bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conclusion
Authors: Darby Derrick , Martinez Eduardo J 
Published: June 2024

Abstract
This Conclusion summarizes how the framework presented in this book can be used to respond to Rustin’s dilemma and how it can be enacted to make change over time. It notes the importance of addressing Rustin’s dilemma, via the uptake of civic responsibilities to make collective self-authorship processes accountable to group heterogeneity, in order to tackle major challenges such as climate change and economic inequality. It is important to not expect quick fixes given how entrenched some tight scripts are, while also recognizing new opportunities to resist boxing in and build new coalitions. The chapter also calls attention to the importance of the work of previous generations for creating the current set of opportunities and the importance of not dropping the baton for future generations.
Legislative Authority and Interpretation in the European Union
Authors: van den Brink Martijn 
Published: June 2024

Abstract
Despite the fact that legislation has, in the past decades, become the cornerstone of European integration, the legislature’s place in the European Union’s (EU’s) institutional framework remains neglected in legal scholarship. This book explores the virtues of the legislative process and the nature of legislative acts, and it asks how moving the legislature from the sidelines to the centre of legal analysis changes our understanding of the judiciary’s proper role in EU law-making. The first part of the book elaborates an account of the allocation of EU legislative versus judicial authority, examining when judicial deference is due to legislation and when, on the other hand, legislative provisions may legitimately be subject to judicial review. The second part sets forth a theory of legislative interpretation according to which judicial officials can interpret legislative provisions in accordance with legislative intent. The book shows, in a nutshell, that the legislative process should be associated with important values that the judicial process cannot be associated with to the same extent. Legislative decision-making lends demo(i)cratic legitimacy to EU law and improves the quality of EU law-making, while legislation is more likely to be complied with by its addressees than case law. These values militate for judicial deference to the choices of the legislature in all but exceptional circumstances and for an interpretation of legislation that observes legislative intent.
Realising Legal and Social Change
Authors: van den Brink Martijn 
Published: June 2024

Abstract
This chapter evaluates the institutional capacity of the legislature and the judiciary. It explains that the legislature is better at initiating legal change and realising social change; that is, it is a better lawmaker than the Court of Justice of the European Union, and legislation is more likely than case law to generate its intended effects domestically. Together with the account of institutional legitimacy from Chapter II, these findings are elaborated in a theory of judicial deference that rests on three principles: institutional legitimacy, institutional capacity, and institutional collaboration. More specifically, the form of judicial deference defended is in line with so-called restrictive institutionalism, which favours the imposition of and adherence to relatively precise legislative rules for reasons associated with the rule of law and democratic legitimacy. Finally, it is shown that restrictive institutionalism is compatible with European Union primary law and appropriate for adjudicating both maximum and minimum harmonisation.
Legislative Rules
Authors: van den Brink Martijn 
Published: June 2024

Abstract
This chapter clarifies the notion of legislative intent by elucidating the rule-based nature of legislative acts. Academic writing on the interpretation of European Union law likes to emphasise its open-ended nature, which, for some, means that legislative purpose must be the object of interpretation. Instead, this chapter explains that legislation establishes a complex set of legislative rules that together constitute the means whereby the legislature seeks to achieve its intended state of affairs. Judges must feel bound by the constraints of these rules, even if it forces them to decide contrary to the purposes underlying the rules. While rule-based decision-making can generate arbitrary outcomes, which may motivate judicial officials to collapse rules into their purpose, it also attains values such as predictability, certainty, and consistency. The EU can effectively coordinate the behaviour of its citizens only if the addressees of legislation abide by legislative rules.
Fighting the next pandemic? Civil–military collaboration in health emergencies after COVID–19
Authors: McInnes Colin 
Published: June 2024

Abstract
Over the past decade, militaries have been highly visible elements in the response to health emergencies and in particular disease outbreaks. Although there has been a long tradition of civil–military collaboration in health, COVID–19 saw an unprecedented worldwide use of militaries which occurred within a permissive environment established by narratives of global health, humanitarian intervention and multi-sectorality. This creates a dilemma: militaries will likely be an important element in responding to a major health emergency and this risks not only militarizing health emergencies, but affects the balance between society and the military more generally. Moreover, the response to the COVID pandemic suggested that current emergency planning is often poorly prepared for the use of militaries in health crises, thereby reducing the effectiveness of a response. This article engages with how concerns over the securitization of health have evolved into concerns over militarization, and the question of how militaries might be used effectively in future health emergencies without risking the militarization of health or damaging civil–military relations more widely.
Breath Biomarkers of Pediatric Malaria: Reproducibility and Response to Antimalarial Therapy
Authors: Berna Amalia Z , Wang X Rosalind , Bollinger Lucy B , Banda Josephine , Mawindo Patricia , Evanoff Tasha , Culbertson Diana L , Seydel Karl , Odom John Audrey R 
Published: June 2024

Abstract

Background
Many insect-borne pathogens appear to manipulate the odors of their hosts in ways that influence vector behaviors. In our prior work, we identified characteristic changes in volatile emissions of cultured Plasmodium falciparum parasites in vitro and during natural human falciparum malaria. In the current study, we prospectively evaluate the reproducibility of these findings in an independent cohort of children in Blantyre, Malawi.

