bluuebunny/crossref_metadata_2025_split huggingface dataset:
(064) TESTOSTERONE THERAPY IS PROTECTIVE AGAINST FALL RISK
Authors: Kassab J , Oppenheimer A , Huang J , Stocks B , Lipshultz L 
Published: December 2024

Abstract

Introduction
Falls continue to be a prominent cause of injury and disability in the elderly. One in three adults 65 and older will fall each year. A significant number of these accidents are severe enough to result in an emergency room visit. Higher levels of endogenous testosterone are protective against falls in elderly men.

Objective
This study aims to evaluate the relationship between Testosterone Therapy (TTh) and fall risk in elderly men.

Methods
We identified elderly male patients (65+) receiving Testosterone Therapy at a large university hospital from 9/2010 to 9/2022. We found 6151 patients who were tracked for falls that prompted emergency room visits. As a presumed positive control, we also identified elderly male patients with metastatic and/or castrate resistant prostate cancer presumed to be receiving androgen deprivation therapy who fell (n = 415). We hypothesized that fall incidence would be greater in this chemically hypogonadal population. Fall incidence rates were then calculated against national age-adjusted fall data for men to yield the standardized incidence ratios (SIR) and the 95% confidence interval range (CI). SIR and CI were calculated using SPSS.

Results
The incidence rate of men aged 65 years and older on TTh requiring emergency room visits for fall injuries was found to be 3.04% at our university hospital. This significantly deviates (p &lt; .05) from the national age-adjusted rate of 6.05%. The SIR was 0.502 (95% CI [0.43-0.58]), indicating that the patients on TTh faced at least a 43% lower deviation from the expected rate. Chemically hypogonadal men in the same demographic demonstrated a 5.09% rate of emergency room visits for fall injuries at our university hospital, which, surprisingly, was comparable to the national expectation.

Conclusions
We demonstrate that elderly men on TTh are at a lower risk of falls, resulting in fewer emergency room visits compared to the general population. This is consistent with some of the protective factors demonstrated in men with high levels of endogenous testosterone. Although we hypothesized that chemically hypogonadal men would demonstrate higher fall risk, our negative finding may be limited by lack of stratification of men on intermittent v. continuous androgen deprivation. Future studies should focus on the use of TTh in a blinded prospective manner to better define its efficacy regarding fall prevention.

Disclosure
No.
(067) EFFECTS OF ORAL TESTOSTERONE UNDECANOATE ON SEMEN PARAMETERS IN HYPOGONADAL MEN: AN INTERIM ANALYSIS OF A PROSPECTIVE PILOT STUDY
Authors: Saffati G , Orozco Rendon D , Kronstedt S , Hinojosa-Gonzalez D , Khera M 
Published: December 2024

Abstract

Introduction
Testosterone replacement therapy (TRT) is commonly prescribed for men with hypogonadism. While injectable testosterone preparations are widely used, oral testosterone formulations have become an increasingly popular treatment option due to their ease of administration and avoidance of repeated intramuscular injections. However, the effects of oral testosterone on semen analysis (SA) parameters and male fertility potential remain understudied.

Objective
To evaluate changes in semen analysis parameters, including sperm concentration, motility, and morphology, among hypogonadal men receiving oral testosterone undecanoate therapy.

Methods
A pilot prospective study was conducted enrolling hypogonadal men. Exclusion criteria included prior TRT, use of clomiphene citrate or human chorionic gonadotropin, and azoospermia. Participants received oral testosterone undecanoate for 3 months. SA evaluating sperm concentration, motility, and volume were performed at baseline and 3 months. Concurrent biochemical assessment included measurement of reproductive hormone levels and hematocrit. An interim blood draw was made for drug titration to the therapeutic testosterone range. Baseline and follow-up semen parameters and hormonal values were compared using paired statistical tests. The primary outcome was a change in semen parameters after 3 months of oral testosterone therapy.

Results
At the interim analysis with 5 patients enrolled thus far, the mean age was 39.6 years (SD: 5.36). Overall, only one patient became azoospermic. When excluding him, a statistically significant increase in total testosterone levels was observed between baseline and follow-up (220.60 ± 42.54 ng/dL vs. 704.67 ± 188.83 ng/dL, p = 0.02), as well as for free testosterone (62.64 ± 9.78 ng/dL vs. 221.98 ± 43.78 ng/dL, p = 0.01). No significant differences were detected between baseline and follow-up values for estradiol, follicle-stimulating hormone, luteinizing hormone, or hematocrit levels. Semen analysis parameters, including sperm concentration, motility, and volume, did not demonstrate statistically significant changes from baseline to 3-month follow-up. These preliminary findings are summarized in Table 1.

