bluuebunny/crossref_metadata_2025_split huggingface dataset:
An indicator-based approach for assessing marine ecosystem resilience
Authors: Flensborg L C , Maureaud A A , Bravo D N , Lindegren M 
Published: May 2023

AbstractMarine ecosystems are under threat from a range of human pressures, notably climate change, overexploitation, and habitat destruction. The resulting loss of species and biodiversity can cause abrupt and potentially irreversible changes in their structure and functioning. Consequently, maximizing resilience has emerged as a key concept in conservation and management. However, despite a well-developed theory, there is an urgent need for a framework that can quantify key components promoting resilience by accounting for the role of biodiversity. In this study, we applied an indicator-based approach to assess the potential resilience of marine ecosystems using the North Sea as an illustrative case study. More specifically, we quantified and compared multiple indicators of ecological resilience, estimated based on high-resolution monitoring data on marine demersal fish species, combined with information on ecological traits. Our results show a pronounced spatial structuring of indicators, including both similarities and differences among individual metrics and indicators. This implies that high resilience cannot be achieved by maximizing all individual aspects of resilience, simply because there seems to be inherent trade-offs between these components. Our framework is generic and is therefore applicable to other systems and can inform spatial planning and management.
Spectral Multiplicity and Nodal Domains of Torus-Invariant Metrics
Authors: Cianci Donato , Judge Chris , Lin Samuel , Sutton Craig 
Published: May 2023

AbstractLet a $d$-dimensional torus $\mathbb{T}$ act freely and smoothly on a closed manifold $M$ of dimension $n&gt;d$. We show that, for a generic $\mathbb{T}$-invariant Riemannian metric $g$ on $M$, each real $\Delta _{g}$-eigenspace is an irreducible real representation of $\mathbb{T}$ and, therefore, has dimension at most two. We also show that, for the generic $\mathbb{T}$-invariant metric $g$ on $M$, if $u$ is a non-invariant real-valued $\Delta _{g}$-eigenfunction that vanishes on some $\mathbb{T}$-orbit, then the nodal set of $u$ is a connected smooth hypersurface. If $n&gt;d+1$, we show that the complement of the nodal set has exactly two connected components. As a consequence, we obtain new examples of manifolds for which—up to a sequence of Weyl density zero—each eigenfunction has exactly two nodal domains.
(026) Management of Psychosocial and Sexual Complains Among Cancer Patients in the African Context: A Scoping Review
Authors: Esho T , Ramlachan P , Osur J , Magueye Gueye S , Ireri E 
Published: May 2023

Abstract

Introduction
There is a lack of specialized psychosocial and sexual therapies for cancer patients in the African context.

Objective
This paper aims to highlight gaps in capacities of health care providers to address psychosocial and sexual needs of patients suffering from cancer disease, develop and share the proposed algorithm of psychosocial and sexual care management in the African context_

Methods
We conducted a scoping review of literature that highlights the psychosocial and sexual complications associated with cancer disease and its management, especially in the African context. A systematic search of bibliographic databases and websites including BioMed Central, PubMed Central, Taylor and Francis Online, Wiley online Library, EBSCOHOST databases using appropriate keywords on management of cancer in Africa was conducted between 1st January, 2000 to 31st March, 2021, using search words: ‘cancer; cancer treatment; ‘cancer management’; ‘cancer complications’; ‘psychosocial and sexual complications of cancer’. