bluuebunny/crossref_metadata_2025 huggingface dataset:
Epsilon Dichotomy for Linear Models: The Archimedean Case
Authors: Suzuki Miyu , Tamori Hiroyoshi
Published: May 2023

Let $G=\textrm {GL}_{2n}({\mathbb {R}})$ or $G=\textrm {GL}_n({\mathbb {H}})$ and $H=\textrm {GL}_n({\mathbb {C}})$ regarded as a subgroup of $G$. Here, ${\mathbb {H}}$ is the quaternion division algebra over ${\mathbb {R}}$. For a character $\chi $ on ${\mathbb {C}}^\times $, we say that an irreducible smooth admissible moderate growth representation $\pi $ of $G$ is $\chi _H$-distinguished if $\operatorname {Hom}_H(\pi , \chi \circ \det _H)\neq 0$. We compute the root number of a $\chi _H$-distinguished representation $\pi $ twisted by the representation induced from $\chi $. This proves an Archimedean analogue of the conjecture by Prasad and Takloo-Bighash (J. Reine Angew. Math., 2011). The proof is based on the analysis of the contribution of $H$-orbits in a flag manifold of $G$ to the Schwartz homology of principal series representations. A large part of the argument is developed for general real reductive groups of inner type. In particular, we prove that the Schwartz homology $H_\ast (H, \pi \otimes \chi )$ is finite-dimensional and hence it is Hausdorff for a reductive symmetric pair $(G, H)$ and a finite-dimensional representation $\chi $ of $H$.
Making Gender Known: Assembling Gender Expertise in International Organizations
Authors: Scott David , Olivius Elisabeth
Published: May 2023

In recent decades, gender equality goals have been adopted widely in global policymaking, creating a demand for specialized knowledge and evidence to support the design and implementation of gender equality policies. Bridging feminist scholarship on gender expertise and practice–theoretical literature on knowledge production, this article examines a knowledge production initiative of the World Bank, the Gender Innovation Laboratories (GILs). While research has examined the position of gender experts and the content of gender expertise in global governance, it has overlooked how knowledge about gender is produced. In this paper, we use a practice–theoretical approach—assemblage thinking—to study the practical work mobilized in the GILs to produce, maintain, and disseminate knowledge about gender inequality. Drawing on interviews with lab researchers, documents, and online materials, and focusing on the epistemic practice of impact evaluations, our analysis demonstrates the work invested in assembling them, such as forging alignments with and securing support among stakeholders, activating repertoires of expertise, and translating results into material objects. These practices produce gender inequality as a governance object, which is amenable to technical policy interventions, which facilitates certain forms of action to address it. Yet, they simultaneously silence more political solutions to gender inequalities.
Comparison of SIREN social needs screening tools and Simplified Omaha System Terms: informing an informatics approach to social determinants of health assessments
Authors: Holt Jeana M , Austin Robin R , Atadja Rivka , Cole Marsha , Noonan Theresa , Monsen Karen A
Published: May 2023

Objective

Numerous studies indicate that the social determinants of health (SDOH), conditions in which people work, play, and learn, account for 30%–55% of health outcomes. Many healthcare and social service organizations seek ways to collect, integrate, and address the SDOH. Informatics solutions such as standardized nursing terminologies may facilitate such goals. In this study, we compared one standardized nursing terminology, the Omaha System, in its consumer-facing form, Simplified Omaha System Terms (SOST), to social needs screening tools identified by the Social Interventions Research and Evaluation Network (SIREN).

Materials and Methods

Using standard mapping techniques, we mapped 286 items from 15 SDOH screening tools to 335 SOST challenges. The SOST assessment includes 42 concepts across 4 domains. We analyzed the mapping using descriptive statistics and data visualization techniques.

Results

Of the 286 social needs screening tools items, 282 (98.7%) mapped 429 times to 102 (30.7%) of the 335 SOST challenges from 26 concepts in all domains, most frequently from Income, Home, and Abuse. No single SIREN tool assessed all SDOH items. The 4 items not mapped were related to financial abuse and perceived quality of life.

Discussion

SOST taxonomically and comprehensively collects SDOH data compared to SIREN tools. This demonstrates the importance of implementing standardized terminologies to reduce ambiguity and ensure the shared meaning of data.

Conclusions

SOST could be used in clinical informatics solutions for interoperability and health information exchange, including SDOH. Further research is needed to examine consumer perspectives regarding SOST assessment compared to other social needs screening tools.
Quantifying land-use regulation and its determinants
Authors: Büchler Simon , v. Ehrlich Maximilian
Published: May 2023

We analyze land-use regulation and the determinants thereof across Swiss municipalities. We construct several residential development stringency indices based on a comprehensive survey. These indices capture various aspects of local regulation and land-use coordination across jurisdictions. Combining these indices, we construct an index that provides harmonized information about what local regulation entails and the local regulatory environment across municipalities. Our analysis shows that historical building density, natural amenities, socio-demographic factors, cultural aspects and municipal competition are important determinants of local land-use regulation. However, a large share of land-use regulation variation remains unexplained. Moreover, our results indicate that more stringent land-use regulation is associated with steeper house price increases but less urban sprawl.
Systematic Review of Instruments Assessing Psychosocial Adaptation and Outcomes Among Families of Children With Congenital Heart Disease
Authors: Eagleson Karen J , McCombs Desiree , Gerlich Tiffany M , Justo Robert N , Kasparian Nadine A , Bora Samudragupta
Published: May 2023

