our two tested groups might have been too similar which might have hindered the finding of positive effects of the intervention. Nevertheless, our study gives first indications for the effectiveness of having participants regularly plan sexual activity. In general, we achieved high adherence opening up new research directions for experimentally testing a sexual intervention with couples in real life.

Conflicts of Interest

None
(89) GENDER-BASED DIFFERENCES ABOUT THE PSYCHOLOGICAL WELL-BEING OF THE ITALIAN BI+ POPULATION: AN EXPLORATORY EMPIRICAL RESEARCH
Authors: Dr. Paolo Antonelli , Dr. Francesco Fantacci , Dr. Lorenzo Borrello , Dr. Anna Russo , Dr. Elisabetta Muto , Dr. Daniel Giunti , Dr. Cristiano Scandurra
Published: July 2023

Objectives

(1) to explore possible differences between Bi+ cisgender and transgender people in terms of identity affirmation, social support, and psychological well-being; (2) to test the mediating role of identity affirmation in the relationship between perceived social support and psychological well-being.

Methods

497 Italian Bi+ individuals (362 cisgender and 135 transgender), aged 14 to 61, participated in an online survey. Gender differences in main variables were tested with the T-test for independent samples, while the mediation model was tested with the SPSS PROCESS macro with bias-corrected bootstrapping and 95% confidence intervals. This analysis was controlled for gender (cisgender vs transgender).

Results

(1) Bi+ transgender participants showed lower levels of perceived social support, environmental mastery, positive relations, purpose in life, self-acceptance and global psychological well-being than Bi+ cisgender counterparts, while Bi+ transgender participants showed higher levels of identity affirmation than Bi+ cisgender counterparts.(2) Perceived social support was positively associated with both identity affirmation and psychological well-being and identity affirmation was positively associated with psychological wellbeing. As identity affirmation was included as a mediator, there was a significant overall effect, while the direct effect remained significant, indicating a case of partial mediation. Indeed, the indirect effects showed that identity affirmation significantly mediated the relationship between perceived social support and psychological wellbeing. Gender was a significant control variable, indicating that being Bi+ cisgender was most strongly associated with psychological well-being than being Bi+ transgender.

Conclusions

The few studies on the Bi+ community show how it suffers from peculiar risk factors in addition to those common to the entire LGBT+ population. Our innovative research shed a light on gender differences showing a general lower level of psychological well-being of Bi+ transgender people despite a higher level of identity affirmation, maybe consequent to the visibility that this community must actively seek to be recognized.

Conflicts of Interest

Paolo Antonelli, Francesco Fantacci, Lorenzo Borrello, Anna Russo, Elisabetta Muto, and Cristiano Scandurra declare that they have no conflict of interest.
(210) ADAPTING THE SEXUAL SELF-CONCEPT: A USEFUL APPROACH TO IMPROVE SEXUAL FUNCTIONING FOR WOMEN WITH A DIFFERENCE OF SEX DEVELOPMENT?
Authors: Arianne Dessens , Nita de Neve-Enthoven , Nina Callens , Yvonne van der Zwan , Maaike van Kuijk , Chris Verhaak , Katja Wolffenbuttel , Peggy Cohen-Kettenis , Stenvert Drop , Ina Beerendonk , Martine Cools
Published: July 2023

Objectives

Differences of Sex Development (DSDs) are a large group of congenital conditions characterized by an altered development of the internal and external genitalia. Examination of sexual function in relationship to cognitions and emotions that hinder or promote sexuality (i.e. sexual self-concept) may contribute to the development of specific interventions to improve sexual functioning.

Methods

91 women participated in a follow-up study consisting of a standardized gynecological examination and psychosocial assessment of sexual functioning. Outcome measures included genital atypicality at birth,1-3 applied surgical and non-surgical interventions,1-3 Dutch versions of the Female Sexual Functioning Index (FSFI),1-4 Female Sexual Distress Scale-Revised (FDFS-R),1-4 Body Image Scale,1-4 (dis)satisfation with the functionality of the genitalia1-4 and the Women Sexual Self-Concept Scale (WSSCS-D).1-4 Statistics: different types of parametric and non-parametric tests for categorical and continuous variables and principal component analysis.1-4

Results

Many women born with DSD reported sexual problems, in particular women who have undergone extensive genital reconstruction.1,3 Large percentages of women were not in a romantic relationship, had not been sexually active recently or had never been sexually active. Of women who completed the FSFI questionnaire, 66% scored in the rangeof a sexual dysfunction and 41% of women experienced sexually related distress (FDFS-R).1,3 Women with DSD harbored more negative emotions and cognitions regarding their sexuality and were less satisfied with their genitalia. Sexual self-concept was associated with compromised outomes on sexual functioning and distress.1,3,4

Conclusions

Problems in sexual functioning are common among women with DSD. Negative cognitions and emotions related to sexual self-concept probably play a role in their sexual functioning. A cognitive behavioral approach with focus on acceptance and coping with genital variety, explorations of the own sexual needs and adaptation of negative emotions and cognitions into more positive ones, could prove useful in this group.

