bluuebunny/crossref_metadata_2025_split huggingface dataset:
(131) Platelet Rich Plasma: Evaluation of Growth Factor Concentration in Men with ED
Authors: Khodamoradi K , Dullea A , Golan R , Leyba Molina M , Masterson T , Arora H , Ramasamy R 
Published: May 2023

Abstract

Introduction
Platelet Rich Plasma (PRP) is a novel restorative therapy rich in growth factors and cytokines used to target the underlying causes of erectile dysfunction (ED). It is not known, however, if the composition of growth factors in PRP varies between men.

Objective
This study aimed to evaluate PRP growth factor variability among men with ED.

Methods
Whole blood was collected from sixteen men, eight participants with at least a six-month history of ED. The others were the control group, including seven men with Peyronie’s Disease (PD) and one healthy man without sexual dysfunction. PRP was extracted from whole blood using the Arthrex Angel system. A Human Growth Factor Antibody Array for 41 proteins was performed. Using all 16 samples, quantitative detection of GM-CSF, VEGF, and TGF-β were validated by western blot.

Results
From the growth factor array, two growth factors - Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) and Transforming Growth Factor-beta (TGF-β) - were identified as having a 1.5-fold decrease between the participants and the control. In addition to the shortlisted growth factors, VEGF was selected because androgens can upregulate VEGF production. Other than a weak negative correlation between VEGF expression and age, we found no correlation between growth factor expression for GM-CSF or TGF-β and age, BMI, or comorbidities.

Conclusions
PRP growth factor concentration appears to vary among men with ED. Depending on individual growth factor concentration, PRP treatment for ED may need to be personalized for patients.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Acerus Pharmaceuticals, Boston Scientific, Coloplast, Endo Pharmaceuticals, Empower Pharmacy, Nestle Health, Olympus, Hims, Inc.
(156) CLINiC Score - A Novel Prediction Model of Collagenase Clostridium Histolyticum Outcomes in Men with Peyronie’s Disease
Authors: Anderson N , Green B , Savage J , Brearton K , Ziegelmann M , Helo S , Kohler T , Trost L 
Published: May 2023

Abstract

Introduction
Since the FDA approval of Collagenase Clostridium Histolyticum (CCH), few studies have been able to identify variables which predict curve improvements, with baseline extent of curvature most highly correlated. In addition to extent of baseline curvature, our team has previously identified curve direction and plaque calcification as additional predictive variables. We therefore sought to create an integrated predictive model which incorporated several factors to better estimate anticipated outcomes.

Objective
To report outcomes of a novel scoring system designed to better predict outcomes of men undergoing CCH injections for Peyronie’s disease (PD).

Methods
A prospective database has been maintained of men undergoing CCH injections for PD. Data were reviewed to identify variables predictive of curve improvements in men with isolated curvature as well as among those with key characteristics, including indentations, hourglass deformities, penile tapering, and calcification. A predictive model was subsequently developed to improve correlations between disease factors and subsequent CCH outcomes. The final model (CLINiC Score) assigned points as follows: +1 point for every 10 degrees of curvature (C for Curvature), +5 points for penile narrowing &gt;25% (IN for INdent), +3 points for narrowing 0-25%, -4 points for pure lateral curvatures (L for Lateral), and -2 points for plaque calcification (C for Calcification). Patients were assigned scores based on the CLINiC model, and results were correlated with final curve outcomes.

Results
A total of 476 PD men were included in the current analysis. Baseline variables for the cohort included a mean age of 55.6 yrs (SD 10.9), PD duration 31.9 months (SD 61.4), composite curvature 64.6 degrees (SD 23.9), 47% with indentations, 42% with hourglass deformity, and 17% with calcification. The mean CLINiC score for the cohort was 6.9 (SD 3.4). For the overall cohort, the use of the CLINiC score increased the correlation coefficient from 0.35 to 0.46 (r-squared 0.13 vs 0.21), with a predictive linear formula of 2.1 - 3.2 * CLINiC score. The difference was more pronounced among a subset cohort of men who had pure lateral curvatures, plaque calcification, or narrowing deformity. In comparing the CLINiC predictive model to baseline curve alone, the correlation coefficient increased to 0.54 (r-squared 0.29, p&lt;0.0001) compared to 0.38 (r-squared 0.15, p&lt;0.001). The linear equation to predict curve improvement outcomes using the CLINiC score was 2.2 - 3.5 * total CLINiC score.