Methods
We enrolled febrile children under evaluation for malaria and collected breath from children with and without malaria, as well as healthy controls. Using gas chromatography/mass spectrometry, we characterized breath volatiles associated with malaria. By repeated sampling of children with malaria before and after antimalarial use, we determined how breath profiles respond to treatment. In addition, we investigated the stage-specificity of biomarkers through correlation with asexual and sexual-stage parasitemia.

Results
Our data provide robust evidence that P. falciparum infection leads to specific, reproducible changes in breath compounds. While no individual compound served as an adequate classifier in isolation, selected volatiles together yielded high sensitivity for diagnosis of malaria. Overall, the results of our predictive models suggest the presence of volatile signatures that reproducibly predict malaria infection status and determine response to therapy, even in cases of low parasitemia.
The Impact of Commercial Military Actors on Armed Conflict Termination, 1990–2010
Authors: Petersohn Ulrich 
Published: June 2024

Abstract
For several decades, the rate of civil war onset has outpaced the rate of conflict termination leading to a “relentless accumulation of ongoing civil wars” (Brandt). The deployment of commercial military actors (CMAs), i.e., private military and security companies and mercenaries, has been considered by some observers as an opportunity to put a halt to this trend, and end a war by writing a cheque. Others are more skeptical and consider CMAs to rather aggravate crises. The argument put forward in this investigation is that a cheque issued early in the conflict facilitates termination, while a later one does not. In the initial state of the conflict, contestants are unprepared to fight, lack capability, and are vulnerable to defeat. However, due to their own weakness, contestants are frequently unable to exploit the opportunity. A CMA intervention early in the conflict can remedy a client's weakness and enable exploitation of the opponent's weakness, and, in turn, conflict termination becomes more likely. The overall results show that CMA intervention within the first year of the conflict is associated with an increased risk of termination as opposed to later or no intervention. The investigation employs Cox proportional hazard models to test the influence of CMAs on conflict termination, and draws on our newly developed Commercial Military Actor Database, which includes PMSC and mercenary deployments in all civil wars between 1980 and 2016.
(047) ORGASM ABILITY AND MAPPED EROGENOUS SENSATION DURING RECEPTIVE VAGINAL AND ANAL INTERCOURSE
Authors: Stelmar J , Zaliznyak M , Isaacson D , Duralde E , Gaither T , Topp K , Sandhu S , Garcia M 
Published: June 2024

Abstract

Introduction
Erogenous sensation zones (ESZs) elicit feelings of sexual arousal in response to touch. Prior research has generated whole-body erogenous sensation maps, but they do not differentiate between individual anatomical structures or assess for erogenous sensation of internal surfaces of the body, such as the vagina and anal canal. There is an even greater paucity of literature on the ability to orgasm from vaginal and anal receptive intercourse.

Objective
To describe detailed maps of erogenous sensation of the vagina and anal canal amongst cisgender women, and assess for ability to orgasm from receptive intercourse.

Methods
Respondents were recruited via Qualtrics and completed an anonymous, online questionnaire. They were instructed to indicate ESZs by selecting from predefined areas that bring them pleasure when touched during sex with a partner from anatomic illustrations of the vagina and anal canal. Respondents were also queried on their ability to orgasm from receptive vaginal and anal intercourse. All statistical analyses were completed using Qualtrics Stats iQ software, with p&lt;0.05 indicating statistical significance. ESZ maps were generated based on the proportion of respondents selecting each anatomical structure as erogenous.

Results
A sample of 441 sexually active cisgender women completed the study survey (mean age 48.9±15.6y). Of the five ESZs of the vagina (Figure 1), the superficial anterior (selected by 48% respondents) and superficial posterior (33%) regions were the most frequently selected areas. The four ESZs of the anal canal further revealed greater erogeneity at the superficial anterior (18%) and superficial posterior (11%) walls (Figure 2). With respect to ability to orgasm from receptive intercourse, 35% of cisgender women reported being able to orgasm from vaginal penetration alone while 45% required simultaneous costimulation of another body part and 10% reported an inability to orgasm during receptive vaginal intercourse, regardless of costimulation (Figure 3a). Additionally, 19% of cisgender women reported an ability to orgasm from receptive anal intercourse alone, while 50% required costimulation and 31% reported an inability to orgasm during receptive anal intercourse, regardless of costimulation (Figure 3b).