Conflicts of Interest

The authors declare no conflict of interest.
(156) WHY IS IT SO CHALLENGING TO TALK ABOUT SEX? A QUALITATIVE ASSESSMENT OF FAMILY DOCTORS’ VIEWS ON THE NEEDS AND BARRIERS TO DEAL WITH THEIR PATIENTS’ SEXUAL HEALTH
Authors: Beatriz F Lopes , Inês Tavares , Ana L Q Gomes
Published: July 2023

Objectives

Evidence shows a lack of training on sexuality in both pre and postgraduate Medicine levels, leading to these professionals’ insecurity in dealing with their patients’ sexual problems. Yet, Family Doctors have a central role in the promotion and education for sexual health of the community. The aim of this study is to identify the main needs and barriers identified by Portuguese Family Doctors in addressing sexuality in their professional context; to assess the receptiveness of Family Doctors to using a training program on sexuality.

Methods

We conducted 2 focus groups with 10 Portuguese Family Doctors. Both focus groups had a maximum duration of 90 minutes and were moderated by two project researchers. The inclusion criteria were the ability to give informed consent, being Family Doctors with clinical activity and have Portuguese nationality. Professionals participating in another sexuality research study were excluded. Confidentiality and fundamental ethical requirements were respected. The data collected was processed using Braun and Clarke's thematic content analysis and it was anonymized and analyzed using the NVivo Software.

Results

The results of this study indicated that Family Doctors identified several needs and barriers to the management of sexuality in their professional context, which were informed by both individual and contextual factors. Employing a qualitative methodology enabled us to explore the subjective experiences in dealing with their patients’ sexuality, as constructions dependent on individual context, obtaining in-depth understanding of its complexity.

Conclusions

The information collected will serve as basis for the content development of a training program on sexuality for Family Doctors. We believe that the present study will have ethical, social, and political implications, contributing to the promotion of sexual health among health professionals and the general population.

Conflicts of Interest

The authors report no conflicts of interest.
(236) HELPLINE PARAPHILE: FINDINGS FROM FIRST SPECIALIZED CZECH PHONE HELPLINE FOR PEOPLE WITH PROBLEMATIC SEXUAL INTERESTS AND/OR BEHAVIOURS
Authors: Kateřina Potyszová , Marek Navrátil , Filip Šinkner , Kateřina Klapilová
Published: July 2023

Objectives

In 2020 the Czech primary prevention project Paraphile launched the first Czech crisis intervention phone line targeting men and women with self-identified paraphilic sexual preference and/or individuals at risk of sexual offending (and their close persons). The overall purpose was to reach the target group and encourage further on-site assessment and treatment.

Methods

The PARAPHILE Helpline offers limited (3-5 sessions) crisis counseling via on-line appointment and/or via an anonymized telephone line. One of the main aims of the service is to assess appropriately the clients' needs in the field of sexual medicine and adjust their risk of sexual offending. The trained operators address the client to the appropriate sexology-related care and/or if appropriate to the Prevention Project PARAPHILE contact therapy treatment. Each client underwent a basic screening, which is a 30-item semi-structured interview covering basic sociodemographic characteristics, data on problematic sexual interests and/or behaviors, mental health conditions, basic risk assessment, and basic mapping of clients' motivation to treatment.

Results

Data collection took place between December 2020 and October 2022. A total of 170 calls were made or arranged via online appointment, out of which 24 followed with on-site assessment and treatment. The topics of the Helpline included risky sexual behavior(s), basic psychoeducation regarding paraphilias, problematic online behavior, informative calls from close persons, issues of compulsive sexual behavior, sexual dysfunction, partnership troubles, other mental health issues (e.g. anxiety, depression, psychotic clients).

Conclusions

Individuals at risk of sexual offending and self-identified individuals with paraphilia can be reached through a specialized helpline service and motivated to undergo further assessment and treatment. The helpline also proved to be a significant low-threshold service for this type of clientele.

Conflicts of Interest

There are no Conflicts of Interest.
(45) SHAEER’S TECHNIQUE FOR PENILE PROSTHESIS IMPLANTATION THROUGH A SINGLE MIDLINE CORPOROTOMY
Authors: Prof. Osama Shaeer , Prof. Kamal Shaeer
Published: July 2023

Objectives

With the infrapubic approach for penile prosthesis implantation (IPA), lateral corporotomies carry the risk of injury to the laterally-coursing dorsal nerves. This is one of the reasons why IPA is not widely adopted despite its potential advantages.

We describe for the first time Shaeer’s IPA; a modification of the infra-Pubic approach, whereby malleable penile prosthesis cylinders are implanted through a single midline corporotomy in the bed of the deep dorsal vein. The midline corporotomy spares the laterally-coursing dorsal nerves.

Methods

We compared semi-rigid penile prosthesis implantation via the single-midline-corporotomy infrapubic approach (IPA-S, n=11), to the classic infrapubic approach with laterally placed dual corporotomies (IPA-D, n=11) and to the penoscrotal approach (PSA, n=13). Shaeer’s IPA is performed through the infrapubic incision. A 3-5 cm length of the deep dorsal vein is stripped. A single 3-5 cm midline corporotomy is cut along the bed of the vein. Dilation, sizing and implantation are performed through the single corporotomy on either side of the midline septum. Patients are discharged same day, allowed to bend the implant after 2 weeks, and to commence intercourse after three weeks.

