bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variability of bile bacterial profiles and drug resistance in patients with choledocholithiasis combined with biliary tract infection: a retrospective study
Authors: Zhang Hang , Cong Yuchen , Cao Lichao , Xue Kuijin , Qi Peng , Mao Qingdong , Xie Cong , Meng Yushan , Cao Bin 
Published: February 2024

Abstract

Background
Biliary tract infection is a common complication of choledocholithiasis. This study aimed to analyse the distribution of pathogenic bacteria in bile cultures from patients with choledocholithiasis combined with biliary tract infection to guide clinical application of antimicrobials and reduce the emergence of drug resistance.

Methods
A total of 880 patients were enrolled in this retrospective study from 30 March 2017 to 31 August 2022 at the Affiliated Hospital of Qingdao University in China. Bile specimens were extracted for microbiological culture under aseptic conditions using endoscopic retrograde cholangiopancreatography. Bacterial culture, strain identification, and antimicrobial susceptibility testing were conducted according to the standard protocol. Baseline data were retrieved from patient files.

Results
Overall, 90.34% (795/880) of bile samples showed positive microbiological results and 37.50% (330/880) demonstrated polymicrobial infections. Among the 795 bile specimens with positive culture results, 1,216 pathogenic bacteria were detected, with gram-negative bacilli accounting for 56.33%, gram-positive cocci for 41.86%, and fungi for 1.81%. The predominant gram-negative bacilli in the bile cultures were Escherichia coli (30.43%) and Klebsiella pneumoniae (13.98%), whereas the main gram-positive cocci were Enterococcus faecium (14.04%) and E. casseliflavus (4.28%). The annual trend analysis revealed a gradual decrease in the proportion of gram-negative bacilli and a gradual increase in the proportion of gram-positive cocci, with a concomitant decrease in the dominance of E. coli. Both E. faecium and E. coli showed high resistance to conventional antibiotics but high sensitivity to piperacillin/tazobactam, carbapenems, amikacin, and vancomycin.

Conclusions
A significant change has occurred in the bile bacterial spectrum in patients with choledocholithiasis and biliary tract infection. The incidence of gram-positive cocci infections has increased annually, while that of gram-negative bacilli and E. coli infections has decreased. Antibiotic administration should be tailored based on the local bacterial profile.
Optimization of ON-grid hybrid PV/wind system for a cement factory in Kuwait using HOMER pro software
Authors: Al-Odat Mohammad , Al-Hasan Mohammed , Obeidat Firas , Chamkha Ali J 
Published: February 2024

Abstract
The reliance on a single energy source leads to many problems, i.e. cost and unsustainable operation. Hybrid renewable energy systems (include more than one energy source) has been effectively shown as a feasible choice to overcome these problems. The main purpose of this research is to carry out a techno-economic optimization to minimize the size of the system with lower cost and higher reliability. This proposed ON-grid hybrid PV/wind energy system is designed to supply the electrical power of a cement factory in Kuwait. To achieve this purpose, the Hybrid Optimization of Electric Energy (HOMER Pro) software was utilized to carry out the optimization process. The results of this study show that the cost of electricity energy generated by the hybrid PV/wind energy system is equal to $0.082/kWh which is much lower when compared to the conventional fuel power plants in Kuwait which is approximately $0.12/kWh.
Changes in bacterial communities during rice cultivation remove phenolic constraints on peatland carbon preservation
Authors: Qin Lei , Tian Wei , Freeman Chris , Jia Zhongjun , Yin Xiaolei , Gao Chuanyu , Zou Yuanchun , Jiang Ming 
Published: February 2024