Conclusions
Erogenous sensation of the vagina and anal canal is primarily localized to the superficial walls of both structures, with a greater preference for the superficial anterior zones. These findings support the proposed location of the “G-spot” existing proximal to Skene’s glands in the anterior portion of the vaginal canal. Results from this study further highlight the importance of costimulation in achieving orgasm during receptive vaginal and anal intercourse, with only a minority of respondents reporting an ability to orgasm from vaginal or anal penetration alone.

Disclosure
No.
(050) RESULTS FROM A PATIENT SURVEY EXPLORING THE EFFECTS OF FLIBANSERIN IN WOMEN WITH HYPOACTIVE SEXUAL DESIRE DISORDER (HSDD) BASED ON TREATMENT DURATION
Authors: Kingsberg S , Quaile H 
Published: June 2024

Abstract

Introduction
Flibanserin is approved in the US to treat premenopausal women and in Canada for pre- and naturally postmenopausal women ≤60 years with acquired, generalized HSDD. Improvement in symptoms can emerge as early as 4 weeks after starting flibanserin but may take up to 8 weeks of daily use. There is limited real-world data exploring patient response to flibanserin based on treatment duration.

Objective
Analyze results from a patient survey to explore the effects of flibanserin based on treatment duration

Methods
Women aged ≥18 years with HSDD prescribed flibanserin via a telehealth platform were invited to participate. Invitational emails containing a secure study link, generated via the platform, were sent 60 days after an initial or renewed flibanserin prescription during the study period (August 1, 2022, to September 30, 2023). The first question screened for current flibanserin use. Women who had discontinued treatment exited the survey. Questions captured changes in HSDD symptoms, partner relationships, weight, sleep, and mood since starting flibanserin. Five multiple-choice response options accompanied each question. A response of “improved a lot” or “improved a little” was categorized as “Benefit”, and a response of “no change,” “worsened a little,” or “worsened a lot” was categorized as “No Benefit”. Results were analyzed descriptively based on treatment duration.

Results
Invitational emails were sent to 17,113 women. Of 638 women who accessed the link, 199 had discontinued flibanserin and exited the survey, and 439 completed the survey (mean age 40 [range 21-66] years). Duration of therapy was &lt;1 month, 1-2 months, and &gt;2 months in 44, 231, and 164 women, respectively. The percentage of women reporting benefits in HSDD symptoms and partner relationships consistently increased with longer treatment. For weight loss and mood, there was a trend of more women experiencing benefit with continued use. For those who experienced improved sleep quality, the improvement began early (&lt;1 month); the percentage of respondents experiencing benefit or lack of benefit in sleep did not change over prolonged use.

Conclusions
Daily flibanserin use may increase interest in sexual activity and improve partner relationships in certain women. These improvements may emerge as early as one month following treatment initiation. However, consistent with previous findings, some women may need longer treatment durations. As expected, effects on weight and mood may take longer to emerge. The impact on sleep quality may be apparent early in treatment and remain consistent with continued use.

Disclosure
Yes, this is sponsored by industry/sponsor: Sprout Pharmaceuticals, Inc
Clarification: Industry initiated, executed and funded study
Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout Pharmaceuticals, Inc.
(067) ASSESSING THE IMPACT OF SEX EDUCATION ON SEXUAL SCHEMAS, SEXUAL SELF-ESTEEM, AND SEXUAL SATISFACTION IN MENOPAUSAL WOMEN
Authors: Behzadipour S , Alibakhshi Z , Azartash F 
Published: June 2024

Abstract

Introduction
Menopause represents a crucial life phase for women, characterized by significant physical and psychological changes.

Objective
This study aims to explore the influence of sex education on women's sexual schemas, sexual self-esteem, and sexual satisfaction among menopausal women.

Methods
This research employed a quasi-experimental pre-test/post-test study with a control group. Participants were selected from women who had sought counseling at counseling center. They were randomly assigned to either the experimental group (15 pairs) or the control group (15 pairs). Data were collected using the Questionnaire of Cognitive Schemas Activation in Sexual Context (QCSASC), Women's Sexual Self-esteem Questionnaire (SSFIW), and Women's Sexual Satisfaction (ISS). The independent variable, sex education, was implemented for the experimental group over 15 hours across a six-week period, with one session per week. Subsequently, the three aforementioned questionnaires were administered to both the experimental and control groups

Results
ANCOVA analysis indicated that the sex education intervention had an impact on women's sexual self-esteem and sexual satisfaction but did not affect women's sexual schemas.