Conclusions
In this pilot study expected increases in total and free testosterone levels were achieved, confirming adequate treatment. No significant changes in semen parameters or other reproductive hormones were observed after 3 months of treatment. Larger scale studies are needed to fully evaluate the effects of oral testosterone formulations on semen quality and male fertility potential.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Disclosures: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast, Halozyme Investor: Sprout.
(084) THE SECURED VAS TECHNIQUE: A SIMPLE STEP TO REDUCE POST-VASECTOMY HEMATOMA COMPLICATIONS
Authors: Kassab J , Joshi P , Ngai M , Mendez Serrano C , Schoor R 
Published: December 2024

Abstract

Introduction
The most common adverse events following routine vasectomy procedures consist of infection and scrotal hematoma. Scrotal hematomas pose a challenge for patients due to their related pain and potential for extraneous procedures such as operative drainage. With a current documented prevalence of hematoma following vasectomy as ranging from 0–29% depending on institution and technique, we sought to decrease this relatively common complication. With the addition of one simple step following the incision of the vas deferens, our institution has successfully mitigated risk of scrotal hematoma.

Objective
To evaluate the effectiveness of a novel surgical technique in reducing the prevalence of scrotal hematomas following vasectomy.

Methods
Upon ideation and deployment of our technique in February 2021, we then documented procedural notes as well as any observed adverse events as part of the standard of care. The referenced technique involves securing the peri-vasal fascia with chromic suture during fascial interposition. As opposed to the traditional approach of cutting both suture-ends, we leave one intact, acting as a tether, to enable repeated reinsertion and inspection of the vas deferens’ hemostatic measures, as needed. Following over three years of implementation, we retroactively queried our electronic medical records to assess the efficacy of this new technique in curtailing subsequent scrotal hematomas compared to national rates. Relative risks and Clopper-Pearson Binomial Confidence Intervals (CI) were calculated for both institutional and national data utilizing SPSS software.

Results
Upon incorporation of this novel technique, commencing in February 2021, there has been one instance of significant hematoma following the secured vasectomy procedure based on ICD-10 codes associated with the encounter and subsequent follow-up visits. With 579 documented procedures performed utilizing this technique at our institution, we observed a 0.17% prevalence rate (95% CI [0.00004, 0.0096]). Compared to national data of 2%, this resulted in a significant relative risk reduction of scrotal hematoma (p = .0023) (Table One).

Conclusions
Though a generally innocuous, yet irritating, complication for patients, scrotal hematomas following vasectomy have become regarded as a relatively common ramification of standard procedure. However, there is reason to contest this complacency and attempt to decrease the frequency of this adverse event. With the implementation of this simplistic step intraoperatively, we can assess bleeding from the vasal artery in both the current and assess risk for delayed bleeding. This technique allows for greater autonomy for the physician, allowing them to maintain prolonged control of the vas deferens until they are confident in the cessation of bleeding. These early favorable results warrant further investigation into this circumspect approach.

Disclosure
No.
(087) PEDIATRIC BILATERAL INGUINAL HERNIA REPAIR IMPACTS FUTURE FERTILITY
Authors: Langston D , Slade A , Malhotra N , Schaeffer A , Hotaling J , Lau G 
Published: December 2024

Abstract

Introduction
Inguinal hernia repair and orchiopexy are common to both pediatric Urologist and Surgeons. Unilateral intervention would be expected to have limited impact on fertility given contralateral testis has been unaffected, which has been confirmed in the literature. Given this, a decrease in fertility would be expected for bilateral intervention. In adults, bilateral hernia repairs have limited impact on fertility; however, there is limited data to suggest the same in pediatric patients. Given the paucity of pediatric literature on the implications of bilateral inguinal surgery on future fertility and sperm parameters, providers are currently unable to adequately counsel parents about the risks this surgery may carry to fecundity.

Objective
We aimed to assess the impact of B/L IHR on male fertility and paternity, hypothesizing significant implications.