Objective

This systematic review identified instruments quantitatively assessing psychosocial adaptation and outcomes in families of children with congenital heart disease (CHD) and evaluated instrument psychometrics.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a prospectively registered protocol, electronic databases (CINAHL, Embase, PubMed/MEDLINE, PsycINFO, and SCOPUS) were searched from inception until June 20, 2021 for peer-reviewed articles published in English, reporting quantitative data on psychosocial outcomes among parents/caregivers, siblings, or family system. Instrument characteristics and psychometrics were extracted, and adapted COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria were applied to assess instrument quality. Descriptive statistics and narrative synthesis were used for analysis.

Results

Overall, 108 articles reporting on 107 distinct samples across 26 countries met inclusion. Across those articles, 40 instruments assessed psychological functioning or distress, 12 assessed coping, 11 assessed quality of life constructs, 10 assessed parenting stress/caregiver burden, 10 assessed family functioning/impact, 10 assessed stress appraisal, 5 assessed sibling psychosocial outcomes, and 2 assessed couple relationship satisfaction/strain. Applying COSMIN criteria to available data on original instrument development articles/manuals for English language instruments (n = 54), 67% scored a positive property evidence rating for content validity, 39% for internal consistency, 4% for test–retest reliability, and 9% for responsiveness (longitudinal validity).

Conclusions

Studies vary widely in instruments used to assess psychosocial adaptation and outcomes among families of children with CHD. Instrument selection informed by robust key psychometrics, increased psychometric reporting, development of both a “toolkit” approach and a comprehensive CHD-specific family instrument are among key recommendations.
A rare case of mixed gonadal dysgenesis in adulthood: diagnostic delay and unique outcomes
Authors: Rueangket Ploywarong , Phansenee Supreechaya , Laoharojvongsa Nutthaporn , Boonyachan Worawat
Published: May 2023

Mixed gonadal dysgenesis (MGD) is a rare sex development disorder, diagnosed by mosaic karyotype of 45,X/46,XY (classical form) with the presence of Müllerian structures, unilateral testis and contralateral streak gonad. MGD expresses diverse phenotypes, from female phenotype with virilization or turner stigmata, to ambiguous genitalia or male phenotype. Early diagnosis is crucial for effective correction of height, sexual development and cancer prevention. The study reports on a case of a 25-year-old patient, reared as female, presenting a large abdominal mass later confirmed as a mixed germ cell tumor. Associated findings were primary amenorrhea, ambiguous genitalia, short statue, gender dysphoria and hyperlipidemia. The study is the first to report on hyperlipidemia in MGD.
Spontaneous knee dislocation: a rare and dreadful complication of septic arthritis
Authors: Alshahir Alwaleed Abdullah , AlNaqa Faisal Hamad , Benmeakel Mohammed Abdulrahman , Alsheikh Khalid Abdullatif
Published: May 2023

Spontaneous knee dislocation without a history of trauma is a rare entity to witness. Herein, we report a case of a patient who presented to the emergency department (ED) with a history of fever, chills and vomiting associated with progressive right knee swelling, pain and impaired range of motion (ROM). Physical exam of her right knee showed symmetrical swelling with diffuse tenderness and limited ROM due to pain. Joint aspirate and full septic workup confirmed the diagnosis of septic arthritis. Following her management and two events of irrigation and debridement of the septic knee, the patient was discharged. However, after 1-week from discharge, she presented to ED with right leg swelling and tenderness despite being bedbound for 3 months and denying any history of trauma with radiographs showing a posterior knee dislocation. This report aimed to shed a light on this dreadful complication of septic arthritis and highlights the importance of early recognition and management.
(029) The Effect of Nipple Neuropathy on Women’s Sexual Health
Authors: Krychman M
Published: May 2023

Introduction

Breast surgery (including lumpectomy, mastectomy, augmentation, and cancer surgery) is a common intervention that women of all ages may experience. In a recent research publication, it is estimated that up to 81.5% reported that stimulation of their nipples/breasts caused or enhanced their sexual arousal whereas 78.2% agreed that when sexually aroused such manipulation increased their arousal, 59.1% had asked to have their nipples stimulated during lovemaking. While breast surgery’s impact on self-esteem has been assessed, breast surgery’s impact on nipple sensation and its relationship to sexual function has often been neglected in the literature. The nipple is a sexual organ; as such, the impact of surgical intervention on sexual function should be assessed.

Objective

An in-office survey was conducted in a sexual medicine office was conducted to assess nipple sensation after a variety of different breast surgeries, and its impact on sexual function.

