bluuebunny/crossref_metadata_2025_split huggingface dataset:
(289) Has the COVID-19 Pandemic Impacted Penile Implant Public Interest in the US?
Authors: Hammad MAM , Nakamura H , Miller J , Azad B , Yafi FA 
Published: February 2024

Abstract

Introduction
The COVID-19 pandemic has significantly impacted various aspects of society, including healthcare-seeking behaviors. Online search trends have become valuable indicators of public health concerns and interests.

Objective
This study focuses on the search trends for penile implants to understand how these trends have changed in different metro/county income levels pre- and post-COVID-19.

Methods
Data on Google search trends for penile implant procedures were collected for specific metropolitan areas before and after the COVID-19 pandemic. The metropolitan areas with the highest search intents were further analyzed. Average household income and per capita income, based off 2021 US Census Bureau, were calculated for the top five metropolitan hot spots (household income, per capita income before and after the pandemic) then visualized in a linear model.

Results
Between 2016 and 2023, pre- and post- COVID-19, the interest in penile implants has been steadily increasing on average in the US (figure 1). Within these interest groups, a handful of counties account for the most searches that result in the following surges, and are associated with specific socioeconomic backgrounds and events. Before COVID-19, the average household income of counties most interested in penile implants was $53,215.80 (39th percentile) and the per capita median income was $34,626.80 (37th percentile). Post-COVID-19, both of these averages decreased over time to $50, 945.17 (37th percentile) and $31, 435.17, respectively (34th percentile) (figure 2).

Conclusions
This study demonstrates significant increases in Google search trends for penile implant procedures after the COVID-19 pandemic. Before the pandemic, higher-income regions demonstrated more interest in penile implant searches, potentially linked to affluence and investment in men’s health, compared to more interest in lower income regions post-pandemic.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.
(317) Significant Cost Savings for Erectile Dysfunction Medications are Available Using Discount Online Pharmacies Compared to Medicare
Authors: Miller JA , Loeb CA , Moukhtar Hammad MA , Nguyen M , Azad B , Yafi FA 
Published: February 2024

Abstract

Introduction
The Mark Cuban Cost Plus Drug Company (CPD) is an online retailer launched in January 2022 that sells generic prescription medications directly to consumers at cost of ingredients and manufacturing plus a fixed 15% margin in addition to a small pharmacy dispensing fee and shipping fee. GoodRx is an online tool which offers coupons redeemable at pharmacies for discounts on prescription medications. The combination of these two tools offers physicians a way to provide prescription medications to patients at lower costs, which may lead to improved medication adherence and lower medication expenditures nationally.

Objective
To compare the cost of various erectile dysfunction medications when purchased through retail pharmacies, reimbursed through Medicare, or obtained utilizing CPD and GoodRx.

Methods
A review of publicly available data from CPD and GoodRx was performed to obtain average retail and discounted prices for generic sildenafil, tadalafil, and vardenafil. GoodRx prices were obtained using prices from Costco, CVS, Walgreens, and Walmart pharmacies in the most from populous zip code from each of the 3 most populous U.S. states: California, New York, and Texas. Prices were adjusted to account for dosage and prescribed quantity to estimate an average cost per dosage unit ($/adu). The Medicare Part D Drug Spending and Utilization data from 2021 were used to report the average spending per dosage unit and total expenditure for each of the listed medications. These data were compared to create an estimate of average national savings after use of CPD or GoodRx.

Results
Average spending per dosage unit for sildenafil, tadalafil, and vardenafil was less when GoodRx or CPD were used (0.28 $/adu, 0.31 $/adu, and 6.17 $/adu respectively), compared to Medicare pricing (2.14 $/adu, 8.08 $/adu, and 27.84 $/adu respectively) or retail pricing (0.52 $/adu, 2.82 $/adu, and 8.35 $/adu respectively). When adjusted for total dosage units, use of CPD over Medicare pricing for the three medications would result in a combined annual national saving of $149M. Use of either CPD or GoodRx compared to retail pricing would similarly result in a combined annual nation saving of $40M.

