bluuebunny/crossref_metadata_2025_split huggingface dataset:
(214) Urethral and Vaginal Injuries Caused by Insertion of Foreign Objects for Sexual Stimulation: A Literature Review of Sexual Emergencies in Males and Females
Authors: Usuga D , Cuascud T , Dominguez-Bali A 
Published: March 2024

Abstract

Introduction
Foreign body genital tract injuries involve injuries to the male or female reproductive organs, including the vagina and urethra, often requiring urgent care from medical professionals. These injuries are associated with autoerotic stimulation, psychiatric disorders, curiosity, self-harm, or lack of knowledge of safe sexual practices. Early diagnosis and management in the emergency department (ED) are crucial to prevent irreversible damage and potential life-threatening complications. This review aims to comprehensively examine sexual emergencies caused by foreign body genital tract injuries, specifically focusing on vaginal and urethral injuries, while also highlighting common complications and contributing factors.

Objective
1. Provide a comprehensive review of foreign body genital tract injuries presenting in ED's at national and international levels. 2. Highlight ED management and common complications associated with these emergencies. 3. Improve medical management, enhance understanding of causative factors, and promote patient education to prevent recurrence.

Methods
A literature review was conducted using PubMed and Google Scholar databases. Search terms included "foreign body," "sexual," "masturbation," "vagina," and "urethra." Out of 53 articles published between 1985–2023, 16 met the inclusion criteria for analysis, focusing on injuries involving the urethra or vagina and autoeroticism.

Results
The review included 141 cases of genital injuries caused by foreign body insertion during sexual activities. Males accounted for 128 cases, females for 12, and one was a transgender female. Various foreign bodies, such as silverware, glass, batteries, rings, tubes, and beads, were found to have caused injuries and complications. Surgical management was indicated in 19 cases, non-surgical management in 7, while the approach in 115 cases remained unknown.

Conclusions
The literature review serves as a crucial reminder of the potential dangers of foreign body insertion during sexual activities. It calls for increased awareness, improved clinical recognition, and better patient education to safeguard individuals from these preventable injuries. By understanding and addressing this issue, healthcare professionals and the broader community can work together to reduce the incidence of genital injuries related to foreign body insertion and enhance overall patient safety and well-being.

Disclosure
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(217) Report of Surgical Treatment Using Allogenic Dermal Graft Penoplasty to Treat Premature Ejaculation
Authors: Jang S 
Published: March 2024

Abstract

Introduction
Premature ejaculation is the major factor that causes low satisfaction of sexual intercourse. Ejaculation time is determined by various factors including such as psychological, habitual and physical factors, sensitive penile shaft and glans.

Objective
This study aimed to report the effectiveness and the safety of newly adopted surgical treatment using allogenic dermal graft.

Methods
We had performed Dermal graft surgery for treating premature ejaculation in 56 men who have short time ejaculatory problems within 5 minutes on average. We adopted a pre-pubic minimal incision and dissected penile shaft and pre-pubic space. Inserted graft materials were Allograft dermis which were fixed at the Buck's fascia. Glans sulcus was dissected from 8 o’clock to 4 o’clock and the thin strip shaped graft was fixed at the dissected space of glans sulcus. Vibratory sense of glans and penile shaft was estimated by biothesiometry and ejaculatory time was surveyed at both preoperative and postoperative status (5month~18month).

Results
48 patients answered that their ejaculatory time was considerably delayed. And 7 patients slightly delayed. Among them, 1 man answered that there was no surgical effects despite of slightly being reduced penis sense. Following being asked raising their frequency of sexual intercourse, 1 man with no surgical effect was considerably improved in delaying the ejaculatory time. Among 136 cases, the inflammation on wound site occurred in 2 patients fully recovered in 2 weeks. No other complication occurred.

Conclusions
The surgical treatment using allogenic dermal graft is very effective in treating premature ejaculation. And this surgical procedure is very safe without no series complication.