Abstract
Northern peatlands contain ~30% of terrestrial carbon (C) stores, but in recent decades, 14% to 20% of the stored C has been lost because of conversion of the peatland to cropland. Microorganisms are widely acknowledged as primary decomposers, but the keystone taxa within the bacterial community regulating C loss from cultivated peatlands remain largely unknown. In this study, we investigated the bacterial taxa driving peat C mineralization during rice cultivation. Cultivation significantly decreased concentrations of soil organic C, dissolved organic C (DOC), carbohydrates, and phenolics but increased C mineralization rate (CMR). Consistent with the classic theory that phenolic inhibition creates a “latch” that reduces peat C decomposition, phenolics were highly negatively correlated with CMR in cultivated peatlands, indicating that elimination of inhibitory phenolics can accelerate soil C mineralization. Bacterial communities were significantly different following peatland cultivation, and co-occurrence diagnosis analysis revealed substantial changes in network clusters of closely connected nodes (modules) and bacterial keystone taxa. Specifically, in cultivated peatlands, bacterial modules were significantly negatively correlated with phenolics, carbohydrates, and DOC. While keystone taxa Xanthomonadales, Arthrobacter, and Bacteroidetes_vadinHA17 can regulate bacterial modules and promote carbon mineralization. Those observations indicated that changes in bacterial modules can promote phenolic decomposition and eliminate phenolic inhibition of labile C decomposition, thus accelerating soil organic C loss during rice cultivation. Overall, the study provides deeper insights into microbe-driven peat C loss during rice cultivation and highlights the crucial role of keystone bacterial taxa in the removal of phenolic constraints on peat C preservation.
(002) An Update to The Safety of VE Therapy for Genitourinary Syndrome of Menopause in Women with a History of Breast Cancer – A Claims Database Analysis
Authors: Agrawal P , Singh S , Able C , Dumas K , Kohn J , Kohn T , Clifton M 
Published: February 2024

Abstract

Introduction
Systemic therapies for breast cancer (BC) may result in genitourinary syndrome of menopause (GSM) in up to 70% of postmenopausal breast cancer survivors. Though systemic estrogen therapy is usually avoided in these patients, vaginal estrogen (VE) therapy may be prescribed to treat GSM symptoms. However, we recently demonstrated, few eligible patients with GSM and a history of breast cancer are prescribed VE.

Objective
To assess the recurrence rates of breast cancer in women diagnosed with GSM with a history of breast cancer by VE therapy status using a large US claims database.

Methods
A US health research network was queried. Our cohort consisted of females diagnosed with BC within five years prior to the initial GSM diagnosis. Patients with active disease within three months prior to diagnosis of GSM were excluded. Recurrence was defined as mastectomy, radiation, chemotherapy, or secondary malignancy within three months to five years after initiating VE therapy for GSM. The study cohort included those with ≥3 VE prescriptions. The control cohort included women with BC without any VE prescriptions after GSM diagnosis. Propensity matching was performed. A sub-analysis evaluating the effect of concurrent aromatase inhibitor (AI) use with VE was also conducted with concurrent AI use defined as ≥3 AI prescriptions.

Results
We identified 42,113 females with a diagnosis of GSM following BC diagnosis with any ER status; 5.0% received VE. Of the initial cohort, 10,584 patients had ER+ BC; 3.9% of this group received VE. Risk of BC recurrence was comparable between those who received VE and those who did not in both the any-ER (RR 1.03, 95% CI [0.91-1.18]) and ER+ status (RR 0.94, 95% CI [0.77-1.15]) analyses. BC recurrence-free survival was comparable between those who received VE and those who did not in both the any-ER (HR 0.98, 95% CI [0.85 – 1.14]) and ER+ status (HR 0.88, 95% CI [0.69 – 1.12]) analysis. A sub-analysis comparing concurrent VE and AI prescriptions to those with VE-only was performed. Risk of BC recurrence was significantly higher among those who received AI+VE versus VE-only in both the any-ER (RR 5, 95% CI [3.05 – 8.19]) and ER+ status (RR 2.64, 95% CI [1.55 – 4.47]) analysis (Table 1). Significant differences in BC recurrence-free survival were observed between the AI+VE and VE-only groups in both the any-ER (HR 9.88, 95% CI [5.50 – 17.73]) and ER+ status (HR 4.82, 95% CI [2.36 – 9.84]) analysis. (Figure 1). No mortality event was observed at five- or ten-year follow-up in either analysis.