Conclusions
The utilization of CPD and GoodRx in the prescription of common erectile dysfunction medications may lead to significant reductions in pricing compared to retail and Medicare estimates. Knowledge of these prescription tools may lead to significant reductions in national expenditures on medications and decreased cost burden for patients seeking treatment.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.
(335) Motivation for Vasectomy Reversal Among U.S. Military Population
Authors: Swargaloganathan P , Maloney T , Hawksworth D 
Published: February 2024

Abstract

Introduction
Vasectomy is a relatively common procedure performed for the purposes of sterilization; however, an estimated up to 6% of men that undergo vasectomy wish for reversal at some point. Few studies have examined the motivation behind vasectomy reversal, and very limited research within special populations, such as U.S. military members.

Objective
The aim of this study was to explore the motivations of U.S. military servicemen who opted for vasectomy reversal (VR) surgery, considering their unique access to this surgical care.

Methods
We conducted a retrospective review of patient records of microsurgical vasectomy reversal performed by a single surgeon (DJH) between 2020 and 2023. We evaluated the age at which vasectomy was performed, age at vasectomy reversal, reasons for seeking VR surgical care, number of children fathered before the vasectomy, and the age of the current partner.

Results
During the specified period, 106 patients underwent vasectomy reversal, and 102 of them had their medical records available for evaluation. The average age at the time of vasectomy was 31.3 years, while the average age at vasectomy reversal was 40.2 years. The average age of the partners they were with at the time of seeking care was 34.8 years. Before undergoing vasectomy, the subjects had fathered an average of 2.7 children. Among the patients, 73% (76) cited having a new partner after divorce as the primary motivation for seeking vasectomy reversal. Within this group, 57 mentioned remarriage, 3 were newly engaged, and 15 were in a new relationship. One individual mentioned seeking VR after their spouse's passing to explore the possibility of fertility with a potential future partner. Additionally, 20.6% (21) of the subjects sought vasectomy reversal to have more children with the same spouse as before vasectomy. Among them, 2 men mentioned an improvement in their financial status, and 2 cited an improvement in their wife's health condition as reasons for seeking VR. Two patients opted for vasectomy reversal due to non-fertility reasons, such as scrotal pain that affected their quality of life, and one patient cited religious beliefs as their motivation.

Conclusions
The primary driver for seeking VR surgical care among these men was the desire for fertility with a new partner, often after divorce. However, approximately 20% of the men cited the wish to have more children with the same partner as their motivation. Non-fertility reasons, such as religious beliefs and scrotal pain after vasectomy, were also observed as motivations for seeking VR, albeit less frequently.

Disclosure
No.
(348) Gender-Affirming Bilateral Orchiectomy Prior to Vaginoplasty versus with Vaginoplasty: A Comparison of Preoperative Goals and Postoperative Satisfaction
Authors: Stelmar J , Zaliznyak M , Mallavarapu S , Sandhu S , Smith S , Garcia M 
Published: February 2024

Abstract

Introduction
Gender-affirming bilateral orchiectomy (GA-BO), defined here as either a standalone procedure and/or precursor to vaginoplasty, is associated with a decrease in dosage of gender-affirming hormone therapy (GAHT). In comparison to bilateral orchiectomy at time of gender-affirming vaginoplasty (GA-V), GA-BO is associated with shorter waitlist times, procedure duration, and outpatient recovery. While objective benefits of GA-BO have been described, there is limited qualitative data that assesses the preoperative goals and postoperative satisfaction of patients who elect GA-BO. We aim to assess the decision-guiding factors that led patients to select GA-BO, and to compare measures of patient satisfaction between GA-BO and GA-V patients.

Objective
We aim to assess the decision-guiding factors that led patients to select GA-BO, and to compare measures of patient satisfaction between GA-BO and GA-V patients.

Methods
A retrospective chart review identified 170 patients who underwent GA-BO (n=106; 64%) or GA-V (n=64; 36%) at our institution between 4/2017 and 12/2020. Patients were emailed a link to an anonymous, online questionnaire (QualtricsTM).