Methods

An in-office survey was given to a random sampling of women attending sexual medicine/obstetrician and gynecology offices. Fifty women completed the survey. A novel, non-validated, single item, nipple sensation scale, Global Assessment of Nipple Sensation Scale (GANSS), was used as an assessment tool. A Likert scale of nipple sensation was also used, where 1 was very sensitive and 7 was absent sensation. Data regarding demographics and the impact of their surgery due to changes in nipple sensation were collected

Results

Fifty female subjects, at least one year post heterogeneous type breast surgery, reporting nipple neuropathy were surveyed for the extent of neuropathy and associated sexual function changes. The average age of the subjects was 53.6 +/-10.8. The average nipple sensitivity score (Likert scale 1-7) was 5.06+/-1.39. Nipple numbness was reported by 82% of the subjects. 40% of the subjects reported that reduced sensitivity affected their sexual function as well as (sexual desire, lubrication, and arousal. 30% reported distressful impact on orgasmic strength with reports of reduced orgasm intensity. 22% of the respondents reported that the changes in nipple sensitivity had impacted their primary relationship and 32% of women reported that it had negatively impacted their overall sexual wellness.

Conclusions

Breast surgery resulting in decreased nipple sensation is perceived by patients to have impactful changes on sexual self-esteem, sexuality and overall sexual wellness. This is a poorly studied phenomenon and has implications on female sexual health. The assessment tool used in this study needs to be validated and larger clinical trials should be conducted.

Disclosure

Yes, this is sponsored by industry/sponsor: applied. iology

Clarification: Industry funding only - investigator initiated and executed study.
(033) Examining the Neuroanatomical Basis of Bremelanotide, a Drug for Low Sexual Desire in Women
Authors: Kohut-jackson A , Borland J , Meisel R
Published: May 2023

Introduction

Low sexual desire is a commonly reported and often distressing form of sexual dysfunction in women. Characterized by diminished interest in sex, disinclination to initiate sex, and a loss of pleasure during sex, disorders of sexual desire among women are not only poorly understood from a psychological perspective, but also in terms of their underlying neurobiology. The drug bremelanotide, trade name Vyleesi, was approved by the FDA in 2019 to treat hypoactive sexual desire disorder in women. The drug is a synthetic analogue of the melanocortin receptor (MCR) agonist alpha-MSH and thus thought to bind to the melanocortin-4 receptor (MC4R) in the brain. However, despite its FDA approval, few preclinical studies or clinical trials have been performed on the drug.

Objective

We attempted to elucidate bremelanotide’s central nervous system effects in an established rodent model of female sexual behavior.

Methods

Female Syrian hamsters underwent 0, 2 or 5 weeks of sexual conditioning in the conditioned place preference apparatus, a validated model that is designed to test the rewarding properties of sexual behavior. Some hamsters that were conditioned for 2 weeks were also given a subcutaneous injection of bremelanotide. After the sexual conditioning experiment, brains were collected for assessment of MC4R expression in the striatum. mRNA expression of dopamine-1 and 2 receptors and MC4R were carried out using Syrian hamster customized RNAscope probes.

Results

Analysis of behavior data indicated the longer (5-week) sexual conditioning period was most effective for increasing responses indicative of reward, though the shorter (2-week) period also increased reward. However, neither the low dose nor high dose of bremelanotide increased reward responding as compared to control hamsters. Further, no brain changes in MC4R expression in the striatum were detected as a function of either sexual experience or bremelanotide treatment. MC4R was not co-expressed with dopamine-1 or dopamine-2 receptors in the nucleus accumbens or dorsal striatum.

Conclusions

Bremelanotide did not increase responding indicative of reward derived from sex in the female Syrian hamster model. Given that MC4R expression was unaffected by sexual experience and/or bremelanotide, our findings did not provide evidence that the drug acts via an MC4R-related mechanism in the central nervous system. MC4R was also not co-expressed with dopamine-1 or 2 receptors, suggesting the MC4R may instead be expressed by interneurons in the striatum. Despite our lack of evidence to support bremelanotide’s efficacy in animals, limitations of the rodent model of female sex behavior include the obvious psychosocial aspects of human sexuality that cannot be replicated. Further research is warranted to clarify bremelanotide’s mechanism of action.

Disclosure

No
(047) A Thematic Analysis of Sexual Health Disparities Among Native Adolescents
Authors: Evans G
Published: May 2023

Introduction

Native adolescents have significantly higher rates of sexually transmitted infections and unintended pregnancies. Compared to their Non-Hispanic White counterparts, Native adolescents have 2.5 times the rate of pregnancy1, 3.7 times the rate of chlamydia, 4.6 times the rate of gonorrhea, and 2.6 times the rate of primary and secondary syphilis2. Furthermore, Native adolescents are engaging in sexual activity at younger ages and using contraceptive methods less often.3

Objective

To address and identify additional factors associated with the sexual health disparities among Native adolescents.

