bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defibrillation test in paediatric patients: should be done?
Authors: Sarquella Brugada G 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.
The defibrillation test (DFT) of an implantable cardioverter-defibrillator (ICD) is performed to evaluate ventricular fibrillation detection and termination. In adults, routine defibrillation testing for transvenous ICD is less usually done as some studies found no advantages but some potentially risks associated with. On the other hand, implantation of ICDs in paediatric patients has different characteristics than in adults. The position of the defibrillation coil will change with the body’s growth and could reflect changes in the defibrillation vector. Also, the reasons of implantation of an ICD are different (ventricular arrhythmias frequently associated with adult’s myocardial infarction vs channelopathies, non-ischemic myocardiopathies and congenital heart defects in children and young). There is still lack of information about the utility of the DFT in paediatric patients.

Objective
To describe the characteristics of paediatric patients who underwent implantation of an ICD , results of DFT and follow-up.

Methodology
Retrospective cohort study of patients less than 21 years old who underwent implantation of an ICD in the lasts 10 years at a reference paediatric hospital. In DFT, VF was induced by T wave shock, fast burst pacing or continuous direct current. Response of ICD to VF was evaluated. Patients with failure to terminate VF by ICD were defibrillated with external defibrillator.

Results
68 patients with 73 ICD implantations (five replacements). Median age was 13 years old. The youngest patient was 2 years old and the oldest 21 years old. 72.6% (53/73) of patients underwent DFT. In 90.6% (48/53) of them, a VF was induced. In two patients (4%, 2/48) the ICD did not terminate the VF. One of these patients had Danon syndrome and the VF did not terminate despite of maximum energy discharged and changes in the vector of defibrillation; the problem was fixed with replacement of the single coil lead by a dual coil system. The other patient had arrhythmogenic cardiomyopathy and the ICD did not detect the VF. During the follow up, there were 20 shocks in 13 patients. 13 shocks were appropriate (and successful). One patient died because of non-arrhythmic illness.

Conclusions
In paediatric patients, the defibrillation test is useful to ensure both adequate detection of malignant ventricular arrhythmias, as well as their ability to reverse them. Its lack of performance could affect 4% of the implants. Therefore, its performance in paediatric patients is recommended. There could be greater utility in patients with hypertrophic cardiomyopathy.
Left cardiac sympathetic denervation in children. A matter of facts
Authors: Sarquella Brugada G 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiac sympathectomy (CS) is a second-line treatment for drug-refractory adrenalin-sensitive channelopathies. We present our series of paediatric sympathectomies for long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) as adjunctive treatment.

Methods
Between 2011 and 2021, 30 CS (28 left, 2 right) were performed by videothoracoscopy in 28 patients (21 LQTS and 7 CPVT), aged 8 days to 21 years. The mean follow-up was 29 months. All patients were treated pharmacologically before surgery, three had an implantable cardiac defibrillator (ICD). Indications for CS in patients with CPVT included previous cardiac arrest (3/7) and sustained VT induced by emotion/stress despite medication (4/7). In LQTS, indications included syncope (4/21), VT despite medication (7/21) and high risk of malignant arrhythmias (10/21).

Results
There were no intraoperative complications or deaths. Four patients had transient palpebral ptosis with mild miosis, 23/28 patients were monitored by ICD or subcutaneous holter. After sympathectomy, 24/28 remain asymptomatic; three patients experienced syncope and one received appropriate discharge. Seven patients experienced VT (3/7 due to pharmacological non-compliance) of which three required ICD and four improved with medication. During follow-up, five high-risk patients received ICDs for primary prevention.