Conclusions
Use of a novel scoring system (CLINiC) improves upon baseline curvature alone to predict post-CCH curve improvements, with the difference more pronounced among men with pure lateral curvatures, plaque calcification, and/or narrowing deformities. External validation is warranted.

Disclosure
No
(250) Male Physicians as Patients: Is Fertility an Issue?
Authors: Parikh N , Alom M , Ahmed M , Robinson M , Mcgriff S , Olive E , Helo S 
Published: May 2023

Abstract

Introduction
Physicians may be subjected to grueling work hours, sleep deprivation, and a stressful work environment during their prime reproductive years. While attention to fertility among female physicians has garnered interest in recent years, little is known about the fertility of their male colleagues.

Objective
In this study we sought to compare semen parameters of male physicians presenting for a fertility evaluation compared to their non-physician counterparts.

Methods
Upon IRB approval, a retrospective review of all hospital employed individuals (or their partners) who underwent a semen analysis between 2013-2019 was performed. Post-vasectomy semen analysis patients were excluded. Baseline patient demographics including age, comorbidities, occupation, and BMI were recorded. Normal semen parameters were defined by the World Health Organization 2010 criteria. A comparison analysis of semen analysis parameters, baseline characteristics, and comorbidities was conducted with a significant p-value defined as &lt;0.05.

Results
Of the 169 physicians and 438 non-physicians identified, physicians were more likely to have a lower BMI (median 25.8 vs. 28.0, p&lt;0.0001) when compared to their non-physician counterparts. Physicians were less likely to have ADHD, depression, obstructive sleep apnea, malignancy, alcohol abuse, and history of smoking (p&lt;0.05). Physicians had better semen parameters including pH, concentration, motility, volume, and morphology (p&lt;0.05), with a greater sperm concentration (68.4 vs. 52.2 million/mL, p&lt;0.0001) and higher total motile sperm count (125 vs. 86.4 million, p&lt;0.0001) compared to non-physicians. However, male physicians were more likely to be older at time of semen analysis (33.8 versus 32.7 years, p&lt;0.05), more likely to utilize assisted reproductive technology (IVF and IUI, p=0.0277), have older female partners (p=0.0053), and have older female partners at time of delivery (p=0.0124).

Conclusions
In this study we report, for the first time, semen parameters of physicians compared to non-physicians. Physicians had a significantly higher total motile sperm count and sperm concentration; however, they were older at time of semen analysis, more likely to utilize ART, and more likely to have older female partners. While physicians may be healthier, this may indicate increased difficulty achieving pregnancy. Patient care is directly impacted by the health and safety provided to their physicians. As the paradigm in the medical field shifts from caring only for our patients to caring for ourselves, fertility amongst male physicians warrants further investigation.

Disclosure
No
(426) Peyronie’s Disease Treatment Pathways in the TriNetX Global Database
Authors: Ebbott D , Prebay Z , Li M , Chung P 
Published: May 2023

Abstract

Introduction
Peyronie’s disease (PD) is a fibrosing condition which commonly leads to penile pain, curvature, plaque development, change in penile shape, and sexual dysfunction. Urologists will benefit from understanding the utilization of the most common treatment pathways followed in practice.

Objective
To identify the pathways of treatment between pentoxifylline, injection therapy, penile plication, plaque excision with/without grafting (PEG), and penile prosthesis in the treatment of PD.

Methods
TriNetX is a research network of real-time data from 58 Healthcare Organizations globally. We queried the network for adult men with Peyronie’s disease and interventions from 2002-2022. Patients were identified based on the International Classification of Disease Tenth Edition (ICD-10) code for Peyronie’s disease (N48.6). Interventions were identified using Current Procedural Terminology (CPT) codes for injection therapy (54200), penile plication (54360), plaque excision +/− grafting (PEG) (54110, 54111, 54112), and penile implant (54400, 54401, 54405). Use of oral pentoxifylline (8013) was identifiable using RxNorm Concept Unique Identifier, part of the Unified Medical Language System. The analysis was run on June 16, 2022.