Methods

The study recruited a purposive sample of key stakeholders who worked in sexual health among American Indian/Alaska Native adolescents by way of an individual with the Healthy Native Youth Project. The individual was provided with information regarding the research study and asked to distribute it to their colleagues. A total of three participants were recruited and interviewed. Qualitative interviews were semi-structured, conducted individually, and recorded using the Zoom recording feature, as well as an iPhone X voice memo application for backup. Interviews lasted 23 – 40 minutes. Interviews were transcribed using Temi and Descript applications and transcripts were coded in Atlas.ti for the thematic analysis. After each transcript had been coded, they were placed into a codebook where they were defined, along with examples of each code. Codes were then grouped into categories where themes emerged.

Results

Three female identifying participants were interviewed for this study. Themes that emerged from the interviews include the overall sexuality education that Native adolescents receive, the importance of culture, and the impact of trauma. Regarding sexuality education among Native adolescents, findings show that it is imperative to acknowledge both the delivery of information, as well as confidentiality concerns. The importance and use of culture within sexual health assists in normalizing sexual health and sexuality education. Lastly, findings from interviews regarding the impact of trauma make it clear that not only is there still medical mistrust, but also that it is imperative to acknowledge it and listen to and validate concerns that the youth have on this matter.

Conclusions

The findings from this study were remarkable and each participant identified the importance of cultural relevancy and the impact that trauma continues to have and the importance of acknowledging it. Given the alarming rates of sexual health disparities among Native adolescents, it is essential to continue research and educational efforts to reduce these disparities. Future implications for this work include ensuring confidentiality, making the invisible become visible, promotion of youth councils, and translation of curricula information to healthcare.

Disclosure

No
(052) Are Vibrators Equally Effective Among Women Engaged in Partnered Versus Solo Sexual Activity?
Authors: Dubinskaya A , Jackson F , Kohli P , Shoureshi P , Eilber K
Published: May 2023

Introduction

Solo sexual activity is solo stimulation of one’s genitals and other body areas for sexual pleasure. Treatment methods for Female Sexual Dysfunction (FSD), developed to date are usually assessed in the context of partnered sexual activity. There is a growing need to compare the effect of therapeutic interventions, like vibrators, among women engaged in only solo sexual activity versus partnered sexual activity.

Objective

The aim of this study was to assess the effect of routine vibrator use on sexual health among women engaged in solo only versus partnered sexual activity.

Methods

This was a prospective pilot study of sexually active women aged 18 to 99 years who presented for consultation in our urogynecology clinic with pelvic floor and/or sexual health concerns. Women were offered a bullet vibrator and instructed to use it according to the protocol. Participants’ demographics, health data, sexual practices, frequency of solo and partnered sexual activity, as well as Female Sexual Function Index (FSFI) were assessed at the initial visit and after three months of intervention. We used descriptive statistics and a paired-sample t-test to determine the effect of vibrator use on sexual function.

Results

Among 61 women enrolled in this study, 60.6% (n=37) were engaged in partnered sexual activity and 39.3% (n=24) were only solo sexually active. Participants were predominantly Caucasian (80.3%), with a mean age of 54.7 ± 16.3. There were no significant differences in demographics and pelvic floor disorders (prolapse, urinary incontinence) between the two groups. Vibrator use among women in a solo group did not show significant improvement in sexual response cycle domains (p>0.05). However, the score statistical trend was noted across all the domains. Women engaged in partnered sexual activity had significant improvement in desire (p=0.03), arousal (p=0.03), orgasm (p=0.05), and the total score (p=0.03) with vibrator use. The study completion was higher among women involved in partnered sexual activity 94.6% (n=35) than women who only engaged in solo sexual activity 58.3%(n=14).

Conclusions

Vibrator therapy results in significant improvement in desire, arousal, and orgasm domains, as well as total score among women in partnered sexual activity when compared to women with only solo sexual activity. Solo sexual activity needs to be considered when recommending treatments, such as vibrators, for sexual health.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Abbvie, Coloplast.
(063) Assessing the Knowledge, Attitudes, and Practices of Graduating Medical Students Towards Sexual Health in Lebanon
Authors: El Kak F
Published: May 2023

Introduction

Despite the growing medical literature pertaining to the topic of SH, only a few studies have investigated the adequacy of medical training programs for graduating physicians who are able to identify, counsel, and manage SH concerns. Additionally, no studies have comprehensively assessed the knowledge, attitudes, and practices of medical students regarding SH. This gap in literature is even more evident in the Middle East and North Africa (MENA) region, which could be attributed to cultural and religious factors. These factors not only impede the exploration of SH topics in the medical field, but also manifest as lack of accessibility and availability of SH services in Arab countries.

Objective

Despite the vital role of Sexual Health (SH) in healthcare, very few studies have investigated the adequacy of training of medical students in SH matters. Our study aims to assess the knowledge, attitudes, practices, and readiness of graduating medical students to learn about SH in Lebanon, and to determine the demographic and educational factors that influence our findings.

Methods

This is a cross-sectional study. A self-designed questionnaire exploring various components of SH (contraception, STIs, IPV, sexuality, etc.) was sent to all graduating medical students in Lebanon. Knowledge, attitude, and practice scores were computed. ANOVA with subsequent post-hoc tests were used for analysis.