Disclosure
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(227) Vaginismus - Current State of Knowledge
Authors: Laskowska A , Gronowski P 
Published: March 2024

Abstract

Introduction
Vaginismus is defined as a penetration disorder in which any form of vaginal penetration is often painful or impossible. It has traditionally been referred to as an involuntary contraction of the pelvic floor muscles due to actual or anticipated pain associated with vaginal penetration. Vaginismus is predominantly unknown among clinicians and women. Vaginismus causes women to feel pain, fear and anxiety with penetration attempts. It is a poorly understood and underdiagnosed condition, for which many women do not gain support. This is due to the lack of knowledge of the condition, for the shame and embarrassment felt by vaginismus sufferers which means many do not discuss the issue.

Objective
Vaginismus is commonly experienced medical issue, affecting about 1–7% of the female population worldwide. Female pain is often viewed not as a medical fact, but as a misimpression or misinterpretation of bodily events. Vaginismus is not the only condition that has been placed in context of neglect. Other sexual pain disorders, such as vestibulodynia, vulvodynia and dyspareunia, have also been met with doubt and disbelief. An examination of the disbelief surrounding female reportage of their own bodily events will not only be beneficial in terms of perception of vaginismus, but also for general women’s health.

Methods
This systematic review will provide an assessment of the current state of vaginismus. The following databases has been searched from the study inception to July 2023: the Cochrane Central Register of Controlled Trials (Cochrane Library), PubMed, MEDLINE, Embase, Scopus, Web Of Science, ProQuest, ScienceDirect, UpToDate, Polish Medical Bibliography and consultations of Polish specialists and discussion forums of patients have been used.

Results
Vaginismus influences the quality of life, in the most serious form it can result in unconsumated marriage, sterility and thus can lead to the separation of a couple. When adequately approached, the problem can mostly be solved. Treatment often involves multimodal approaches such as education, medication, cognitive behavioral therapy, physical therapy and possibly surgery.

Conclusions
Vaginismus is a common and significant sexual problem that causes distress and frustration for both partners. There are women for whom vaginismus is a serious problem and who are not able to cope with the situation without professional help of specialists. Deepening the specialists knowledge in this field is essential for successful treatment. Vaginismus is a well recognized clinical condition associated with non-consummation and considerable distress in women. It has received little scientific attention, and further well designed studies are needed.

Disclosure
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(229) Late Life Male Virgins: Exploring the Psycho-Social-Sexual Consequences of Sexual Inexperience in Cisgender American Males Seeking Sex Therapy
Authors: Cuascud T 
Published: March 2024

Abstract

Introduction
Reports on past studies about male sexuality, as it compares to women’s, indicate that men have higher sex drives, more positive attitudes toward casual or uncommitted sexual encounters, being more eager to engage in a variety of sexual activities, having more positive emotional responses to intercourse and having higher value regarding sexual experience and activity than women. Although the literature and cultural norms have perpetuated the myth of the sexual male, there is a dearth of literature regarding male virginity, specifically, late life male virginity, and its impacts on psycho-social-sexual health.

Objective
To investigate the experiences of later in life male virgins and the effects of their sexual status on their psycho-social-sexual health. To provide new insight into late life male virgins' assumptions, feelings, and gender role expectations and their perceptions on how those impact their attainability of sexual interactions and romantic relationships. To increase awareness among clinicians regarding the need for targeted interventions for late life male virgins in clinical practice.

Methods
This exploratory qualitative research was based on the case studies of five cisgender heterosexual men in the United States of America, who were late life virgins at the time of the study (defined as men 45 years and older, with no previous sexual experiences or interactions with the opposite sex) who sought Sex Therapy and Surrogate Partner Therapy to assist in their objective to acquire social and sexual skills with the goal of having their sexual debut.

Results
The common themes that stemmed from the case studies revealed that: 1) although the men in the study were able to achieve academic and professional status, they felt flawed and out of the norm due to their virginity status; 2) all the men hid their sexual inexperience from peers and family due to shame and fear of negative consequences to their reputation and even professional loss; and 3) made evident the challenges these men face while navigating social and sexual experiences later in life; 4) underscored the damaging effects of myths, stereotypes and societal expectations around male sexuality; and 5) highlighted the lack of information, education and therapeutic tools that could help guide late life male virgins in their pursuit to exercise their sexuality.

Conclusions
The study provides a greater understanding of the challenges and issues late life male virgins face in their quest to reach their sexual debut and live satisfactory sex lives that meet their particular needs. The themes offer guidance for the development and implementation of sex therapy interventions that will help this specific cohort, as well as directions for future research.