Results
The questionnaire was completed by 136/170 (80%) patients: 86/136 (63%) respondents were GA-BO patients and 50/136 GA-V (37%). 78/86 (91%) of GA-BO respondents had either subsequently undergone vaginoplasty, or, planned to do so in the future. For patients who later underwent vaginoplasty, the mean reported time interval between GA-BO and vaginoplasty was 15 months [Range: 1-34 months]. Respondents prioritized the following expectations in their decision to undergo GA-BO: potential to decrease GAHT medications and dosages (reported as important by 67%), low rates of complications (56.5%), short recovery time (51.6%), and low postoperative pain (46.2%). GA-BO and GA-V patients reported high postoperative improvement in various indices of gender dysphoria and body image, with only 1/4 indices of gender dysphoria differing significantly between the two groups (Figure 1). Unsurprisingly, GA-V patients reported a significantly greater improvement in 3/3 body image indices.

Conclusions
GA-BO is a low-risk procedure that provides a more immediate option to decrease gender dysphoria and improve QOL. All patients who were assigned male at birth and are interested in genital gender-affirming surgery should be made aware of the advantages of GA-BO and offered GA-BO alongside GA-V.

Disclosure
No.
(360) National Trends in Male Artificial Urinary Sphincters: 2016-2019
Authors: Han D , Marte J , Lee J , Joice G 
Published: February 2024

Abstract

Introduction
The artificial urinary sphincter (AUS) remains the gold standard for male stress urinary incontinence. However, current understanding of which patient- and facility-level characteristics that are associated with inpatient versus (vs.) outpatient AUS procedures is limited on a national scale.

Objective
We therefore sought to evaluate contemporary national trends of AUS procedures.

Methods
We performed a retrospective review of male AUS procedures using the National Inpatient Sample and the Nationwide Ambulatory Surgery Sample – the largest publicly available all-payer inpatient and ambulatory healthcare databases in the United States – from 2016 to 2019. AUS insertion, repair, replacement, and removal were identified by Current Procedural Terminology and International Classification of Diseases (10th Revision) Procedure Coding System codes. Our unit of analysis was inpatient or outpatient encounters, and we performed stratified cluster sampling to create weighted national estimates. The primary outcome was the proportion of AUS procedures performed in the inpatient and outpatient settings over time. We performed multivariable logistic regression to evaluate factors associated with an inpatient encounter.

Results
There were 21,916 weighted AUS procedures analyzed from 2016 to 2019 (6% inpatient vs. 94% outpatient). There was a 15% increase in total number of annual surgeries (n=5066 to n=5843), and the proportion performed outpatient increased from 92% to 95% over the study period [Figure]. Mean total charge for inpatient AUS surgery was $92,045 vs. $72,887 for outpatient (p&lt;0.05). Inpatient AUS surgery was associated with greater Elixhauser Comorbidity Index, non-private insurance, and Western hospital region (vs. Northeast) (p&lt;0.05) [Table]. Predictors of outpatient AUS procedures included older age, 3rd quartile of median income by Zip Code (vs. 1st quartile), and Midwest/Southern hospital region (vs. Northeast) (p&lt;0.05).

Conclusions
With an increasing rate of AUS procedures in the United States, the majority of these procedures continue to be performed on an outpatient basis. Outpatient procedures have lower hospital charges compared to inpatient encounters, and outpatient AUS is associated with private insurance in older patients with fewer comorbidities. Hospital geographic region appears to affect encounter type, and further work may elucidate how these factors affect patient outcomes nationally.

Disclosure
No.
(391) A Comparative Meta-analysis of Revision Strategies for Malfunctioning Inflatable Penile Prosthesis: Partial Vs Complete Component Replacement With or Without Retained Reservoir
Authors: El-Achkar A , Khalafalla K , Nguyen T , Mahdi M , Wang R 
Published: February 2024

Abstract

Introduction
In cases of non-infected malfunctioning Inflatable penile prosthesis (IPP) device, surgeon often opt to exchange all the device rather than the defective component for fear of increased infection rate and future mechanical dysfunction.