Results

The overall mean knowledge score was relatively low (2.61, range -13 to 10). A statistically significant difference was found in the mean knowledge score across religion (p = 0.028) and religiosity (p < 0.001) categories as the mean knowledge score was higher in the atheist group when compared to the religious groups, and that of the “moderately/very religious” category was lower than that of the “not/slightly religious” (p = 0.001). The mean practice score also differed significantly across income groups (p = 0.01). No other significant associations were found between gender, sexuality, environment, primary source of SH education, or language and the mean knowledge, attitude, and practice scores.

Conclusions

Our findings suggest that graduating students in Lebanese medical schools are not appropriately trained to address SH matters in clinical practice. This allows medical educators to examine the gaps in knowledge, attitude, and practice towards sexual healthcare. Pertinently incorporating, reforming, and updating SH education in medical school curricula would provide students with the appropriate skillset needed for their upcoming medical practice. Additional standardized assessment of medical students’ competencies in SH matters through diverse research models is needed. Reexamination of existing medical curricula and inclusion of more extensive SH education is necessary to improve patient care. Our study is the first study in Lebanon and the MENA to look at SH competencies of future physicians in a comprehensive approach.

Disclosure

No
(070) Treatment of Genitourinary Syndrome of Menopause is Beneficial for Lichen Sclerosus Patients
Authors: Myers A , Marino J , Pope R
Published: May 2023

Introduction

Postmenopausal women with Lichen Sclerosus frequently report vulvar symptoms consistent with genitourinary syndrome of menopause (GSM) including pruritus, dyspareunia, or non-provoked pain. Our data revealed not surprising vulvar itching as the most frequently reported symptom of LS, second most frequent was general irritation, followed by vaginal dryness, and vulvar burning. Distinguishing these symptoms from GSM which occurs in 27-84% of postmenopausal women can be problematic.

Objective

The purpose of this study was to understand the symptoms of postmenopausal women with LS. We specifically surveyed them regarding their symptoms and treatments they had tried including both prescription and over the counter.

Methods

We interviewed 25 women with biopsy proven LS. This was part of a larger study on the microbiome and genetics of postmenopausal women with LS.

Results

Our data revealed that while the majority of the women in our study were using standard treatments such as high or medium potency steroid ointments or calcineurin inhibitor, less than 25% reported using hormonal medicines in their vulva (4 of 17), a common treatment for postmenopausal symptoms of vulvar burning, general irritation and dryness; Our data revealed that 50% of the women reported they had used at least more than one prescription or over the counter product to manage symptoms, none of which were hormone related.

Conclusions

Our data suggests that while these women were treated for their LS, their menopausal symptoms were not addressed. These findings lead us to believe perhaps their menopausal symptoms had been undertreated and that LS symptoms may be difficult to manage exclusively with standard treatments such as steroids and/or calcineurin inhibitors in postmenopausal women. Treatment of GSM with standard recommended treatments is beneficial for LS patients.

Disclosure

No
(093) “Vagina” is Not a Bad Word: Historical and Contemporary Censorship of the Word “Vagina”
Authors: Popat S , Horwitz R , Eilber K , Lee U
Published: May 2023

Introduction

The first recorded use of the word “vagina” was in 1680. It is the only contemporary anatomic term for the female reproductive canal and has no anatomically accurate substitute. For the last 350 years, use of the word has been intentionally avoided in media, print, and society in general.

Objective

We sought to characterize instances of “vagina” censorship to better understand perceptions and behaviors surrounding the word “vagina.”

Methods

An internet and relevant database (PubMed, Academic OneFile, Proquest, Health Business Elite, etc.) search was conducted for “vagina, “censor,” and related wildcard terms. Search results were filtered by three independent reviewers for relevance. Related articles were summarized and reviewed for common themes.

Results

Examples of censorship of the word “vagina” were compiled in Table 1, and several themes were identified: (1) Policies surrounding censorship are unclear. Affected parties typically receive generic responses – for instance, that content “does not comply” with standards. Censoring parties oftentimes will not explicitly identify language or elements of concern. (2) Policies appear highly variable. In advertisements for similar products on the same social media platforms, some companies successfully use the word “vagina” while others are barred, highlighting puzzling inconsistencies. (3) Another related theme that emerges is differing standards between references to male and female genitalia. For example, “penis” and associated references were often allowed by the same television shows that mandated censorship or omission of “vagina.” (4) Objections often call the use of “vagina” overtly sexual, profane, or unprofessional. However, “vagina” refers to an anatomical term for which there is no suitable, biologically accurate alternative. Censorship of the word forces inaccurate, over-generalized, ambiguous references to female genitalia.

Conclusions

The word “vagina” is censored across multiple platforms: print, film and television, social media, politics, education, and more. It has been censored for centuries and continues to be today. This erects barriers to care for women. Patients increasingly turn to the internet and other media platforms as accessible sources of high-quality health information about their bodies. Pervasive censorship of the word “vagina” perpetuates a culture of ignorance and shame about women’s bodies. Until we normalize the term “vagina,” we cannot make progress on women’s pelvic health.