Conclusion
CS is an effective and safe technique in children as an adjunctive treatment for severe arrhythmias due to channelopathies. After CS, 85% remained asymptomatic. Medication non-compliance is an important cause of VT after CS, although ICD was occasionally required. In our experience, long-term remote monitoring is key to effective follow-up.
Minkowski Inequality in Cartan–Hadamard Manifolds
Authors: Ghomi Mohammad , Spruck Joel 
Published: May 2023

Abstract
Using harmonic mean curvature flow, we establish a sharp Minkowski-type lower bound for total mean curvature of convex surfaces with a given area in Cartan-Hadamard $3$-manifolds. This inequality also improves the known estimates for total mean curvature in hyperbolic $3$-space. As an application, we obtain a Bonnesen-style isoperimetric inequality for surfaces with convex distance function in nonpositively curved $3$-spaces, via monotonicity results for total mean curvature. This connection between the Minkowski and isoperimetric inequalities is extended to Cartan–Hadamard manifolds of any dimension.
Changes in Inflammatory Markers in Patients Treated for Buruli Ulcer and Their Ability to Predict Paradoxical Reactions
Authors: Phelippeau Michael , Marion Estelle , Robbe-Saule Marie , Ganlanon Line , Chauty Annick , Adeye Ambroise , Blanchard Simon , Johnson Christian , Marsollier Laurent , Dubee Vincent 
Published: May 2023

Abstract
Mycobacterium ulcerans causes Buruli ulcer, the third most frequent mycobacterial disease after tuberculosis and leprosy. Transient clinical deteriorations, known as paradoxical reactions (PRs), occur in some patients during or after antibiotic treatment. We investigated the clinical and biological features of PRs in a prospective cohort of 41 patients with Buruli ulcer from Benin. Neutrophil counts decreased from baseline to day 90, and interleukin 6 (IL-6), granulocyte colony-stimulating factor, and vascular endothelial growth factor were the cytokines displaying a significant monthly decrease relative to baseline. PRs occurred in 10 (24%) patients. The baseline biological and clinical characteristics of the patients presenting with PRs did not differ significantly from those of the other patients. However, the patients with PRs had significantly higher IL-6 and tumor necrosis factor alpha (TNF-α) concentrations on days 30, 60, and 90 after the start of antibiotic treatment. The absence of a decrease in IL-6 and TNF-α levels during treatment should alert clinicians to the possibility of PR onset.
Patient-centered Care: Value Added by Breast Radiologists in the Management of Breast Pain
Authors: Dodelzon Katerina , Shah Shreena , Prasad Lona , Atallah Juliana , Katzen Janine T 
Published: May 2023

Abstract
With the shift of the healthcare system toward patient-centered, value-based care, the role of the breast radiologist is essential and increasingly multifaceted. Beyond sole image interpreters, breast radiologists serve as subject matter experts within multidisciplinary care teams, acting as advocates and initiators into the healthcare system and providing patient-centered care through effective communication and patient education. These vital roles are well demonstrated through the imaging evaluation and management of the most common breast symptom that affects the majority of the patient population—mastalgia. By leveraging the opportunities provided during the evaluation of the symptomatic breast to optimize patient communication and education, as well as integration of care delivery, breast radiologists add significant value to patient care and ultimately improve patient outcomes.
An improved YOLOX approach for low-light and small object detection: PPE on tunnel construction sites
Authors: Wang Zijian , Cai Zixiang , Wu Yimin 
Published: May 2023

Abstract
Tunnel construction sites pose a significant safety risk to workers due to the low-light conditions that can affect visibility and lead to accidents. Therefore, identifying personal protective equipment (PPE) is critical to prevent injuries and fatalities. A few researches have addressed the challenges posed by tunnel construction sites whose light conditions are lower and images are captured from a distance. In this study, we proposed an improved YOLOX approach and a new dataset for detecting low-light and small PPE. We modified the YOLOX architecture by adding ConvNeXt modules to the backbone for deep feature extraction and introducing the fourth YOLOX head for enhancing multiscale prediction. Additionally, we adopted the CLAHE algorithm for augmenting low-light images after comparing it with eight other methods. Consequently, the improved YOLOX approach achieves a mean average precision of 86.94%, which is 4.23% higher than the original model and outperforms selected state-of-the-art. It also improves the average precision of small object classes by 7.17% on average and attains a real-time processing speed of 22 FPS (Frames Per Second). Furthermore, we constructed a novel dataset with 8285 low-light instances and 6814 small ones. The improved YOLOX approach offers accurate and efficient detection performance, which can reduce safety incidents on tunnel construction sites.
Investigating fracture toughness of graphene epoxy nanocomposites using single edge notched bending specimens
Authors: Chuang Po-Chun , Yu Chao Chen- , Yang Mi , Tsai Jia-Lin 
Published: May 2023

