bluuebunny/crossref_metadata_2025_split huggingface dataset:
(089) TESTICULAR VASAL DIAMETER: A NEW INTRA-OPERATIVE PREDICTOR OF SUCCESSFUL VASECTOMY REVERSAL
Authors: Armstrong D , Grant LJ , Maloney TJ , Dean RC , Hawksworth DJ 
Published: December 2024

Abstract

Introduction
Vasovasostomy (VV), a preferred surgical technique for vasectomy reversal (VR), carries much higher reported success rates than a more complex vasoepididymostomy (VE). Although increased patient age and obstructive interval (OI) are well-established pre-operative factors predictive of need for a VE, the ultimate choice of VR technique is made at surgeon’s discretion, based on intra-operative findings. Intra-operative vasal fluid evaluation results may be affected by the level of operative staff experience and training.

Objective
We aimed to examine vasal lumen diameters, measured by the surgeon, as additional objective predictors of VR success.

Methods
Consecutive records of patients who underwent VR at our Institution between January 2008 and June 2023 were queried retrospectively. Patient demographics, medical and social history, pre-operative physical examination, and available laboratory data (Semen Analysis, Testosterone, Estradiol, and Inhibin B) were collected. Operative reports were reviewed and data including type of reversal (VV or VE), and intra-operative findings (vasal lumen diameters, presence of sperm granuloma/surgical clips, sperm quality, and vasal fluid quality) were recorded. Patient telephone calls were conducted to collect post-VR pregnancy information. Data were analyzed with use of descriptive statistics, t-tests, ANOVA, and Mann Whitney U tests when appropriate.

Results
733 records were reviewed, consisting of 536 bilateral VV, 99 combination VV/VE, and 75 bilateral VE operations. Average patient age at reversal was 38 years with an average OI of 10 years. VE was associated with a significantly larger testicular vasal lumen diameter (0.94 mm vs 0.88 mm; p &lt; 0.05), decreased odds of positive post-operative semen analysis (92.4% bilateral VV versus 64.4% VV/VE or bilateral VE), and increased OI (7.84 years bilateral VV versus 11.5 years VV/VE or bilateral VE).

Conclusions
This study identifies a previously unreported association between testicular vasal lumen diameter measurements and likelihood of VR success. Furthermore, the study confirms previously reported pre- and intra-operative factors predictive of VR success. Additional analysis and correlation with pregnancy outcomes are in progress.

Disclosure
No.
(093) EFFECT OF VARICOCELECTOMY ON SPERM DNA FRAGMENTATION QUANTIFICATION IN INFERTILE MEN
Authors: Fleming B , Song J , Burchfiel E , Boyne A , La T , Desai S , Applewhite J , Orozco Rendon D , Khera M 
Published: December 2024

Abstract

Introduction
Varicoceles are present in up to 35% of men presenting with male factor infertility and are thought to affect spermatogenesis by raising testicular temperature among other mechanisms. Varicocelectomy is a viable intervention to improve sperm quality in infertile men. One measure of sperm quality, sperm DNA fragmentation (SDF), refers to the percent of sperm with damaged DNA in an ejaculate which can be a major indicator of male infertility. While the correlation between varicoceles and elevated SDF has previously been established, there are relatively few studies that quantify the effect varicocelectomy has on SDF.

Objective
The purpose of this study is to quantify the change in SDF following varicocelectomy in a cohort of infertile men from a single institution at three months post varicocelectomy and at the time of their most recent follow up visit compared to their initial preoperative SDF measurements.

Methods
An ongoing retrospective chart review of infertile men who underwent varicocelectomy from 2009-2024 at our high-volume men’s health center was undertaken. A total of 338 adult men with no prior varicocelectomy at an outside institution were included in our database. Only patients with SDF assays obtained before and after varicocele repair were included in our analysis (n = 21). The mean difference between SDF baseline values and SDF values at three months and at the time of their most recent follow up visit post varicocelectomy was calculated for each patient, and a paired t-test was used to test for significance.

Results
In our cohort, the average age at presentation was 34.3 (SD 1.812) years, and each subject was referred to our clinic for possible male factor infertility. Initial SDF assays (measured from 0-100%) performed before varicocelectomy revealed a mean baseline SDF of 38.19% (SD 6.613). The SDF assays performed at three months post varicocelectomy revealed a mean reduction in SDF of 6.19% (SD 3.44; p = .02), equating to a mean SDF of 32.0%. At the time of the patients’ most recent follow up (mean 9.47 ± 1.77 months), SDF decreased by a mean of 9.38% (SD 6.23; p = .03), which equates to a mean SDF of 28.81%.