Methods
We conducted a case–control study utilizing a statewide database, which encompasses demographic, medical, and residential data for over 90% of the state's pediatric population. Cases, matched 1:1, comprised males who had B/L IHR and males who underwent pediatric BO before age 18 from 1996-2022. Controls were those without a history of pediatric B/L IHR or BO (matched 3:1). Multivariate Cox proportional hazards models assessed the association between BO or B/L IHR and infertility and paternity. For models, patients were followed from either age 18, first residence in Utah, or 1996 (study initiation), until receiving an infertility diagnosis or until appearing as a father on a birth certificate. An infertility diagnoses, unidentified partners, or children prior to 18/residence in Utah/1996, were excluded.

Results
1156 B/L IHR and 494 BO cases with 5780 non-surgical controls were included. The cohort was predominantly white (87.8%) and non-Hispanic (68.4%). 20.5% having at least one child. Multivariate Cox regression showed higher likelihoods of infertility for B/L IHR cases (HR = 2.07, [1.20-3.58], P = 0.01) and BO cases (HR = 2.01, [1.03-3.94], P = 0.04) versus non-surgical controls. No significant trend in paternity likelihood was observed for B/L IHR cases (HR = 0.97, [0.84-1.13], P = 0.7), while BO individuals showed a trend toward reduced paternity (HR = 0.84, [0.70-1.02], P = 0.08) compared to controls.

Conclusions
Pediatric B/L IHR and orchiopexy elevate infertility rates compared to controls, with orchiopexy suggesting a potential trend towards reduced paternity. The risk of male-factor infertility post-pediatric B/L IHR is notably higher, akin to that of patients undergoing bilateral orchiopexy.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: StreamDx, Inherent Bioscience, Turtle Health, Maimus, Carrot Fertility.
(112) DO TRANSGENDER WOMEN TAKING GENDER-AFFIRMING HORMONE THERAPY, AND WITH OR WITHOUT BILATERAL ORCHIECTOMY, EXPERIENCE PENILE ERECTION, AND DO ALL, OR ONLY SOME, REPORT BOTHER FROM ERECTIONS?
Authors: Dadashian E , Sandhu S , Mallavarapu S , Smith S , Garcia M 
Published: December 2024

Abstract

Introduction
Gender-affirming (GA) hormone therapy (GAHT) and bilateral orchiectomy (GABO) reduce gender dysphoria in transgender women (TW). A key source of dysphoria in TW is related to erections before patients undergo their vaginoplasty. To date, no studies have described erectile function (EF) among TW pre-vaginoplasty.

Objective
We aimed to: 1) Evaluate EF in TW only taking GAHT &gt;6 months, and GAHT + &gt;6 months post-GABO; 2) Determine the incidence of erections among TW based upon using their penis for sexual activity; 3) Query interest for any treatment to reduce/eliminate erections pre-vaginoplasty.

Methods
Pre-vaginoplasty TW on GAHT were surveyed anonymously. Participants were grouped based on GABO status. We queried EF using the Sexual Health Inventory for Men (SHIM) questionnaire pre-GAHT, &gt;6 months on GAHT, and &gt; 6 months post-GABO. We also queried the incidence of any erections in these three states, and, whether patients would undergo a procedure to reduce/eliminate erections.

Results
50 participants were surveyed (29 GAHT-only; 21 GAHT+GABO). Median age was 36.5 years (IQR 23.8 years) and median years on GAHT was 5 years (IQR 5 years). 35/50 (70%) participants reported they do not use their penis for sexual activity. TW on GAHT and GAHT+GABO showed reduced SHIM scores, with lowest scores in TW not using their penis for sexual activity (Fig. 1a). Spontaneous erections were significantly reduced in GAHT+GABO women not using their penis during sex, but both groups reported a higher incidence of erections with sexual arousal and activity (b). The majority of TW showed a high interest in any procedure which could reduce/eliminate their erections (c).

Conclusions
Our study is the first to show that GAHT reduces SHIM scores, with greater reductions in TW who do not use their penis for sexual activity. GAHT+GABO significantly reduced spontaneous erections vs. GAHT, but did not impact erections with sexual arousal/activity. The majority of women reported an interest in surgically reducing/eliminating their erections. Further study with larger numbers is warranted.