Disclosure
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(244) Optimization of Sperm Retrieval in Non-Obstructive Azoospermic Patients using Conventional TESE
Authors: Abdel-Fattah M , Alzahrani T , Abdel-Fatah M , Aljohani M , Abolhasan A , Eltholoth H , Amer A 
Published: March 2024

Abstract

Introduction
Sperm retrieval in NOA patients remain to be the only hope for these patients for fatherhood using assisted reproductive techniques. Micro-TESE is the gold standard with the best retrieval rate. Microsurgical facilities are not available at every center and conventional TESE techniques are not standardized between different centers.

Objective
Our aim is To improve the spermatogenic function of NOA patients to enable the appearance of sperm in their ejaculate or to improve the chances of a successful retrieval from the testis for ICSI and To optimize and standardize our conventional TESE technique

Methods
Over last 7 years 94 cases of NOA patients were subjected to conventional TESE. We Exclude the cases of Obstructive Azoospermia, Cases with abnormal chromosomal analysis were referred for higher center for genetic counselling and diagnosis. Laboratory workup including at least two semen samples, hormonal valuation (FSH, LH, Prolactin, Testosterone) and chromosomal analysis (Karyotyping and Testing for Y chromosome micro-deletions. Pre-TESE medical Treatment: included Clomiphene citrate: 50 mg OD for 3–6 months, Anti-oxidant therapy (Vitamin E 200mg BID and Vitamin C, 1 gm, OD). 6 biopsies from each testis: upper pole 2(medial &Lateral), mid zone 2 (medial & Lateral), lower pole 2(medial &Lateral). Separate biopsy from each testis was sent for definitive histopathological correlation. Experienced embryologist attends each procedure examining each biopsy until sperms are retrieved. Samples taken were centrifuged and re-examined at lab for any missed sperm

Results
sperm retrieval was successful in 38patients (40.4%). All cases were done as day case No single case of wound infection or intra-testicular hematoma.Post-operative pain was tolerable and managed by paracetamol ±NSAID Negative cases for sperms were continued on higher dose of CC and referred for microTESE

Conclusions
Though of low-evidence, empiric Pre-TESE enhancement of spermatogenesis should be attempted whenever possible and after proper patients counselling. This systematic anatomical approach for biopsies yielded high SRR compared to other conventional TESE. Exact localization of + ve testicular site and side If patient needed Re-do TESE for more sperms in the future. Although micro TESE remains to be the best modality for SR in NOA, in our hands and in canters without Micro-TESE facilities, applying this standardized technique with pre-operative hormonal manipulation yields accepted rate of sperm retrieval

Disclosure
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(285) Heme-Binding Protein 1 Delivered via Pericyte-Derived Extracellular Vesicles Improves Neurovascular Regeneration in a Mouse Model of Cavernous Nerve Injury
Authors: Yin G , Ock J , Limanjaya A , Kwon M , Suh J , Ryu J 
Published: March 2024

Abstract

Introduction
As a peripheral nerve injury disease, cavernous nerve injury (CNI) caused by prostate cancer surgery and other pelvic surgery causes organic damage to cavernous blood vessels and nerves, thereby significantly attenuating the response to phosphodiesterase-5 inhibitors.

Objective
Here, we investigated the role of heme-binding protein 1 (Hebp1) in erectile function using a mouse model of bilateral CNI, which is known to promote angiogenesis and improve erection in diabetic mice.

Methods
To investigate the efficacy and mechanism of Hebp1 in restoring erectile function in CNI-induced ED mice, we injected recombinant mouse Hebp1 protein into the penis of CNI-induced ED mice. Detailed mechanisms were assessed using Signaling Explorer Antibody Arrays on penile tissue from CNI-induced ED mice; MPG tissue and Schwann cells were cultured in the presence of 2.5 μg/ml LPS.

Results
We found a potent neurovascular regenerative effect of Hebp1 in CNI mice, demonstrating that exogenously delivered Hebp1 improved erectile function by promoting the survival of cavernous endothelial-mural cells and neurons. We further found that endogenous Hebp1 delivered by mouse cavernous pericyte (MCP)-derived extracellular vesicles promoted neurovascular regeneration in CNI mice. Moreover, Hebp1 achieved these effects by reducing vascular permeability through regulation of claudin family proteins.