Conclusions
Our results indicate that varicocelectomy significantly reduces SDF in infertile men at both their three month and most recent follow up visits. In our sample, patients’ SDF values improved from the time of their three months visit to their most recent. This study can eventually be used to manage expectations for infertile patients who undergo varicocelectomy, however additional research is necessary to determine how the grade of varicocele at presentation, laterality, and number of veins ligated affect SDF change.

Disclosure
No.
(098) IMPACT OF PRE-TREATMENT COUNSELLING ON DECISIONAL REGRET OF PROSTATE CANCER SURVIVORS: CROSS-SECTIONAL ANALYSIS OF PATIENT REPORTED EXPERIENCE FOLLOWING DIAGNOSIS OR TREATMENT
Authors: Southall T , Chung D , Sidhom K , Nayak J , Patel P 
Published: December 2024

Abstract

Introduction
Prostate cancer (PCa) impacts patient lives beyond oncological concerns alone. PCa survivorship includes the mental, physical, sexual, emotional, and financial effects patients endure from time of diagnosis, through treatment, and beyond. For some, this includes decision regret (DR). We aim to determine survivor experiences and understanding from a functional perspective throughout survivorship.

Objective
Our objective was to describe the local experiences and perspectives of PCa survivors regarding their functional outcomes at both the pre and post treatment level. Additionally, we sought to investigate the relationship between patients’ understanding of sexual and urinary side effects of treatment as well as modality of care delivery (ie virtual or in person) and development of treatment DR.

Methods
This is a cross-sectional survey of survivors. Our survey was circulated to all members of the Manitoba Prostate Cancer Support Group. Topics included erectile dysfunction (ED), penile shortening, urinary incontinence, and patient understanding throughout their care. Survey items included binary and Likert scale questions regarding patient understanding and treatment impact, as well as an open answered question asking how survivorship care may be improved. Responses were used identify predictors of DR.

Results
514 patients received our survey with a response rate of 23.7% (n = 122). The average age of diagnosis and treatment were 65.2 and 65.9 respectively. Most common treatments included 63.9% radical prostatectomy (RP), 54.1% radiotherapy (RT), and 36.1% androgen deprivation therapy (ADT). 71.9% reported sexual health to be very or somewhat important, but 27.9% reported no pre-treatment discussion of potential ED. 14.9% reported lacking understanding of treatment impact on erections. 76.9% reported no counselling on penile shortening and 95.0% reported no counselling on climacturia, prior to treatment. 27.3% reported no pre-treatment discussion of urinary incontinence and 11.5% reported lacking understanding of treatment impact on urination. Predictors of DR included treatment with RP, and low pre-treatment understanding of potential ED and urinary incontinence. Common open answer responses included desire for more information regarding support groups, treatment side effects, and management of such.

Conclusions
PCa survivors are at high risk of DR. Virtual care does not seem to impact DR. However, the degree of pre-treatment understanding of treatment options and their functional impact does. Survivors are motivated to learn about their condition, requesting more information on treatments, side effects, and local support groups. Apart from PCa diagnosis and management, it is equally as important to discuss functional aspects.

Disclosure
No.
(099) UNDER PRESSURE: STRESS IS NEGATIVELY ASSOCIATED WITH LIBIDO AND INTERCOURSE FREQUENCY
Authors: Seyer A , Nolte D , Kenfield S , Belarmino A , Civello D , Smith J , Helo S 
Published: December 2024

Abstract

Introduction
Undergoing fertility testing can be a stressful event in a couple's life. This can impact multiple aspects of life, including sex.

Objective
To evaluate the relationship between stress and sexual function in men undergoing fertility testing.

Methods
We performed a review of a prospectively maintained database of men utilizing a mail-in semen analysis test system developed by Fellow Health, Inc. Those included consented to participate in research, were 18 or older, and completed survey questionnaires on both their quality of life and sexual function. Stress level (low, moderate, or high stress) was determined using the validated Perceived Stress Scale (PSS) 10-question survey. The sexual function survey assessed libido, orgasmic and ejaculatory dysfunction, intercourse frequency, Erection Hardness Score, and IIEF-5 score. Descriptive statistics were reported and chi-squared and t-tests were used to determine statistical significance at the 0.05 alpha level.