Objective
To assess whether partial component exchange of IPP device has comparable outcomes to complete explant and replacement of IPP device with or without retained reservoir.

Methods
A meta-analysis was completed in line with PRISMA 2020 and AMSTAR guidelines. A comprehensive search was done on MEDLINE (OVID), PubMed, and Cochrane Library electronic databases from their inceptions until May 2023, identifying studies that reported on outcomes and complications of revision surgery for non-infected malfunctioning IPP device. Three groups were compared: the first group underwent a single or two-component exchange, the second group had a complete explant replacement of the entire device, and the third group had replacement of all components with a 'drained and retained' primary reservoir.

Results
A total of 9 articles were included in the analysis. 12,152 patients had complete replacement of their device, 128 had partial exchange of their device and 151 patients had “drained and retained” reservoir following revision. The mean age was similar among the 3 groups between 62-68 years. The median follow up time ranged between 12 and 79 months. Partial component exchange had a higher rates of mechanical failure 10.3% versus 1.3% and 2.3 % (p=0.03) for complete and “drain and retain” groups respectively. (Figure 1) Similarly, partial component exchange had higher perioperative complications at 21.2% compared to complete replacement group 9.5% and “drain and retain” group 14.5% (p=0.022). However, the infection rate was similar among the three groups, 7.7%, 2.7% and 3.3% respectively (p= 0.301). (Figure 2)

Conclusions
Partial component exchange during IPP revision has higher rates of perioperative complication and future mechanical failure but has similar rate of infection compared to complete component replacement with or without “drain and retain” of original reservoir.

Disclosure
No.
Dark matter measurements combining stellar and H i kinematics: 30 per cent 1σ outliers with low dark matter content at 5Re
Authors: Yang Meng , Zhu Ling , Lei Yu , Boardman Nicholas , Weijmans Anne-Marie , Morganti Raffaella , Oosterloo Tom , Duc Pierre-Alain 
Published: February 2024

ABSTRACT
We construct the Schwarzschild dynamical models for 11 early-type galaxies with the SAURON and Mitchell stellar IFUs out to 2–4Re, and construct dynamical models with combined stellar and H i kinematics for a subsample of four galaxies with H i velocity fields out to 10Re obtained from the Westerbork Synthesis Radio Telescope, thus robustly obtaining the dark matter content out to large radii for these galaxies. Adopting a generalized-NFW dark matter profile, we measure an NFW-like density cusp in the dark matter inner slopes for all sample galaxies, with a mean value of 1.00 ± 0.04 (rms scatter 0.15). The mean dark matter fraction for the sample is 0.2 within 1Re, and increases to 0.4 at 2Re, and 0.6 at 5Re. The dark matter fractions within 1Re of these galaxies are systematically lower than the predictions of both the TNG-100 and EAGLE simulations. For the dark matter fractions within 2Re and 5Re, 40 and 70 per cent galaxies are 1σ consistent with either the TNG-100 or the EAGLE predictions, while the remaining 60 and 30 per cent galaxies lie below the 1σ region. Combined with 36 galaxies with dark matter fractions measured out to 5Re in the literature, about 10 per cent of these 47 galaxies lie below the 3σ region of the TNG-100 or EAGLE predictions.
An optimal ALMA image of the Hubble Ultra Deep Field in the era of JWST: obscured star formation and the cosmic far-infrared background
Authors: Hill Ryley , Scott Douglas , McLeod Derek J , McLure Ross J , Chapman Scott C , Dunlop James S 
Published: February 2024