Abstract
The purpose of this study was to examine the fracture toughness of epoxy-based graphene nanocomposites. The single edge notched bending (SENB) samples with precrack tips were created by either tapping or sliding methods. For the tapping method, a single tap was conducted on a razor blade such a crack with a length of 2 mm was instantly propagated. For the sliding method, a razor blade was slid forward and backward into the samples, and a crack was generated with the blade edge. The SENB samples with graphene loadings (0.15 and 0.3 wt%) were subjected to three-point bending tests to evaluate fracture toughness. Results indicated that the graphene loading did not considerably affect the fracture toughness of the samples with tapping-induced precrack tips. However, the fracture toughness of the samples with sliding-induced precrack tips decreased as the graphene loading increased. For the 0.3 wt% graphene nanocomposites, the fracture toughness levels of the samples with sliding- and tapping-induced precrack tips were equal. In order to explicate the experimental results, the plastic zone sizes around the crack tip were evaluated using finite element analysis. For the sharp precrack tips (tapping method), the plastic zone was comparatively small (brittle behavior); hence, the effect of graphene on the inception of crack extension was minimal. Nevertheless, for blunt crack tips (sliding method), the plastic zone was larger and the size decreased as graphene loading increased; thus, the fracture behavior measured from the sliding method was dramatically influenced by the graphene loading.
(015) Sexual Health and Relationship Enhancement (SHARE) for Women with Breast Cancer: Results from a Clinical Trial
Authors: Carpenter K , Holmes H , Conroy K , Black L 
Published: May 2023

Abstract

Introduction
Sexual difficulties in the context of cancer survivorship remains an important, unsolved problem. Interventions must be efficacious and disseminable. Interventions that can be delivered to heterogeneous survivor groups can maximize impact on patients' quality of life.

Objective
Test a group psychosexual intervention -- Sexual Health and Relationship Enhancement (SHARE) -- designed for gynecologic cancer survivors in a sample of breast cancer survivors to determine feasibility and efficacy.

Methods
Participants were breast cancer survivors (N = 28). The majority (53.6%) was diagnosed at stage I (stage II: 35.7%, stage III: 10.7%). The participants were primarily Caucasian (75%) with an average age of 50.6 years (SD = 11.7, range = 29-79) and the majority were partnered (75%). Intent-to-treat (IIT) analyses were conducted for treatment outcomes. Using all available data, mixed effects modeling tested for change in treatment outcomes from the initial assessment to 3-, 6-, and 9-month assessments. Cohen’s d effect sizes were reported at post-treatment (6 months) and follow-up (9 months). The reliable change index was used to determine whether reliable clinical change had been achieved for each patient.

Results
The 12-session attendance rate was 23%. The mean number of SHARE sessions attended was 9 (SD=3.2). The rate therapy dropout was 10% (n=3). The patients viewed the treatment as helpful; average helpfulness ratings were 2.5 out of 3.0 (SD=0.4) and 84% of ratings fell in the moderately to very helpful range. Using a 0 to 10 point scale for cohesion, the means were 8.0 (SD=1.1) for involvement in the therapy experience and 9.2 (SD=1.1) for felt support. Significant linear effects of time (improvements) were seen for sexual function, satisfaction, and distress (p&lt;.001); sexual behavior did not change. Effect sizes of change from baseline to post-treatment and follow-up on significant outcome measures were large (d=0.75-1.06). Most participants’ improvement in sexual function (65.2%) and sexual distress (66.7%) was reliable. Almost half of participants reported clinical levels of sexual distress at baseline that decreased to sub-clinical levels at follow-up, and 16.7% of participants had baseline clinical sexual dysfunction that was sub-clinical at follow-up.

Conclusions
SHARE-B is feasible and efficacious for addressing sexual morbidity following breast cancer, indicating it is likely possible to deliver to women with a variety of disease sites improving scalability of the intervention.