Disclosure

No
(102) Basic Research for Determination of Normal Levels of Sex Hormones (Testosterone, Free Testosterone, DHEA-S, Estradiol, IGF-1) in Middle-aged and Elderly Japanese Women
Authors: Sekiguchi Y
Published: May 2023

Introduction

Testosterone, the hormone that also keeps women motivated to live with sexual desire, is important in maintaining the health of women of all ages. However, it remains difficult to judge whether testosterone levels in female patients are normal or not, based on test results in general clinical practice.

Objective

From October 2020 to February 2021, 160 healthy volunteer women who visited 5 clinics were collected blood, tested, and free testosterone. Testosterone, DHEA-S, were measured. At same time, estradiol and IGF-1 which suggested the level of growth hormone were measured.

Methods

The measurement was outsourced to LSI Medience Biomedical Blood Test Department, and male hormone levels were collectively measured by the CLIA method. Age of the female volunteers was mean 45 years, median 41 years, maximum 87 years, minimum 20 years. The population distribution was 16 in their 20s, 52 in their 30s, 43 in their 40s, 17 in their 50s, 15 in their 60s, 10 in their 70s, and 7 in their 80s.

Results

See Table 1

Conclusions

DHEA, free testosterone and IGF-1 declined with age, but the level of decline of testosterone was smaller than the others. Moreover estradiol was maintained as 10∼20pg/ml so called therapeutic window.

Disclosure

No
(121) Female Sexual Dysfunction: Can it be Addressed During Infertility Treatment?
Authors: Schaub A , Dubinskaya A , Eilber K , Pisarska M
Published: May 2023

Introduction

Female sexual dysfunction (FSD) is a highly prevalent and distressing condition in the general population. Women undergoing fertility treatments are at higher risk of developing sexual dysfunction due to associated stress, sense of sexual activity as being routine, and demanding treatment regimens. Despite the known association between FSD and infertility, the optimal FSD treatment regimen for the infertility patient has not been described.

Objective

Our objective was to determine the optimal FSD treatment strategy for women with infertility.

Methods

We conducted a systematic review on the current approaches to treat FSD while undergoing fertility treatments. PubMed, PMC and Google Scholar were queried, and results were screened using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria for this review were: 1) Subjects were women presenting for infertility treatment, 2) Sexual health was described and measured, 3) Interventions were performed or recommended to the subjects with measured outcomes and 4) The manuscript was written in English between January 2000 to June 2022. Case reports and studies that did not address conditions of interest were excluded from analysis.

Results

Queries identified 2,341 studies of which title and summary were screened. 15 articles were identified for full text review, and only 1 article met inclusion criteria. The single article identified was a prospective cohort study including 35 women with infertility in each arm. The intervention arm underwent 2 sessions of sexual counseling following the BETTER method, and at a 3 month follow up period FSFI scores were significantly improved in the intervention arm compared to the control arm.

Conclusions

Given the significant risk for FSD in this population, the fact that only one study could be identified on this topic is a huge gap in the medical knowledge that requires more investigation. The single study identified suggests counseling may be a successful treatment option for women with FSD and infertility, but more studies are needed to determine what other options are available and effective for FSD in this population.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Ferrring pharmaceuticals
(122) Provider Attitude towards Postpartum Sexual Health
Authors: Shearer K , Khanna P
Published: May 2023

Introduction

The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41% and is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic and the use of a standardized screening questionnaire could be implemented to improve outcomes during postpartum appointments.

Objective

To assess provider knowledge and practices towards postpartum sexual health with the goal of improving postpartum sexual health.

Methods

Providers who care for postpartum patients at [institution and city obscured], were asked to complete an anonymous survey online to assess providers’ general knowledge and practices.

Results

79% of respondents answered that they felt very comfortable assessing postpartum sexual health and 88% expressed a need for continuing education on sexual medicine. The most common response for barriers to care was a lack of time. None of the respondents reported using questionnaires to assess sexual health.

Conclusions

The most significant barriers to assessing postpartum sexual health are a lack of time and provider knowledge. To overcome this, a standardized questionnaire should be created and improved continuing education should be implemented.

Disclosure

No
(126) Development of a Patient Reported Outcome Measure for Lichen Sclerosus
Authors: Pope R , Myers A , Marino J
Published: May 2023

Introduction

Patient-reported outcome measures (PROMs) can provide information that complements the provider-assessed clinical outcome measures of gynecologic and dermatologic diseases. As part of a larger study on lichen sclerosus (LS), genetics and the microbiome, we noted discrepancy between clinical assessment of LS and participant symptoms. Without a PROM, it is impossible to compare our results to those in the literature. Lichen sclerosus is a chronic vulvar dermatosis that affects approximately 1 in 70 women and can cause scarring, sexual dysfunction and malignancy (Krapf, 2020). However, the severity of LS symptoms may not be representative of the current clinical appearance. For example, the patient may report extreme pruritus and general irritation, yet the vulva may not appear erythematous or even consistent with active disease. On the other hand, patients may incidentally be diagnosed w lichen sclerosus after the provider noted classic characteristics including white plaques, erythema, and architectural changes of the labia and clitoral hood and yet the patient may not realize they had a vulvar skin condition with a history of only minimal to no symptoms noted.