Results

There were no statistically significant differences in age, post-implantation IIEF-5 or satisfaction between the three groups. Average operative time for the IPA-S group was 21.8% shorter than the IPA-D group, and 34.5% shorter than the PSA group. Pain as per the 10-point pain scale was least in the IPA-S group, with a 37.8% difference from the IPA-D group and a 41.9% difference from the PSA group. Those differences were statistically significant. No complications were recorded in the IPA-S group. Infection occurred in one PSA case, and partial hypoesthesia in one IPA-D case.

Conclusions

“Shaeer’s Single-Midline-Corporotomy Infra-Pubic Approach” is a minimally invasive approach for implantation of the semi-rigid penile prosthesis, avoiding injury of the laterally-coursing dorsal nerves of the penis.

Conflicts of Interest

None
(101) CAVERNOSAL BANDING: A NEW PROCEDURE TO ADDRESSSIGNIFICANT WEAKENING/LOSS OF ALBUGINEA, PARTICULARLY FOLLOWING REITERATED PENILE PROSTHESIS SURGERIES
Authors: Dr. Edoardo Pescatori , Dr. Andrea Loreto , Davide Dell'Orco
Published: July 2023

Objectives

We present an original technique to address loss and/or weakening of albuginea in patients with inflatable penile prostheses.

Methods

A 52 y.o. white male with four former implant surgeries (penoscrotal) reported that upon activation no erection developed, while the scrotum enlarged. MRI disclosed bilateral cylinders extrusion at the site of former corporotomies.

Surgical procedure. Penoscrotal approach: in the extrusion area there was bilaterally a wide loss of albuginea. In the involved area we circumferentially isolated the albuginea dorsally from Buck’s fascia, inclusive of the neurovascular bundle, and ventrally from urethra. We developed some tissue planes to cover the albuginea loss. The old device was removed and replaced with a new AMS 700CX. We measured: circumference of isolated corpora in tumescence state (12 cm), and distance between the limits of the two isolated circumferences -proximal and distal- (5 cm). A 12x5 cm rectangle of Tutopatch® was fashioned. CAVERNOSAL BANDING was achieved transferring the fashioned Tutopatch® rectangle around the isolated albuginea of the two corpora cavernosa. The two short sides were sutured together and to the ventral albuginea, beneath the urethra, and anchoring stitches fixed the patch to the albuginea, to keep it flat (figure). Patient had to daily cycle the device for three months, not exceeding the tumescence status, to allow a sound remodelling process of the graft.

Results

At 3 months control MRI: normal appearance of the inflated cylinders, without bulging. At 5 months from surgery patient is having regular sexual intercourse without any clinical evidence of bulging, with high satisfaction: IIEF score at 1 month= 24; QoLSPP scores: 25 - functional domain, 15 - social domain, 19 - relational domain, 18 - personal domain.

Conclusions

Cavernosal banding with bovine pericardium appears to be a working solution for challenging cases of albuginea loss in patients with penile prosthesis.

Conflicts of Interest

None
(204) ABDOMINOPLASTY AND PENILE PROSTHESIS IMPLANT: A NEW STANDARD APPROACH FOR OBESE PATIENTS?
Authors: Manuel Alonso-Isa , Esther García-Rojo , Elena Peña-Vallejo , Borja García-Gómez , José Medina-Polo , Javier Romero-Otero
Published: July 2023

Objectives

One-third of adult men are obese and profound sexual dysfunction is quite common in this population. A penile prosthesis implant (PPI) has been proven to be an effective option for patients that do not respond to non-surgical treatments. Together with an abdominoplasty, it could be an alternative treatment in obese patients to improve satisfaction and facilitate sexual intercourse. For us, this is the new gold standard.

Methods

We retrospectively reviewed 15 patients from 2016 to 2022 who underwent an abdominoplasty and PPI. Demographic, comorbidities, type of PPI, the perform of other additional techniques, surgery time, complications, and other relevant variables were recorded for analysis.

Results

All patients were obese with erectile dysfunction and 8 suffered from diabetes. 10 inflatable penile prostheses and 5 malleable ones were implanted. Only one device had to be removed due to a prosthesis infection. The mean surgery time was 97 minutes. The mean hospital stay was 3.6 days after surgery. A significant increase in postoperative penile length of 2.8 cm (1.3-4.2cm) and reasonable satisfaction rates (85% in Erectile Dysfunction Inventory of Treatment Satisfaction, EDITS) were achieved.

Conclusions

Abdominoplasty is a safe and reproducible technique that can be performed simultaneously with the placement of a penile prosthesis in selected patients. It is possible to combine it with other surgical techniques. Patients must always be counseled on the expectations and the risk of postoperative complications. However, due to the excellent postoperative results and patient satisfaction, it is the new gold standard for this kind of patient for us.

Conflicts of Interest

The authors have no potential conflict of interest to report.