Results
There were 45,944 cases of PD within the database with a mean age of 62 +/− 13 years. The cohort identified as 73% white, 8% black, and 18% race unknown. Figure 1 shows the cases by treatments and pathways. The most common management was no treatment in 69.5% of cases (n=31,912). A single medical or surgical therapy was used in 79.6% of patients who received treatment (n=11,166). Of single medical therapy cases, pentoxifylline (60.0%, n=4,541) was the more commonly used medical treatment followed by injection therapy (40.0%, n=3,033), while penile plication was the most frequently utilized surgical therapy (54.2%, n=1,946) followed by penile prosthesis (30.6%, n=1,100), PEG (15.2%, n=546). Patients required multiple therapies 20.4% of the time (n=2,866). Of patients requiring multiple therapies, a progression of medical to surgical treatment occurred in 20.4% (n=584).

Conclusions
PD was predominantly managed without any intervention, followed by medical therapy, and then surgery. Surgical therapy occurred less frequently after medical treatment suggesting that few patients are interested or require a stepwise approach to PD.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific and Coloplast.
(489) Comparison of Penile Prostheses Outcomes in Veterans with Peyronie’s Disease: A Single-Center Analysis
Authors: Handing G , Park B , Patel S , Jones J , Srikishen N , Khera M 
Published: May 2023

Abstract

Introduction
Peyronie’s disease (PD) causes erectile dysfunction (ED) in at least 40% of cases. ED refractory to medical and injection therapy can be treated with implantable penile prosthesis, which may also address the penile deformities. However, prosthesis surgery has significant associated morbidity-including erosive disease and infection-and frequently requires explant or revision. Data for Veterans Affairs (VA) patients with PD is limited, especially with respect to penile prosthesis placement. More information is needed for proper counseling and perioperative planning in this high-risk population.

Objective
The aim of this study is to compare outcomes and revision rates in Veteran patients with and without PD after primary penile prosthesis implantation.

Methods
A retrospective cohort study of the xxx VA Medical Center Informatics and Computing Infrastructure database was performed. Veterans who underwent penile prosthesis surgery between January 2013 and February 2022 were identified and included in the study. Patient factors including age, race, procedure type, and relevant comorbidities were collected. Patients with and without history of PD were identified and separated into two cohorts and patient factors of these two groups were compared using chi-square and Fisher’s exact tests. Freedom from revision was analyzed using Cox regression and hazard ratios.

Results
A total of 229 patients underwent penile prosthesis placement with at least 4 months follow-up. 24 patients (10.48%) with history of PD were identified. The mean age at prosthesis placement of PD patients was younger than that of non-PD patients (61.3 vs 65.0 respectively, p=0.0358). Rear tip extender length was longer in the PD cohort than the non-PD cohort (3.02 cm vs 2.32 cm respectively, p=0.0313). Operative time was shorter in patients with PD than in patients without PD (91 minutes vs 111 minutes respectively, p=0.0409). Prosthesis type, hospital stay, and post-operative complication rates were not significantly different between groups. PD was not associated with significantly increased risk of prosthesis revision or removal (p&gt;0.05). No patients in the PD cohort experienced infection or erosion; two explants were performed for component migration and supersonic transporter deformity respectively.

Conclusions
Veterans with PD undergoing prosthesis placement have similar revision rates and explant rates as compared to veterans without PD. Additionally, penile prosthesis implantation for men with PD is associated with low morbidity and similar complication rates compared to men without PD undergoing prosthesis placement for erectile dysfunction.

Disclosure
No
(527) The Unprecedented Number of Google Searches for Vasectomy Following the Overturning of Roe Versus Wade
Authors: Sellke N , Tay K , Sun H , Tatem A , Thirumavalavan N 
Published: May 2023

Abstract

Introduction
On June 24, 2022, the United States Supreme Court overturned the landmark 1973 Roe v. Wade decision. This removed constitutional protection for women seeking abortions and introduced uncertainty for couples desiring reproductive autonomy. Currently, each state’s laws determine specific protections or bans for abortion. As a result, many individuals are investigating alternate forms of family planning such as vasectomy.