Objective

The aim of our study is to develop patient-reported outcome measures of lichen sclerosus to incorporate patient’s experiences of LS and be able to correlate them to clinical management.

Methods

Methods: We evaluated 25 initial participants with biopsy proven lichen sclerosus and collected incidence of patient reported outcome measures as the first step of developing a larger PROM based investigation.

Results

25 participants enrolled in the study and completed questionnaires on symptoms. Many of these participants were not using topical steroid treatment for symptoms. Most commonly experienced symptoms were: prutitis (52%, n=13, burning (28%, n=7, general irritation (n=12, dryness (48%, n=8), dyspareunia (40% n=10). For many women, the symptoms radiated, woke them up from sleep and caused overall disruption of their quality of life.

Conclusions

The next step will be to create a prospective survey of women living with LS to collect the most important symptoms according to patients and not just frequency. We hope eventually therapeutic strategies can be targeted at treating these specific symptoms and managing the disease state.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Johnson and Johnson.
Deep integrative models for large-scale human genomics
Authors: Sigurdsson Arnór I , Louloudis Ioannis , Banasik Karina , Westergaard David , Winther Ole , Lund Ole , Ostrowski Sisse Rye , Erikstrup Christian , Pedersen Ole Birger Vesterager , Nyegaard Mette ,   DBDS Genomic Consortium, Banasik Karina , Bay Jakob , Boldsen Jens Kjærgaard , Brodersen Thorsten , Brunak Søren , Burgdorf Kristoffer , Chalmer Mona Ameri , Didriksen Maria , Dinh Khoa Manh , Dowsett Joseph , Erikstrup Christian , Feenstra Bjarke , Geller Frank , Gudbjartsson Daniel , Hansen Thomas Folkmann , Hindhede Lotte , Hjalgrim Henrik , Jacobsen Rikke Louise , Jemec Gregor , Kaspersen Katrine , Kjerulff Bertram Dalskov , Kogelman Lisette , Hørup Larsen Margit Anita , Louloudis Ioannis , Lundgaard Agnete , Mikkelsen Susan , Mikkelsen Christina , Nielsen Kaspar Rene , Nissen Ioanna , Nyegaard Mette , Ostrowski Sisse Rye , Pedersen Ole Birger , Henriksen Alexander Pil , Rohde Palle Duun , Rostgaard Klaus , Schwinn Michael , Stefansson Kari , Stefónsson Hreinn , Sørensen Erik , Thorsteinsdóttir Unnur , Thørner Lise Wegner , Bruun Mie Topholm , Ullum Henrik , Werge Thomas , Westergaard David , Brunak Søren , Vilhjálmsson Bjarni J , Rasmussen Simon
Published: May 2023

Polygenic risk scores (PRSs) are expected to play a critical role in precision medicine. Currently, PRS predictors are generally based on linear models using summary statistics, and more recently individual-level data. However, these predictors mainly capture additive relationships and are limited in data modalities they can use. We developed a deep learning framework (EIR) for PRS prediction which includes a model, genome-local-net (GLN), specifically designed for large-scale genomics data. The framework supports multi-task learning, automatic integration of other clinical and biochemical data, and model explainability. When applied to individual-level data from the UK Biobank, the GLN model demonstrated a competitive performance compared to established neural network architectures, particularly for certain traits, showcasing its potential in modeling complex genetic relationships. Furthermore, the GLN model outperformed linear PRS methods for Type 1 Diabetes, likely due to modeling non-additive genetic effects and epistasis. This was supported by our identification of widespread non-additive genetic effects and epistasis in the context of T1D. Finally, we constructed PRS models that integrated genotype, blood, urine, and anthropometric data and found that this improved performance for 93% of the 290 diseases and disorders considered. EIR is available at https://github.com/arnor-sigurdsson/EIR.
Carotid intima-media thickness and atherosclerotic plaques are associated with renal function decline: a 14-year longitudinal population-based study
Authors: Goepfert Miriam , Ittermann Till , Dörr Marcus , Friedrich Nele , Völzke Henry , Dabers Thomas , Felix Stephan B , Schminke Ulf , Stracke Sylvia , von Rheinbaben Sabrina
Published: May 2023

Background

Chronic kidney disease (CKD) leads to increased morbidity and mortality. The underlying causes of CKD are often similar to those of atherosclerosis. We investigated whether carotid atherosclerotic parameters are associated with renal function decline.

Methods

Within the population-based Study of Health in Pomerania (SHIP), Germany, 2904 subjects were observed over 14 years. The carotid intima-media thickness (cIMT) as well as carotid plaques were measured by standardized B-mode ultrasound protocol. CKD is defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and albuminuria as urinary albumin–creatinine ratio (ACR) ≥30 mg/g. eGFR was calculated by the full age spectrum (FAS) equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Mixed models were applied to associate carotid parameters with change in renal function longitudinally and adjusted for confounding.