Conclusions
We found similar BC recurrence risk between BC survivors with and without prescriptions of VE. An increased risk of BC recurrence was seen with concurrent AI and VE use. These results suggest that VE therapy in select patients with GSM is safe.

Disclosure
No.
(008) Update on Female Sexual Dysfunction Training in Urology Residencies: Are We Making Progress?
Authors: Brink S , Nguyen J , Implicito C , Ullah N , Shin D 
Published: February 2024

Abstract

Introduction
As urologists and sexual medicine specialists, we are the experts in treating sexual health issues. Female sexual dysfunction (FSD) receives considerably less attention than male sexual dysfunction (MSD). The AUA Core Curriculum includes lessons on FSD and MSD, and thus urology residencies should be providing education on both.

Objective
We sought to evaluate all AUA accredited urology residency program websites in order to determine the availability of FSD and MSD information. Our group conducted a preliminary study on this subject in 2017 and now wish to see how this information has changed over time.

Methods
Program websites of accredited U.S. urology residencies listed on the AUA website were analyzed. Two independent reviewers each collected information from the websites of the 147 residency programs. Information on FSD and MSD content, curricula, subspecialists on faculty, and program directors (PDs) were recorded, as well as the minimum number of clicks required to reach each topic. Data was stratified by AUA section. Chi-square analysis was performed to compare the proportion of programs with FSD and MSD content.

Results
In 2023, 132 (89.8%) program websites included MSD content with a median of 1 click required to access that content, compared to 74 (58.2%) programs in 2017 when 2.5 clicks were required (p&lt;0.01). In 2023, 43 (29.3%) program websites included FSD content with a median of 2 clicks, compared to 12 (9.4%) in 2017 with the number of clicks remaining at 2 (p&lt;0.01). In 2023, all AUA sections are represented by programs containing both MSD and FSD content, although there are significantly fewer programs with FSD (43) compared to MSD content (132) across all sections (p &lt;0.01). However, this is an improvement from 2017 when the Northeastern, Mid-Atlantic, and Southeastern sections contained no program websites with FSD content. Curricula with FSD is lacking; only 4 programs (2.7%) specifically include FSD, compared to MSD being included in 39 (26.5%) program’s curricula (p&lt;0.01). 127 (86.4%) residencies have MSD subspecialists on faculty compared to only 29 (19.7%) with FSD subspecialists on faculty (p &lt;0.01). Interestingly, 15% of PDs (22/147) are FPMRS subspecialists compared to 8% (12/147) who are Andrology or Sexual Medicine subspecialists. Neither PD subspecialty of FPRMS vs Andrology/Sexual Medicine nor PD gender predicted FSD content.

Conclusions
More urology residency program websites are including FSD and MSD content, although the number with MSD content has increased to a greater degree compared to the number with FSD content. MSD content is becoming more available, now requiring fewer clicks to access than FSD content. While increasing, FSD content still remains lower than MSD content in all analyzed domains. Although the gap is closing, the opportunity to increase FSD education still exists within urology residency programs.

Disclosure
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(021) ChatGPT's Ability to Assess Quality and Readability of Online Medical Information
Authors: Golan R , Ripps SJ , Raghuram R , Loloi J , Bernstein A , Connelly ZM , Golan NS , Ramasamy R 
Published: February 2024

Abstract

Introduction
Health literacy plays a crucial role in enabling patients to understand and effectively use medical information. As technology rapidly advances, the significance of health literacy becomes even more pronounced, particularly in comprehending complex medical information. Artificial Intelligence (AI) platforms have garnered significant attention for their remarkable ability to generate automated responses to a wide range of prompts. However, their capacity to assess the quality and readability of provided text remains uncertain. Given the growing prominence of AI web assistant tools, we hypothesized that integrating these tools into patients' web searches could enhance the retrieval of accurate medical information.

Objective
To evaluate the proficiency of Conversational Generative Pre-Trained Transformer (ChatGPT) in assessing readability, and utilizing the DISCERN tool to assess quality of online content regarding shock wave therapy for erectile dysfunction.