Objective
We aimed to characterize the public interest in vasectomy since the overturning of Roe v. Wade and elucidate whether interest varies based on state.

Methods
We extracted relative search volumes from Google Trends (July 2017 to July 2022) for the keyword “vasectomy”. We compared the relative rates of Google searches for the two weeks preceding and following the Supreme Court decision date of June 24, 2022. The mean rates were compared using a Welch t-test. Lastly, we assessed geographic variations in public interest after the decision by extracting the relative search data separated by state from Google Trends.

Results
Google searches peaked on June 25, 2022. This was the highest rate of Google searches for vasectomy within the past five years and was about four-fold higher than the average rate over that time (25.9%). There are two other prominent spikes: one on May 4, 2022 to about 60% of the highest rate, and another on May 16, 2019 to about 55% (Figure 1). In the two weeks following the Supreme Court announcement, there was a higher rate of searches for vasectomy (47.3%) compared to searches two weeks prior (17.2%) (P&lt;0.05). Utah was the state with the most Google searches for vasectomy. Idaho, Texas, and North Dakota were the next most common states. The four regions with the lowest search rate were the District of Columbia, Massachusetts, New Jersey, and New York (Figure 2).

Conclusions
The overturning of Roe v. Wade corresponds with the highest increase in Google searches for vasectomy in the past 5 years with a significant increase in searches the days following. In addition, the two previous spikes in vasectomy searches corresponded to events that threatened access to abortion. The spike in searches in May 2022 happened on the same day the draft of the Supreme Court’s decision on Roe v. Wade was leaked to the public. The spike in May 2019 correlates with the passing of a strict anti-abortion law in Alabama which received national attention. Interestingly, states with the highest rates of searches are also states with laws banning abortion in place. States with the lowest rates appear to be states with laws in place to protect access to abortion. Urologists should be aware of the unprecedented increase in public interest in vasectomy as it relates to a potential flux of patients seeking counseling for this procedure.

Disclosure
No
(540) Aesthetic Penile Augmentation Procedures: A Comprehensive and Current Perspective
Authors: Xing M , Hou S , Raheem O 
Published: May 2023

Abstract

Introduction
Society has perpetuated the misconception that penis shape and size are a marker of masculinity and sexual ability. Unfortunately, many men experience small penis anxiety syndrome (SPS), a body dysmorphic disorder in which a patient believes their penis to be small even when it is clinically average in length and girth. In these situations, patients who have received proper psychological evaluation may choose to pursue clinical procedures to augment their penis. There is a lack of consensus on current approaches for aesthetic penile augmentation in patients with small penis anxiety. As cosmetic surgery becomes more widely accepted, management of SPS may present a challenge for urologists.

Objective
We aim to provide a updated review of aesthetic penile augmentation procedures that are available for physicians to discuss with this unique patient population. Our review focuses on procedures and techniques that have been of interest in the scientific literature over the last five years.

Methods
A PubMed literature review was performed to identify articles published between 2015-2021 on penile aesthetic augmentation procedures. Relevant prospective studies, retrospective studies, and systematic reviews were included, while abstracts and opinion papers were excluded. Search terms included “penis”, “penile,” “augmentation,” “enhancement,” “aesthetic,” “girth,” and “length.”

Results
After thorough psychological counseling, patients with small penis syndrome may choose to undergo penile augmentation. Augmentation procedures range from invasive to non-invasive. Surgical solutions include grafts and flaps, suspensory ligament release, and suprapubic lipectomy. Minimally invasive solutions include injections of fillers (hyaluronic acid, polylactic acid, and polymethyl methacrylate). Noninvasive solutions include external devices such as vacuum pumps and traction devices.

Conclusions
In the current climate, aesthetic penile augmentation is becoming a desirable option for many patients but remains clinically controversial. While there are a multitude of treatment options with varying degrees of invasiveness, there is no standardized recommendation for patients who are pursuing penile enhancement. Our review of the literature summarizes recent and relevant studies and demonstrates the need for further research and consensus on penile augmentation procedures.