ABSTRACT
We combine archival ALMA data targeting the Hubble Ultra Deep Field (HUDF) to produce the deepest currently attainable 1-mm maps of this key region. Our deepest map covers 4.2 arcmin2, with a beamsize of 1.49 arcsec $\, {\times }\, 1.07\,$ arcsec at an effective frequency of 243 GHz (1.23 mm). It reaches an rms of 4.6 μJy beam$^{-1}$, with 1.5 arcmin2 below 9.0 μJy beam−1, an improvement of ${\gt }\,$5 per cent (and up to 50 per cent in some regions) over the best previous map. We also make a wider, shallower map, covering 25.4 arcmin2. We detect 45 galaxies in the deep map down to 3.6$\sigma$, 10 more than previously detected, and 39 of these galaxies have JWST counterparts. A stacking analysis on the positions of ALMA-undetected JWST galaxies yields 10 per cent more signal compared to previous stacking analyses, and we find that detected sources plus stacking contribute (10.0 ${\pm }$ 0.5) Jy deg−2 to the cosmic infrared background (CIB) at 1.23 mm. Although this is short of the (uncertain) background level of about 20 Jy deg−2, we show that our measurement is consistent with the background if the HUDF is a mild (${\sim }\, 2\sigma$) negative CIB fluctuation, and that the contribution from faint undetected objects is small and converging. This suggests that JWST has detected essentially all of the galaxies that contribute to the CIB, as anticipated from the strong correlation between galaxy stellar mass and obscured star formation.
Discovery and timing of pulsar J2016+3711 in supernova remnant CTB 87 with FAST
Authors: Liu Qian-Cheng , Zhong Wen-Juan , Chen Yang , Wang Pei , Zhou Ping , Yue You-Ling , Li Di 
Published: February 2024

ABSTRACT
We report on our discovery of the radio pulsar, PSR J2016+3711, in supernova remnant (SNR) CTB 87, with a ∼10.8σ significance of pulses, which confirms the compact nature of the X-ray point source in CTB 87. It is the first pulsar discovered in SNRs using Five-hundred-meter Aperture Spherical radio Telescope (FAST). Its integrated radio pulse profile can be well described by a single component, with a width at 50 per cent of the peak flux density of about 28.1○ and an effective width of about 32.2○. The mean flux density at 1.25 GHz is estimated to be about 15.5 $\mu$Jy. Combined with the non-detection of the radio pulse at lower frequencies, the radio spectral index of the pulsar is constrained to be ≲2.3. We also present the timing solution based on 28 follow-up FAST observations. Our results reveal a period of 50.81 ms, period derivative of 7.2 × 10−14 s s−1, and dispersion measure of 428 pc cm−3. The strength of the equatorial surface magnetic dipole magnetic field is inferred to be about 1.9 × 1012 G. Using the ephemeris obtained from the radio observations, we searched Fermi-LAT data for gamma-ray pulsations but detected no pulsed signal. We also searched for radio pulses with FAST towards the X-ray counterpart of the gamma-ray binary HESS J1832−093 proximate to SNR G22.7−00.2 but found no signal.
From total destruction to complete survival: dust processing at different evolutionary stages in the supernova remnant Cassiopeia A
Authors: Kirchschlager Florian , Sartorio Nina S , De Looze Ilse , Barlow M J , Schmidt Franziska D , Priestley Felix D 
Published: February 2024

ABSTRACT
The expanding ejecta of supernova remnants (SNRs) are believed to form dust in dense clumps of gas. Before the dust can be expelled into the interstellar medium and contribute to the interstellar dust budget, it has to survive the reverse shock that is generated through the interaction of the preceding supernova blast wave with the surrounding medium. The conditions under which the reverse shock hits the clumps change with remnant age and define the dust survival rate. To study the dust destruction in the SNR Cassiopeia A, we conduct magnetohydrodynamical simulations of the evolution of a supernova blast wave and of the reverse shock. In a second step, we use these evolving conditions to model clumps that are disrupted by the reverse shock at different remnant ages. Finally, we compute the amount of dust that is destroyed by the impact of the reverse shock. We find that most of the dust in the SNR is hit by the reverse shock within the first 350 yr after the SN explosion. While the dust destruction in the first 200 yr is almost complete, we expect greater dust survival rates at later times and almost total survival for clumps that are first impacted at ages beyond 1000 yr. Integrated over the entire evolution of the SNR, the dust mass shows the lowest survival fraction (17 per cent) for the smallest grains (1 nm) and the highest survival fraction (28 per cent) for the largest grains (1000 nm).