Disclosure
No.
Pelvic floor muscle activation in response to pressure stimuli applied to the vulvar vestibule: an observational study comparing women with and without provoked vestibulodynia
Authors: McLean Linda , Antonio Flavia Ignacio , Rodrigues Marina Petter , Pukall Caroline 
Published: December 2024

Abstract

Background
The nature of pelvic floor muscle (PFM) involvement in provoked vestibulodynia (PVD) is poorly understood.

Aim
We aimed to determine if PFM electromyographic (EMG) activity in anticipation of or response to pressure applied to the posterior vaginal fourchette differs between those with and without PVD, and if the magnitude of PFM response is associated with pressure pain sensitivity, psychological or psychosexual function.

Methods
This was an observational case–control study. Forty-two volunteers with PVD and 43 controls with no vulvar pain participated. Five on-line questionnaires were completed, then participants underwent a laboratory-based evaluation of vulvar pain sensitivity. EMG activation of the PFMs, hip adductor, and upper trapezius muscles was measured before, during, and after pressure stimuli (low, moderate) were applied, in random order, to the posterior vaginal fourchette and the posterior thigh (control site).

Outcomes
EMG amplitude of the pubovisceralis (PV), bulbocavernosus (BC), and external anal sphincter (EAS) muscles. Secondary outcomes were EMG activation of the hip adductor brevis and upper trapezius muscles, questionnaire scores reflecting psychological/psychosexual outcomes, pressure pain threshold (PPT) at the vulvar vestibule, pain reported on a tampon test, and heart rate/heart rate variability.

Results
Compared to controls, EMG activation of the PV and EAS, but not the BC, was higher in anticipation of the pressure applied to the vaginal fourchette, was higher in all PFMs while the pressure was applied, and remained higher than baseline after the pressure was removed among those with PVD. EMG response amplitudes were modulated by the intensity of the pressure applied, with the largest responses reaching over 40% MVC in the EAS among those with PVD. PFM EMG amplitudes were associated with greater pain sensitivity and lower sexual function, but not with pain catastrophizing, central sensitization, depression, anxiety, or stress.

Clinical implications
While some anticipatory activation was observed, EMG responses were primarily observed during and after the application of the pressure. Among those with PVD, digital assessment of PFM tone might reflect PFM responses to pain at the vulvar vestibule, and interventions to reduce local pain sensitivity may be an important first step to successful improvements in vaginal function.

Strengths and limitations
This study includes a robust analysis of EMG activation. However, the cross-sectional design precludes the determination of causal relationships.

Conclusions
Those with PVD demonstrate higher PFM responses and a higher prevalence of anticipatory activation in the PV and EAS muscles than controls in response to pressure applied at the vulvar vestibule,
Trichoderma gets by with a little help from Streptomyces: fungal–bacterial symbiosis in plant growth promotion
Authors: Reid Tessa E , Gifford Miriam L 
Published: December 2024

This article comments on:
Kabir AH, Thapa A, Hasan R, Parvej R. 2024. Local signal from Trichoderma afroharzianum T22 induces host transcriptome and endophytic microbiome leading to growth promotion in sorghum. Journal of Experimental Botany 75, https://doi.org/10.1093/jxb/erae340.
Analysis of the bamboo SWEET gene family reveals that Dendrocalamus farinosus SWEET14 is involved in source-sink carbohydrate partitioning
Authors: Gu Xiaoyan , Peng Jiahui , Ou Qian , Chen Sen , Feng Wei , Huang Yiqin , Deng Bin , Cao Ying , Hu Shanglian 
Published: December 2024

Abstract
In higher plants, SWEET genes play a crucial role in source-sink carbohydrate partitioning. Dendrocalamus farinosus is an economic bamboo species because of its high fiber content and rapid growth. The transportation of photosynthetic products is essential for bamboo growth. Here, we identified 50 major SWEET genes in D. farinosus. Phylogenetic analysis indicated that DfSWEET14 and DfSWEET44 were homologs of OsSWEET11 and OsSWEET4, respectively. DfSWEET5, DfSWEET14 and DfSWEET44 were highly expressed in leaf veins, stems and roots, respectively, and their expression was responsive to glucose and sucrose. DfSWEET9 and DfSWEET28 were involved in photosynthetic product distribution, ABA/MeJA signaling and pathogen responses. DfSWEET14 was localized to the plasma membrane, and was highly expressed in lateral buds and young shoots only. The overexpression of DfSWEET14 in wheat resulted in higher root/shoot biomass ratio under drought stress and increases in grain-filling duration, seed yield, net photosynthetic capacity, soluble sugar content, seed size and grain weight. This suggests that DfSWEET14 is involved in sucrose partitioning from leaves to grains. These results provide new insights into genetic improvement of bamboo and into the breeding of other economic crops for high yield by manipulation of source-sink carbohydrate partitioning and drought responses.
Debts, Credits, and Dealings
Authors: Derham Rory 
Published: December 2024