Disclosure
No
Improved Wisdom Tooth Diagnosis Can Reduce Dental Disease and Nonbattle Injuries
Authors: Mendoza Andres M , Rodenas Yann J , Eidson Brittany K 
Published: May 2023

ABSTRACT

Introduction
Wisdom teeth are a frequent cause for dental disease and nonbattle injuries (D-DNBIs) during expeditionary deployments. Improved diagnosis and timely treatment before deployment can reduce the need to evacuate a D-DNBI while in a theater. This study proposed key identifiers to diagnose wisdom teeth as Dental Readiness Classification (DRC) 3.

Materials and Methods
This study was a retrospective chart review conducted to measure concurrence among Army dentists when assigning DRC for wisdom teeth. This study also recorded demographic data and physical findings among the observed patients. Concurrence, or inter-rater reliability, was measured using Cohen’s kappa (κ).

Results
A Cohen’s κ of 0.04 suggested that there was no concurrence among Army dental providers in the diagnosis of wisdom teeth. The study concluded that caries and pericoronitis accounted for 37% and 13% of class 3 nondeployable troops, respectively. Forty-one percent of tobacco users had caries. Fifty-eight percent of the population was diagnosed as DRC 3.

Conclusions
This study proposed DRC 3 criteria for wisdom teeth and measured concurrence among dental providers’ diagnoses. Dental Readiness Classification 3 criteria include caries, pericoronitis, infection, and pathology. A Cohen’s κ of 0.04 indicated there was a lack of concurrence in examining dentists compared to the DRC 3 criteria. Caries and pericoronitis were the most frequent diagnoses for third molars. Early diagnosis and treatment of these key identifiers can help reduce a significant source of D-DNBIs in the deployed environment.
Faith, Local Actors, and the Localization of International Humanitarian Response
Authors: Wilkinson Olivia 
Published: May 2023

Abstract
The localization agenda has recently been a dominant debate in the international humanitarian system. While many projects and programs have been launched to “localize” humanitarian response, that is, shift power and resources to local rather than international actors, there is only scant evidence of progress in this regard. This chapter argues that one barrier to progress is the “functional secularism” of the humanitarian system and the way that manifests as the exclusion of people’s religious beliefs and practices to the detriment of humanitarian responses worldwide. In particular, local faith actors are potentially powerful partners and already significant implementers of humanitarian response. International humanitarians can consider equitable partnerships with local faith actors as part of the process of dismantling structures of power that will lead to more successful localization.
Protest Waves in Latin America
Authors: Almeida Paul 
Published: May 2023

Abstract
This chapter examines the basic dynamics of protest waves in Latin America—periods of widespread popular mobilization by multiple sectors across the national territory. Protest waves are relatively rate events, but when they do erupt, they result in profound social change as recently witnessed in Chile, Colombia, Ecuador, Honduras, and Panama. Special attention is given to the facilitating conditions associated with the outbreak of protest cycles. These conditions include elaborate organizational infrastructures, political liberalization, economic threats, repressive threats, and unifying frames. Some of the most common outcomes of protest waves are considered in terms of repression, political reforms, electoral success, radicalization, and revolution.
Social Movements and Globalization in Latin America
Authors: Burridge Daniel , Markoff John 
Published: May 2023

Abstract
“Globalization” refers to the growing web of economic, political, and cultural processes that connect people across national borders. In Latin America in the 1990s and beyond, the policies of globalized neoliberal capitalism coincided with regional democratization, new technologies of communication, and changing ideas on the Left to both generate varied grievances and facilitate varied forms of resistance. Harms were especially pronounced for the historically marginalized—precariously employed workers, rural people, women, and indigenous communities—who often took the lead in the social movement activism enabled by democratic circumstances and who were often joined by such other social categories as students and the middle classes. In so doing, these movements established new connections across borders that linked local, national, and transnational analyses and practices. The movements, therefore, were not only responding to the harms of injurious globalizing processes but were themselves globalizing actors who forged alternative global visions. Our analysis draws on world-system perspectives, the political sociology of social movements, and analyses of Latin American cultures of opposition and activism.