Methods
Websites were generated using a Google search of “shock wave therapy for erectile dysfunction” with location filters disabled. Readability was analyzed using the Readable software (Readable.com, Horsham, United Kingdom). Quality was assessed independently by three reviewers using the DISCERN tool. The same plain text files collected were inputted into ChatGPT to determine whether it produced comparable metrics for readability and quality.

Results
The study results revealed a notable disparity between ChatGPT's readability assessment and that obtained from a reliable tool, Readable.com (p&lt;0.05). This indicates a lack of alignment between ChatGPT's algorithm and that of established tools, such as Readable.com. Similarly, the DISCERN score generated by ChatGPT differed significantly from the scores generated manually by human evaluators (p&lt;0.05), suggesting that ChatGPT may not be capable of accurately identifying poor-quality information sources regarding shock wave therapy as a treatment for erectile dysfunction.

Conclusions
ChatGPT’s evaluation of the quality and readability of online text regarding shockwave therapy for erectile dysfunction differs from that of human raters and trusted tools. ChatGPT's current capabilities were not sufficient for reliably assessing the quality and readability of textual content. Further research is needed to elucidate the role of AI in the objective evaluation of online medical content in other fields. Continued development in AI and incorporation of tools such as DISCERN into AI software may enhance the way patients navigate the web in search of high-quality medical content in the future.

Disclosure
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(034) Lifetime Receptive Anal Intercourse Exposure Influences Pelvic Sensations During Sex
Authors: Gaither T , Siapno A , Kianian R , Vincent N , Williams K , Piquerias E , Russell M , Litwin M 
Published: February 2024

Abstract

Introduction
Despite the negative societal stigma on receptive anal intercourse (RAI), this behavior has a positive influence on individuals’ sexual and relationship health. No large studies have previously looked at the sensations experienced during RAI, especially their association with lifelong exposure.

Objective
This study aims to quantify commonly reported pelvic sensations during RAI and determine whether their presentation changes with increasing experience to RAI.

Methods
An internet survey was conducted on sensations felt during RAI among people with prostates (i.e. cis men and trans women) from July 2022-January 2023. The survey content was developed based on a mixed-methods qualitative study and inquired about demographic and sexual histories as well as sensations (pleasure, pain, urinary, and bowel) experienced during RAI. We used descriptive statistics to describe demographic and sexual histories. All data was stratified by lifetime exposure to RAI. The primary outcomes assessed included both the quantification of the primary sensations experience during RAI and associated bother.

Results
975 participants completed the survey. Nine percent reported less than 10 experiences with RAI, 26% reported 11-50 RAI experiences, 32% reported 51-200 experiences, 16% reported 201-500 experiences, and 18% reported &gt;500 experiences. As the number of experiences with RAI increased (from &lt;10 exposures to &gt;500 exposures), the reported frequency of pleasurable sensation and satisfaction with pleasure at the level of anus increased from 41% to 92% (p&lt;0.0001), whereas severe pain and symptoms of bowel urgency decreased from 39% to 13% and from 21% to 6% respectively (p&lt;0.0001). Urinary urgency sensation did not differ by lifetime RAI experience.

Conclusions
Lifetime exposure to RAI is positively associated with pleasure and is negatively associated with pain and bowel urgency. Pelvic sensations experienced during RAI appear to be dependent on lifetime RAI exposure history regardless of age. Lifetime RAI exposure can be readily assessed and correlates not only with pelvic sensation but also many other aspects of sexual health. These results imply that the etiology of dissatisfaction with pleasure or anodyspareunia during RAI may be distinct by lifetime RAI exposure status. This is the first study assessing pelvic sensations experienced during RAI among a large sample of individuals. This is a cross-sectional study, and we cannot conclude how pelvic sensations change overtime among individuals. Internet based participants may not be representative of clinical populations.