Disclosure
No
(022) Durability of Vestibulectomy Surgery for Neuroproliferative Vestibulodynia
Authors: Yee A , Goldstein S , Drian A , Goldstein I 
Published: May 2023

Abstract

Introduction
In 2006, Goldstein et al reported on 134 patients who underwent complete vestibulectomy surgery with vaginal advancement flap reconstruction for neuroproliferative vestibulodynia (NPV). Ninety-seven of 104 participants (93%) noted being satisfied/very satisfied with surgical outcome. The mean duration of follow up was 26 months (12 – 72 months). NPV is a genital pain condition hypothesized to be caused by an accumulation of excess mast cells in the vestibular epithelium and sub-epithelial stroma that release nerve growth factor. This promotes sub-epithelial stromal nerve ending proliferation (Figure 1). The excess nerve endings result in bothersome, persistent provoked vestibular allodynia and hyperalgesia. Durability of post-operative outcomes past 72 months has not been previously characterized. It is yet unknown if the immunohistochemical pathologic findings of excess mast cells and nerve endings ever reaccumulate in the vestibule, causing recurrent allodynia, hyperalgesia and entrance dyspareunia.

Objective
We assessed the long-term surgical outcome durability (&gt;6 years) of resolution of pain from total vestibulectomy with vaginal advancement flap reconstruction.

Methods
We routinely perform post-operative follow-up of surgical patients who undergo complete vestibulectomy surgery with vaginal advancement flap reconstruction for NPV. We identified patients who claimed successful resolution of their entrance dyspareunia at least 72 months after complete vestibulectomy surgery. We contacted them to determine whether or not they continued to have resolution of their entrance dyspareunia.

Results
57 patients have had complete vestibulectomy surgery with vaginal advancement flap reconstruction from 2007 – 2016 (&gt; 6 years ago). 41 patients responded to long term follow-up contact. 34 patients (78%) were satisfied/very satisfied with surgical outcome in the first 72 months post-operatively. All 34 (100%) continued to note excellent durability of their surgical result, still claiming being satisfied/very satisfied with surgical outcome, a mean of 9.3 years post-op (range 5-14 years).

Conclusions
Based on this small series, it appears that if a patient is a treatment responder to complete vestibulectomy surgery, there is strong durability of the surgical result. These data suggest that in treatment responders, there is no evidence of re-accumulation of excess mast cells and nerve endings in the introitus. These data support that the pathology of NPV lies in the endodermal vestibule and that complete excision is an important long term treatment strategy in many NPV patients.

Disclosure
No
(043) “I’m Coming!” (No, She’s Not): Inequitable Pleasure
Authors: Watson K , Collina S , Park D Y , Rowen T 
Published: May 2023

Abstract

Introduction
Gendered differences in pleasure can be observed in pornography, individual pleasure (masturbation), and pleasure with partners.

Objective
This project intends to synthesize and review current research on gendered differences in various forms of pleasure.

Methods
This study is a narrative review of peer-reviewed journal articles, each of which reinforced and contextualized the existence of the pleasure gap. We considered articles that collected and analyzed data from pornography sites as well as epidemiologic data gathered from researchers studying pornography and sexual activity.

Results
The pleasure gap in one of pornography’s largest tube sites, Pornhub, was 60 percentage points wide: 78 percent of men were shown reaching orgasm, as compared to 18 percent of women. Regarding gender disparities in masturbation, one article found that among a sample of college students, men were twice as likely as women to have ever masturbated. Additionally, the men that had masturbated during early adolescence did so with a frequency three times higher than their female counterparts. It must be noted that, for both of these studies, the categories “men” and “women” are not clearly defined. Partnered pleasure is primarily measured by orgasm frequency within sexual partnerships. Overall, more than 90 percent of men reach orgasm during sex, as compared to 50 percent of women (note that, in this research, “men” and “women” are not defined). For self-identified men, orgasm frequency was similar across sexual orientation, whereas for self-identified women, sexual orientation dramatically influenced the occurrence of orgasms. Notably, lesbian women had a significantly higher orgasm frequency (74.7 percent), as compared to bisexual women (58 percent) and heterosexual women (61.6 percent).