Results
A total of 2077 men undergoing fertility testing were included in this study. 50.2% reported moderate stress levels and 2.6% reported high stress levels. Those with low stress were older than those with moderate or high stress (average 35.4 vs. 34.3 and 34.0 years, respectively; p &lt; 0.01). Men with high stress levels were more likely to report a “poor” or “terrible” libido (31.4%) compared to those with moderate or low stress, 17.2% and 9.5%, respectively (p &lt; 0.01). Stress was highly associated with weekly intercourse frequency (p &lt; 0.01): among men with high levels of stress, 25.5% reported having sex less than once a week compared to 6.0% of men with low stress. Likewise, no highly stressed men reported having sex more than six times per week compared to 2.8% of men with low stress. Whereas 80.4% of men with low stress were evaluated to have “No signs of ED” by the IIEF-5, the same was true for only 62.3% of moderately stressed men and 56.0% of highly stressed men (p &lt; 0.01).

Conclusions
More than half of men undergoing fertility testing report increased levels of stress, which is negatively associated with libido and erectile function. In men seeking fertility evaluation, lifestyle factors such as stress levels should be assessed to identify patients who may benefit from stress management strategies.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Fellow Health.
(109) CONTEMPORARY HIGH-LEVEL RADIATION THERAPY PROSTATE CANCER TRIALS MAY UNDERESTIMATE THE RISK OF BIOCHEMICAL RECURRENCE
Authors: Mulhall J , West M , Flores J 
Published: December 2024

Abstract

Introduction
Prostate specific antigen (PSA) is an important tool for the diagnosis of prostate cancer and detection of biochemical recurrence (BCR) after treatment. Secretion of PSA is a testosterone (T) dependent process. When T levels are below saturation point, PSA levels may be artificially low. T recovery rates after ADT cessation are variable and often fail to normalize. Recent data suggest that PSA levels should be indexed to T levels. The Radiation Therapy Oncology Group (RTOG, now NRG) has performed numerous clinical trials of radiotherapy (RT) with androgen deprivation therapy (ADT) in this population.

Objective
We explored whether the RTOG trials have indexed post-treatment PSA to T levels.

Methods
The clinicaltrials.gov (CTG) website was reviewed for RT/ADT clinical trials run by the RTOG/NRG over the past decade. For studies with results, manuscripts were reviewed; for the others the CTG protocol was reviewed. Demographic, oncologic, and treatment characteristics such as age, baseline PSA, Gleason grade, and length of treatment were collected if available. Data were reviewed assessing for mention of T measurement at time of post-treatment PSA checking, as well as assay suggested and time of day adherence for T measurement.

Results
15 clinical trials that met the study criteria were identified (Table). 14 029 patients have been enrolled. Median age was 64 (IQR [interquartile range] 2.5) years, median PSA was 0.5 (IQR 3.8), median Gleason grade group was 2 (IQR 1). 6/15 (40%) made no mention of T measurement whatsoever. None of the manuscripts published to date reported any T levels. One study had T recovery after ADT in the CTG results. Only 4/10 (40%) protocols stipulated that T should be measured concurrently with PSA, for an overall 27% T measurement performance rate. Only 1 protocol stipulated the type of assay and time of day (morning) measurement. 9/15 (60%) did not require regular follow up testosterone measurements for patients on ADT, while only 2/15 (13%) studies required a baseline T level to be measured.

Conclusions
Routinely indexing testosterone to PSA levels after high level RT/ADT trials is uncommon. This renders the BCR data unreliable, potentially underestimating BCR rates in these trials.

Disclosure
No.
(111) PROSTATE SPECIFIC ANTIGEN LEVELS IN TRANSGENDER WOMEN ARE LOWER THAN CISGENDER MEN
Authors: Nguyen V , Morris S , Meagher M , Burke L , Freedland S , Nik-Ahd F , Rose B , Patel D , Salmasi A , Anger J , Jamieson C 
Published: December 2024

Abstract

Introduction
Little is known about incidence and screening patterns of prostate cancer, a hormone-sensitive malignancy, among transgender and nonbinary (TGNB) individuals assigned male at birth.

Objective
We sought to evaluate prostate specific antigen (PSA) levels in this population compared to cisgender men and to investigate effect of gender affirming hormonal therapy.

Methods
We identified TGNB HIV-negative individuals age &gt; 40 from the California Collaborative Treatment Group 603 study aimed at evaluating pre-exposure prophylaxis. We then assembled a 3:1 comparison group of cisgender men age &gt; 40 followed by Urology for a diagnosis other than elevated PSA. Data abstracted included age, sex assigned at birth, gender identity, race/ethnicity, PSA, testosterone and estradiol levels, and use of hormone therapy.