Conclusions
Our findings provide new insights into Hebp1 as a neurovascular regeneration factor and demonstrate its potential therapeutic application to various peripheral nerve injuries.

Disclosure
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Characteristics of systemic testosterone therapy for female hypoactive sexual desire disorder—a claims database analysis
Authors: Agrawal Pranjal , Lee Yeonsoo Sara , Grutman Aurora J , Dumas Kathryn , Kohn Taylor , Kohn Jaden , Yee Alyssa M , Clifton Marisa 
Published: March 2024

Abstract

Background
Testosterone therapy (TTh) is recommended for postmenopausal women with hypoactive sexual desire disorder (HSDD); however, there remain insufficient data to support use of TTh in premenopausal women with sexual dysfunction.

Aim
In this study, we used a large national database to evaluate prescribing trends of TTh for women with HSDD.

Methods
We conducted a cohort analysis of information from electronic health records acquired from the data network TriNetX Diamond. The study cohort consisted of women 18-70 years of age with a diagnosis of HSDD. We analyzed trends of testosterone prescriptions, routes of testosterone administration, and coadministration of testosterone with estrogen.

Outcomes
Despite an increase in rates of testosterone prescriptions for HSDD, there remains a high degree of variability in the duration of treatment, route of administration, and coadministration of estrogen with significant underprescription of testosterone.

Results
Our query of the TriNetX database led to the identification of 33 418 women diagnosed with HSDD at a mean age of 44.2 ± 10.8 years, among whom 850 (2.54%) women received a testosterone prescription. The testosterone prescriptions were highly variable with regard to duration and route of administration and coadministration with estrogen. For all patients until 2015, the prevalence of testosterone prescriptions for HSDD showed a positive quadratic relation was observed. Since 2015 a linear increase in prevalence was observed, with the highest rate of increase for patients aged 41-55 years.

Clinical Implications
The findings of this study reveal a significant need for further research investigating the optimal use of TTh to enhance the sexual health of women with HSDD, and further studies on the long-term effects of testosterone use must be undertaken to ensure that patients have access to safe and effective treatment.

Strengths and Limitations
Limitations to this study include patient de-identification and lack of availability of testosterone dosage data. However, this study also has many strengths, including being the first, to our knowledge, to characterize the prescribing trends of testosterone for women with HSDD.

Conclusion
Testosterone therapy should be considered as a potential therapy for premenopausal female patients with HSDD. Further studies on the long-term effects of testosterone use must be undertaken to address disparities in the management of HSDD and to ensure patients can access treatment.
Double longitudinal myotomy in gender-affirming colovaginoplasty: an innovative surgical technique to prevent and treat neovaginal spasms
Authors: Mañero Vazquez Iván , Labanca Trinidad , Herrero Roberto 
Published: March 2024

Abstract

Background
Gender-affirming colovaginoplasty (GACv) presents excellent postoperative results. However, neovaginal spasms, reported as painful cramps, can affect the sexual life of patients.

Aim
The study sought to describe an innovative surgical technique and evaluate its impact on the prevention and treatment of neovaginal spasms.

Methods
This was a single-center prospective observational study with 2 series of patients: (1) patients who underwent GACv with double myotomy (DM) for spasm prevention (series A), in which longitudinal myotomies were performed across the defunctionalized colon, transecting the taenias, and resecting 2 strips of the intestinal muscle layer of approximately 1- to 2-mm wide and tall, leaving intact colonic tissue between strips; and (2) patients who reported neovaginal spasms in whom intravaginal-DM was performed as treatment surgery (series B), in which the posterior wall of the neovagina was dissected from the rectum and transected by longitudinal myotomies, resecting 2 strips of endoluminal mucosa and submucosal muscle of approximately 1- to 2-mm wide and tall, and the colonic mucosa was subsequently closed.

Outcomes
Patient-reported outcomes and neovaginal examination were performed following standardized protocols.

Results
In series A, 177 patients underwent GACv with the DM technique and were prospectively followed for a median time of 18 months (interquartile range, 13-60 months). No patients reported neovaginal spasms. In series B, 18 patients who reported neovaginal spasms after GACv were treated with intravaginal DM. After a median time of 35 months (interquartile range, 26-45 months), 83% (n = 15 of 18) reported remission of symptoms.