Disclosure
No.
(038) Health-Related Quality of Life after Gender-Affirming Pelvic Surgery: A Systematic Review and Meta-Analysis
Authors: Uloko M , Dolendo I , Goldstein B , Okamuro K , Anger J 
Published: February 2024

Abstract

Introduction
Various validated questionnaires have been designed to evaluate sexual dysfunction as it relates to specific phases of the sexual response cycle, which include desire, arousal, orgasm, and resolution. Although there is a breadth of data on the surgical and aesthetic outcomes of patients who have undergone gender-affirming pelvic surgery (GAPS), there are limited data on sexual outcomes as they relate to the sexual response cycle after GAPS. Questionnaires are a crucial tool for research and clinical assessment of sexual dysfunction. However, many of the validated questionnaires for sexual dysfunction were not created for use in transgender patients after GAPS. To date, there is not a validated questionnaire specifically for patients who have undergone GAPS.

Objective
We sought to review the most commonly used sexual function questionnaires and assess their inclusivity as it relates to transgender patients who have undergone GAPS.

Methods
A PubMed and PsycINFO search was carried out using the keywords: “Validated questionnaires” AND “sexual dysfunction” OR “arousal” OR “desire” OR “libido” OR “satisfaction” OR “quality of life”. We then reviewed the most commonly used validated sexual dysfunction questionnaires and graded them on the metrics of medical applicability of patients who had undergone vaginoplasty, metoidioplasty, or phalloplasty, affirming language, and inclusion of identities beyond fully binary transgender people. The validated questionaries were reviewed by a comprehensive sexual health expert and a gender-affirming surgeon.

Results
Of the 13 questionnaires reviewed, only 5 met all metrics for inclusiveness. 4/13 of the validated questionnaires used exclusionary gendered language (female vs male), 6/13 were not physiologically applicable to patients who had undergone GAS (vaginal lubrication, ejaculation etc) and 2/13 assumed heterosexual orientation.

Conclusions
The current clinical and research tools used to define sexual dysfunction are not inclusive of people who have undergone gender-affirming surgery. Validated questionnaires are needed to optimally assess the sexual outcomes of patients who have undergone GAS.

Disclosure
No.
(056) Cross-sectional Analysis of the Vas Deferens and Its Associated Blood Supply
Authors: Narasimman M , Kim M , Varnum A , Qureshi F , Zhang G , Loloi J , Goldstein M , Kryvenko O , Ramasamy R 
Published: February 2024

Abstract

Introduction
In performing both vasectomy and vasectomy reversal, a precise understanding of the local anatomy and blood supply of the vas deferens and associated structures is essential. However, the exact importance and contribution of the perivasal versus intramural vessels in perfusion to the vas deferens has not been investigated. This may be clinically relevant as the perivasal blood supply may be prone to compromise with bipolar electrocautery during the vasectomy reversal, potentially resulting in a poor blood supply to the anastomosis which can detrimentally affect outcomes.

Objective
To highlight the importance and contributions of the perivasal and intramural vessels in the blood supply to the vas deferens

Methods
92 consecutive bilateral vas deferens specimens from 46 patients undergoing first time vasectomy were examined. H&E slides were reviewed by a senior genitourinary pathologist to describe architectural and growth pattern of the small arteries. Intramural (arterioles in the muscular coat of a vas deferens) and perivasal (those located in the vas adventitia immediately juxtaposed to the organ) arterioles were counted microscopically. Clinical data, including patient age and ethnicity, were obtained by reviewing medical charts.

Results
The average number of perivasal arteries surrounding the bilateral vas deferens in each patient was 15 ± 4 whereas the number of intramural arteries was 4.5 ± 3. There was no linear trend between the age of our patients or the number of intramural or perivasal arteries. Five patients (11%) had less than 2 total intramural arteries.

Conclusions
Our study found significantly more perivasal arteries than intramural arteries in vas deferens samples. Interestingly, this association did not seen to vary with patient age. To our knowledge, this represents the first study to demonstrate this anatomical relationship and suggests there may be greater reliance on perivasal arteries for overall vas deferens perfusion, thus emphasizing the importance of prioritizing the preservation of the perivasal blood supply during vasectomy. This may be particularly relevant should a future reversal be considered. Future directions may include examining specimens of patients undergoing vasectomy reversal and evaluating the relevant vasculature and procedure outcome/success.

Disclosure
No.