Results
We identified 31 TGNB individuals (median age 47 years, 77% on estrogen, 48% on antiandrogen) and 94 cisgender men (median age 57 years, 25% on testosterone; Table 1). PSA was significantly lower in TGNB individuals (0.23 vs 0.93 ng/ml, p &lt; 0.01); this remained true after stratifying by age (Table 2). Age and testosterone were significant predictors of increased PSA (p &lt; 0.01) in both cohorts. Estradiol levels significantly predicted decreased PSA (p &lt; 0.01) in both cohorts, whereas antiandrogen and estrogen therapy were predictors of decreased PSA in TGNB individuals (p &lt; 0.01, Table 3). On multivariate analysis, testosterone level remained the only significant predictor of PSA (p &lt; 0.01).

Conclusions
PSA levels are lower among TGNB individuals assigned male at birth with a retained prostate. Testosterone level is a key determinant of PSA and use of gender affirming hormones is associated with lower PSA. Further studies are needed to establish prostate cancer screening cutoffs in this population.

Disclosure
No.
(145) TRANSDERMAL APPLICATION OF H100™ GEL TO THE PENILE SHAFT IN PATIENTS WITH PEYRONIE’S DISEASE INFILTRATES THE TUNICA ALBUGINEA
Authors: Twidwell J , Tortorelis D , Mahon J , Levine L 
Published: December 2024

Abstract

Introduction
Noninvasive treatment options for Peyronie’s disease (PD) remain limited. Topical H100™ gel (Hybrid Medical, Edina, USA) which contains nicardipine, super oxide dismutase and emu oil showed safety and efficacy in a previous small double-blind, placebo- controlled pilot study.

Objective
The present study evaluates if topically applied H100™ gel applied to the penile shaft infiltrates the tunica albuginea. Nicardipine is a key active ingredient in H100™ and serves as a surrogate marker.

Methods
3 men already scheduled to undergo a planned surgical procedure for PD applied commercially available H100™ gel twice daily to the penile shaft for up to 30 days prior to the procedure. Tunica albuginea samples were obtained at surgery. Nicardipine evaluation was performed using isotope dilution technique via liquid- chromatograph-mass spectrometry (LCMS).

Results
All 3 patients tolerated H100™ gel application without side effects. All 3 tunica albuginea specimens showed detectable nicardipine in the tunica tissue.

Conclusions
Transdermal application of commercially available H100™ gel is able to penetrate the tunica albuginea tissue and is detectable in men with acute and chronic PD. This finding may support the encouraging results found in the prior H100™ pilot study.

Disclosure
Yes, this is sponsored by industry/sponsor: Hybrid Medical.
Clarification: Industry initiated, executed and funded study.
Any of the authors act as a consultant, employee or shareholder of an industry for: Hybrid Medical.
A detailed investigation of particle energization mechanisms in models of collapsing magnetic traps
Authors: Mowbray Kate , Neukirch Thomas , Threlfall James 
Published: December 2024

ABSTRACT
In this paper, we provide a detailed investigation of the energization processes in two-dimensional, two and a half-dimensional, and three-dimensional collapsing magnetic trap models. Using kinematic magnetohydrodynamic models of collapsing magnetic traps, we examine the importance of Fermi acceleration in comparison with betatron acceleration in these models. We extend previous work by investigating particle orbits in two-dimensional models without and with a guide field component and from full three-dimensional models. We compare the outcomes for the different models and how they depend on the chosen initial conditions. While in the literature betatron acceleration has been emphasized as the major mechanism for particle energization in collapsing magnetic traps, we find that Fermi acceleration can play a significant role as well for particle orbits with suitable initial conditions.
Observations of the 3.4 mm line of HCN in C/2020 T2 (Palomar)
Authors: Wang Zhen 
Published: December 2024