Clinical implications
Double longitudinal myotomy performed on the derived portion of the colon in colovaginoplasty is an easy-to-perform and safe technique that may prevent and treat postoperative neovaginal spasms.

Strengths and limitations
Our results presented certain limitations, mainly associated with a low prevalence of neovaginal spasms, which, being of personal perception, can be underdiagnosed. To the same extent, the fact that it is a monocentric experience limits the possibility of extrapolating it to other centers. Moreover, a more trained surgical team may be the cause of fewer postoperative complications. On the other hand, the fact of being a reference center for gender-affirming surgery, having our procedures protocolized, and the prospective nature of the study allowed us to obtain a certain homogeneity and granularity of the results.

Conclusion
DM is a safe procedure and appears to be highly effective for the prevention and treatment of neovaginal spasms after GACv. Routine use of this technique does not increase the operating time or postoperative complications. Multicenter, prospective studies are required to validate our results.
Catholicism as Environmental Protest in Rudolfo Anaya’s Bless Me, Ultima and Ana Castillo’s So Far from God
Authors: Spencer Andrew M 
Published: March 2024

Abstract
The geographical region of the US Southwest now known as New Mexico has been colonized by successive waves of invaders. First, the Spanish arrived carrying with them a militant Catholicism that sought to uproot and replace Native spiritualities. Next, the newly independent Mexican government also used Catholicism as a tool of colonization to counter the threat of Native uprisings and Anglo-American encroachment. Finally, following the Treaty of Guadalupe-Hidalgo in 1848, New Mexico was overrun by Anglo settlers as US policies uprooted Spanish and Mexican landowners from their inherited land grants. While Catholicism remained the dominant religion among the mestiza/o population, Native spiritualities were also able to subvert and influence the direction that this now-distinctive New Mexican Catholicism would take. While scholars have read the decolonial and environmental justice themes at work in these Native spiritualities in both Rudolfo Anaya’s Bless Me, Ultima (1972) and Ana Castillo’s So Far from God (1993), I argue that the Catholic faith of the characters in these novels also plays an important role despite the religion’s use as a tool of colonization in the past. Different from the hybridization process used by the Roman Catholic church to erase/subsume indigenous spiritualities, the iterations of Catholicism in these novels seek a more subtle subversion of the faith’s colonial history. By recognizing the function of guilt within the Catholic church to control behavior, these novels throw this guilt back on the colonizer by redefining the Catholic terminology of sin as harm against people of color and the earth.
Trinity – III. Quasar luminosity functions decomposed by halo, galaxy, and black hole masses as well as Eddington ratios from z = 0–10
Authors: Zhang Haowen , Behroozi Peter , Volonteri Marta , Silk Joseph , Fan Xiaohui , Aird James , Yang Jinyi , Hopkins Philip F 
Published: March 2024

ABSTRACT
We present the redshift evolution of quasar luminosity functions (QLFs) decomposed by halo mass, galaxy mass, supermassive black hole (SMBH) mass, and Eddington ratio, as well as SMBH/radiative energy output ratios from trinity, a flexible empirical model that self-consistently infers the halo–galaxy–SMBH connection that match observational data. Key findings include: (1) The normalization of quasar luminosity function increases by ∼3–4 dex from z ∼ 10 to z ∼ 4, due to the fast mass build-up of different SMBH populations; (2) From z ∼ 4 to z ∼ 1, less massive galaxies and SMBHs make up bigger and bigger fractions of QLFs, due to the active galactic nuclei (AGNs) downsizing effect; (3) At z ∼ 0, massive haloes/galaxies/SMBHs are responsible for most bright quasars due to low Eddington ratios among all SMBHs; (4) The bright ends of QLFs are dominated by SMBHs that are at least 0.3 dex overmassive relative to the median SMBH mass–galaxy mass relation; (5) QLFs at z ∼ 6–7 are dominated by SMBHs accreting at Eddington ratios 0.1 &lt; ηrad &lt; 1, but super-Eddington AGNs contribute more significantly to QLFs towards z ∼ 9–10.