Conclusions
Training in sex skills can enhance and elevate women's sexual satisfaction, even during a period where a decline in sexual self-esteem might be anticipated

Disclosure
No.
(110) THE SURGICAL ANATOMY OF CLITORAL INNERVATION: A REVIEW OF THE CURRENT MEDICAL LITERATURE
Authors: Burr E , Bains K , Bottorff E , Amukamara A , Rubin R 
Published: June 2024

Abstract

Introduction
The clitoris is a crucial structure for sexual arousal and orgasm in people with gynecological anatomy. Despite its functional importance, the innervation of the clitoris has historically been understudied. The innervation of the clitoris includes somatic afferents of the dorsal nerve of the clitoris, a branch of the pudendal nerve and sacral plexus, and autonomic afferents of the cavernous nerve, a branch of the inferior hypogastric plexus. Although we have identified these structures, there remains a paucity of research on surgical techniques to avoid clitoral innervation during pelvic surgery, despite the importance of these nerves in gynecological sexual function.

Objective
This paper aims to summarize the current literature on clitoral innervation with special attention paid to the anatomical locations of nervous structures within the pelvis to inform future pelvic surgeons and reduce sexual side effects related to clitoral nerve damage.

Methods
We performed a PubMed search from inception through June 14, 2023 utilizing the Medical Subject Headings (MeSH) search terms “(clitor*)) AND (innerv* OR nerv*) AND (surg*)” and imported this search into Covidence software. Included in the literature search were observational studies, clinical trials, review articles, correspondence, and communications, and only articles in English were included.

Results
An initial abstract screen of 200 articles resulted in 87 articles that were fully screened and 53 articles that were utilized as within the scope of this paper. 45 papers discussed the dorsal nerve of the clitoris, while 15 papers explored autonomic afferents via the cavernous nerve. The anatomical location of the dorsal nerve of the clitoris has been tracked in 29 papers, most of which utilize cadaver dissection, with at least six anatomic variations identified. The cavernous nerve’s exact location, however, has not been traced as extensively as has the location of the dorsal nerve of the clitoris, perhaps due to its smaller diameter and shorter length. Additional innervation to the clitoris was proposed in 12 studies as well. Many studies suggested that commonly performed procedures, including midurethral sling placement for stress urinary incontinence, labiaplasty, clitoral hood reduction, clitoroplasty, and urogenital sinus repair may interfere with clitoral innervation if not otherwise modified. Two studies discussed sensory mapping techniques prior to pelvic surgery to account for anatomic variation in clitoral innervation.

Conclusions
The clitoris is a vastly innervated structure with both somatic and autonomic afferents whose locations and anatomic variations should be considered when performing pelvic surgery. Failure to consider not only the dorsal nerve of the clitoris but the cavernous nerve as well may have consequences that negatively impact clitoral sensitivity, engorgement and erection, orgasmic ability, and overall sexual function.

Disclosure
No.
(112) SEXUAL HEALTH AFTER RISK REDUCING SALPINGO-OOPHERECTOMY FOR BRCA PATIENTS
Authors: Rowen T , Chen L M , Goldman M , Boscardin J , Jacoby V 
Published: June 2024

Abstract

Introduction
There is no study assessing the changes in sexual health after risk reducing oopherectomy in premenopausal women.

Objective
Objective: To evaluate the effect of risk-reducing salpingo-oophorectomy (RRSO) on change in sexual function in women aged 34-50 years with pathogenic variants in BRCA1 or BRCA2 (BRCA1/2).

Methods
Methods: The PROSper (Prospective Research of Outcomes after Salpingo-oophorectomy) study is a prospective cohort of women aged 34-50 years with BRCA1 or two germline pathogenic variants that compares health outcomes after RRSO to a non-RRSO control group with ovarian conservation. Women aged 34-50 years, who were planning either RRSO or ovarian conservation, were enrolled for 3 years of follow-up. Sexual Function was measured using the Sexual Health Outcomes in Women (SHOW-Q) a validated survey tool that measures sexual desire, frequency, satisfaction, orgasm, and discomfort specifically in patients with a history of a pelvic condition, including oophorectomy. Differences in sexual function between the RRSO and non-RRSO groups, were determined by using mixed effects multivariable linear regression models.

Results
Results: Of 100 PROSper participants, all completed SHOW Q. At baseline patients who had undergone RRSO before enrollment had lower SHOW-Q scores (71 vs 64). Across all 60 months of the study the SHOW-Q scores remained persistently lower in those undergoing RRSO raging from 6-13 points across the time studied (p &lt;0.05) controlling for age, depression, partner, menopausal symptoms and hormone therapy

Conclusions
Conclusion: Women with pathogenic variants in BRCA1/2 who undergo RRSO before the age of 50 years have greater effects on sexual function than those that do not. The detrimental effect of rRRSO is not otherwise explained by hormone therapy, depression or menopausal symptoms. This information should be incorporated into counseling and post op management to consider options to improve sexual health post surgery

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: sprout pharma.