Abstract
This chapter covers the key concepts of debts, credits, and dealings. It clarifies that the insolvency set-off provision applies when there are mutual credits, mutual debts, or other mutual dealings, but the original bankruptcy set-off section in 1705 referred only to mutual credit. The insertion of ‘other’ before mutual dealings appears to qualify both mutual credits and mutual debts, which then suggests that they should also have arisen out of dealing between the parties to the proposed set-off. The chapter considers different dealings and contracts before discussing the liability of insolvent. It elaborates on the claim and provability of insolvent
Commensurable Demands
Authors: Derham Rory 
Published: December 2024

Abstract
This chapter examines the extent of commensurable demands. It starts with the requirement of commensurability, while referencing the principle concerned with value measurable with precision in money. In Rolls Razor Ltd v Cox case, a set off in respect of a claim to recover property was permitted. The chapter discusses the notion of insolvency as a repudiation and the set-offs where contracts involve non-money obligations, such as commodities or securities. It explains the discussions surrounding the requirement of commensurability under the context of foreign exchange contracts due to the conflicting views concerning the nature of foreign money and foreign exchange contracts.
Sureties
Authors: Derham Rory 
Published: December 2024

Abstract
This chapter examines contracts of suretyship, and the availability of rights of set-off as between a creditor, the debtor, and a guarantor of the debt. If a principal debtor has a cross-claim against the creditor which is available as a set-off against the debt, equitable considerations dictate that the creditor should not be able to avoid the set-off by proceeding against a guarantor. The chapter then discusses the set-off available to the guarantor and the guarantor’s rights to rely on the principal debtor’s set-off. Meanwhile, a contract of suretyship may take the form of a mortgage given to secure a debt owed by another person to a creditor. The chapter also considers the surety’s right to rely on a co-surety’s set-off.
Methodological problems in every black-box study of forensic firearm comparisons
Authors: Cuellar Maria , Vanderplas Susan , Luby Amanda , Rosenblum Michael 
Published: December 2024

Abstract
Reviews conducted by the National Academy of Sciences (2009) and the President’s Council of Advisors on Science and Technology (2016) concluded that the field of forensic firearm comparisons has not been demonstrated to be scientifically valid. Scientific validity requires adequately designed studies of firearm examiner performance in terms of accuracy, repeatability, and reproducibility. Researchers have performed “black-box” studies with the goal of estimating these performance measures. As statisticians with expertise in experimental design, we conducted a literature search of such studies to date and then evaluated the design and statistical analysis methods used in each study. Our conclusion is that all studies in our literature search have methodological flaws that are so grave that they render the studies invalid, that is, incapable of establishing scientific validity of the field of firearms examination. Notably, error rates among firearms examiners, both collectively and individually, remain unknown. Therefore, statements about the common origin of bullets or cartridge cases that are based on examination of “individual” characteristics do not have a scientific basis. We provide some recommendations for the design and analysis of future studies.
Uroderma magnirostrum (Chiroptera: Phyllostomidae)
Authors: Carneiro Lucas , Viana Milena , Monteiro Leandro R , Nogueira Marcelo R 
Published: December 2024

Abstract
Uroderma magnirostrum Davis, 1968, the Brown Tent-making Bat, is a medium-sized frugivorous phyllostomid. It is characterized by poorly defined facial and dorsal stripes, large bifid upper inner incisors, and a laterally expanded mesethmoid bone. Uroderma magnirostrum is widely distributed between western Mexico and southeastern Brazil, and across its distribution, it inhabits different types of environments (e.g., pristine tropical forests; farmlands; mangroves; savannas; urban green areas). It is listed as “Least Concern” (LC) by the International Union for Conservation of Nature and Natural Resources but appears in national red lists, such as those from Guatemala and Nicaragua, due to the significant impact of the human activities in these countries.