Results

The age range of the study sample was 25–86 years with a median of 54 years at baseline. In longitudinal analyses, subjects with high cIMT and the presence of plaques at baseline showed a greater decrease in eGFR (cIMT: FAS-eGFR: P < .001, CKD-EPI-eGFR: P < .001; plaques: FAS-eGFR: P < .001, CKD-EPI-eGFR: n.s.) as well as an increased risk of developing CKD during the follow-up (cIMT: FAS-eGFR: P = .001, CKD-EPI-eGFR: P = .04; plaques: FAS-eGFR: P = .008, CKD-EPI-eGFR: P = .001). There was no association between atherosclerotic parameters and the risk of developing albuminuria.

Conclusions

cIMT and carotid plaques are associated with renal function decline as well as CKD in a population-based sample. Furthermore, the FAS equation adapts best to this study population.
A Prospective Study of Key Correlates for Household Transmission of Severe Acute Respiratory Syndrome Coronavirus 2
Authors: Brown Elizabeth R , O’Brien Meagan P , Snow Brian , Isa Flonza , Forleo-Neto Eduardo , Chan Kuo-Chen , Hou Peijie , Cohen Myron S , Herman Gary , Barnabas Ruanne V
Published: May 2023

Background

Randomized controlled trials evaluated monoclonal antibodies for the treatment (Study 2067) and prevention (Study 2069) of coronavirus disease 2019 (COVID-19). Household contacts of the infected index case in Study 2067 were enrolled in Study 2069 and prospectively followed; these cohorts provided a unique opportunity to evaluate correlates of transmission, specifically viral load.

Methods

This post hoc analysis was designed to identify and evaluate correlates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, adjusting for potential confounding factors related to source SARS-CoV-2 viral load and risk of SARS-CoV-2 acquisition in this population. Correlates of transmission were evaluated in potential transmission pairs (any infected household member plus susceptible household contact).

Results

In total, 943 participants were included. In multivariable regression, 2 potential correlates were determined to have a statistically significant (P < .05) association with transmission risk. A 10-fold increase in viral load was associated with a 40% increase in odds of transmission; sharing a bedroom with the index participant was associated with a 199% increase in odds of transmission.

Conclusions

In this prospective, post hoc analysis that controlled for confounders, the 2 key correlates for transmission of SARS-CoV-2 within a household are sharing a bedroom and increased viral load, consistent with increased exposure to the infected individual.
International trade shapes global mercury–related health impacts
Authors: Xing Zhencheng , Chang Ruirong , Song Zhengcheng , Zhang Yanxu , Muntean Marilena , Feng Kuishuang , Liu Yifan , Ma Zongwei , Wang Jigan , Zhang Jie , Wang Haikun
Published: May 2023

Mercury (Hg) is a strong neurotoxin with substantial dangers to human health. Hg undergoes active global cycles, and the emission sources there of can also be geographically relocated through economic trade. Through investigation of a longer chain of the global biogeochemical Hg cycle from economic production to human health, international cooperation on Hg control strategies in Minamata Convention can be facilitated. In the present study, four global models are combined to investigate the effect of international trade on the relocation of Hg emissions, pollution, exposure, and related human health impacts across the world. The results show that 47% of global Hg emissions are related to commodities consumed outside of the countries where the emissions are produced, which has largely influenced the environmental Hg levels and human exposure thereto across the world. Consequently, international trade is found to enable the whole world to avoid 5.7 × 105 points for intelligence quotient (IQ) decline and 1,197 deaths from fatal heart attacks, saving a total of $12.5 billion (2020 USD) in economic loss. Regionally, international trade exacerbates Hg challenges in less developed countries, while resulting in an alleviation in developed countries. The change in economic loss therefore varies from the United States (−$4.0 billion) and Japan (−$2.4 billion) to China (+$2.7 billion). The present results reveal that international trade is a critical factor but might be largely overlooked in global Hg pollution mitigation.
Hydrogen transfer reactions via organic radicals in gamma-irradiated chibaite
Authors: Yokoyama Yuka , Isogai Shusuke , Kusuki Kenta , Tani Atsushi , Nishido Hirotsugu
Published: May 2023

Chibaite, a silica-framework structure with cage-like voids occupied by gaseous molecules, was found in marine sediments. Its formation age could be evaluated using electron spin resonance (ESR) if the radicals formed by natural radiation can be assumed to accumulate over time. To investigate whether hydrogen transfer reactions, where organic radicals withdraw hydrogen atoms from other molecules in adjacent cages, occur in chibaite and affect ESR dating, gamma-irradiated chibaite was measured by ESR. Methyl, ethyl, n-propyl, isopropyl, tert-butyl radicals and hydrogen atoms were created by gamma irradiation at 77 K. The amount of tert-butyl radicals increased around 240 K and the similar amount of the other organic radicals decreased simultaneously, implying that hydrogen transfer reactions occur between isobutane and the organic radicals in chibaite around 240 K and therefore would have no influence on ESR dating because the reactions are completed at the environmental temperature.