Conclusions
This review indicates a significant gap between orgasm and masturbation rates (as proxies for pleasure) in self-identified men and women. Future directions are twofold, 1) conduct experiments on the pleasure gap to better understand its etiologies, and 2) begin to investigate pleasure beyond the constructs of orgasm, as pleasure can and does exist beyond the climax of sexual stimulation.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Blueberry Hill Strategies.
(049) Blue Balls: Fact or Fiction? Experiences of Genitopelvic Pain and Sexual Coercion Among People with Penises and Vulvas
Authors: Henkelman M , Levang S , Neish R , Zukerman W , Terrel B , Jackman V , Coyle S , Brahmbhatt J , Pukall C 
Published: May 2023

Abstract

Introduction
The term “blue balls”, formally known as epididymal hypertension, is often used in public discourse to describe scrotal pain following sexual arousal that did not result in orgasm. Even though many health-related and popular online sources feature information on its potential causes and treatments, only one interview-based study and one case report exist on this phenomenon in the scientific literature. Controversy exists around the factual nature of blue balls/vulva considering its use for sexual coercion.

Objective
This cross-sectional, mixed-methods, online study aimed to characterize and evaluate the experience and prevalence of discomfort/pain following sexual arousal without orgasm, and assess whether individuals have been pressured to continue sexual activity because of a partner’s fears of experiencing discomfort/pain without orgasm.

Methods
A total of 2621 individuals with a penis (N = 1483) or vagina (N = 1138) were recruited for an online survey on the experience of “blue balls/vulva”. Analyses included descriptive statistics, between-group chi-squared analyses, and thematic analysis on several open-ended questions.

Results
Results from a chi-square test of independence suggested significantly more individuals with a penis than a vagina reported believing blue balls are real, and significantly more individuals with a vagina than a penis reported being pressured into engaging sexually because of a partner’s fear of getting blue balls. Descriptive statistics indicated that for the individuals who disclosed experiencing blue balls/vulva, the experience of pain/discomfort is reportedly mild, with few participants rating the experience as severe. Thematic analysis results indicated that overall, participants felt people with vulvas are expected to engage in sexual acts to prevent their partner’s experience of blue balls despite endorsing that it shouldn’t be used as a sexual coercion tactic.

Conclusions
Despite public discourse that “blue balls” is extremely painful and common, this study suggests that severe pain exists in a minority of people, that solitary sexual and nonsexual activities can alleviate discomfort/pain, and that pain experiences are not a valid reason to pressure others into engaging sexually.

Disclosure
No
(084) A Case Report of Alcohol-Induced Vestibule Pain, Resolved in the Setting of Vestibular Anesthesia Test
Authors: Martin A , Rubin R 
Published: May 2023

Abstract

Introduction
Vestibulodynia is a term to denote pain in the vestibule, which encompasses the vulvar tissue beginning within the labia minora at Hart’s line to the hymen, extending anteriorly just inferior to the clitoris and to the posterior fourchette. Three subtypes of vestibulodynia exist including neuroproliferative, hormonally-mediated and inflammatory. All three subtypes can cause a constellation of symptoms including dyspareunia, dysuria, and discomfort with wearing tight clothes or wiping.

Objective
Described here are two patients who note pain in the vestibule within seconds of drinking alcohol. Notably, in the setting of a vestibular anesthesia test, in which the entire vestibule was completely numbed, they noticed resolution of their typical symptoms and were able to drink alcohol without vestibular pain.

Methods
This first patient is a 40 year old female with endometriosis, adenomyosis, PMDD, POTS, pelvic pain and 19 year history of unprovoked vestibulodynia with multiple failed treatment modalities. Upon consumption of alcohol, notices immediate pain in the vestibule. The second patient is a 27 year old female with provoked neuroproliferative vestibulodynia s/p vestibulectomy. Notes that four minutes after drinking any type of alcohol has worsening stinging and burning of the vestibule. A vestibular anesthesia test was performed, coating the vestibule in 30% Benzocaine, 8% Lidocaine and 6% Tetracaine, allowing it to sit for 10 minutes.

Results
Both patients drank alcohol after the 10 minutes and noted no symptoms at the tissue level whatsoever. They both still had hypertonic pelvic floors. The second patient went on to vestibulectomy and still had symptoms present, though they had decreased.

Conclusions
These cases indicate that alcohol may play a role in inciting vestibulodynia symptoms, and numbing of the vestibule can negate those symptoms. Possible pathophysiology may be due to the vasodilation effects of alcohol on the vestibular tissue, or a histamine response, but further research is needed to determine any potential link.

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