ABSTRACT
The observations of comet C/2020 T2 (Palomar) were carried out using the 3.4 mm wavelength microwave band before perihelion from 2021 January 22 to July 5 and after perihelion on 2021 July 13. During this period, the comet was located at a heliocentric distance of between $r_\text{h}$ = 2.840 and 2.055 au. The consecutive long-term monitoring of outgassing of C/2020 T2 was conducted with Purple Mountain Observatory (PMO) 13.7 m telescope and the Institut de RadioAstronomie Millimétrique (IRAM) 30 m telescope in the atmospheric radio window. The hyperfine triplet components of hydrogen cyanide (HCN (1−0) F = 0−1, F = 2−1, and F = 1−1) of the J = 1−0 vibrational ground-state transitions, as the primary tracer of molecular gas, were unambiguously identified in this comet C/2020 T2. Combining all data, we derived the positive signal of line width corresponds to the coma expansion velocity $v_{\rm exp}$ from $\sim$0.2 to $\sim$0.4 km s$^{-1}$. The mean gas molecular production rates of HCN were derived $Q_{\rm HCN}$ = (2.92 $\pm$ 0.51) $\times$ 10$^{25}$ molecules s$^{-1}$ at PMO 13.7 m, and $Q_{\rm HCN}$ = (6.26 $\pm$ 1.55) $\times$ 10$^{25}$ molecules s$^{-1}$ at IRAM 30 m, respectively. Overall, studying the gas composition of the long-period comet revealed abundant information about the missing link between interstellar molecular clouds and the outer regions of a distant protoplanetary accretion disc, and the relationship between amorphous ice sublimation mechanism and heliocentric distance.
The SARAO MeerKAT Galactic Plane Survey filamentary source catalogue
Authors: Williams G M , Thompson M A , Mutale M , Rigby A J , Bordiu C , Riggi S , Bietenholz M , Anderson L D , Camilo F , Goedhart S , Jaffa S E , Obonyo W O , Trigilio C , Umana G 
Published: December 2024

ABSTRACT
We present a catalogue of filamentary structures identified in the SARAO (South African Radio Astronomy Observatory) MeerKAT 1.3 GHz Galactic Plane Survey (SMGPS). We extract 933 filaments across the survey area, 803 of which (${\sim }86~{{\ \rm per\ cent}}$) are associated with extended radio structures (e.g. supernova remnants and H ii regions), while 130 (${\sim }14~{{\ \rm per\ cent}}$) are largely isolated. We classify filaments as thermal or non-thermal via their associated mid-infrared emission and find that 77/130 (${\sim }59~{{\ \rm per\ cent}}$) of the isolated sources are likely to be non-thermal, and are therefore excellent candidates for the first isolated, non-thermal radio filaments observed outside of the Galactic Centre (GC). Comparing the morphological properties of these non-thermal candidates to the non-thermal filaments observed towards the GC, we find that the GC filaments are on the whole angularly narrower and shorter than those across the SMGPS, potentially an effect of distance. The SMGPS filaments have flux densities similar to those of the GC; however, the distribution of the latter extends to higher flux densities. If the SMGPS filaments were closer than the GC population, it would imply a more energetic population of cosmic ray electrons in the GC. We find that the filament position angles in the SMGPS are uniformly distributed, implying that the local magnetic field traced by the filaments does not follow the large-scale Galactic field. Finally, although we have clearly shown that filaments are not unique to the GC, the GC nevertheless has the highest density of filaments in the Milky Way.
Evolving properties of pits on 67P/C-G due to illumination induced mass-loss – I. Isolated shape morphology
Authors: Rezac L , Zhao Y 
Published: December 2024

ABSTRACT
Our aim is to characterize patterns of evolution of morphological units on the nucleus of 67P-CG such as pits, sink-holes or, more generally, pit-like features. This work focuses on developing suitable metrics to contrast different stages and changes during the time evolution. We adopt a 3D mass-loss evolution model (MONET) assuming water ice sublimation is the primary driver of erosion activity. This paper considers isolated pit-like structures without the process of merging which will be addressed in our subsequent work. The modelling study cases investigate how latitude, obliquity, and initial pit shape converge in defining the final morphology of the pits, for a spherical nucleus as well as shape model of 67P/C-G. Our results corroborate to some extent the previous studies quantifying exes heat retention due to the concavity of these pit features, however, we demonstrate a clear dependence of ‘smoothing’ or ‘deepening’ effects on the orientation and initial shape. Furthermore, it is shown that the diameter evolution of the pits is influenced by a combination of factors such as solar incidence, shadowing, and/or self-heating acting on its walls. Under certain circumstances, we also observe pronounced asymmetry in mass-loss at the pit floors, a weak effect of terracing. Mass-loss-induced evolution may result in the transformation of circular depressions into elongated ones due to specific solar illumination directions. The modelling results presented here represent the first explicit simulators of the deepening, widening, and smoothing processes in the context of 67P-C-G.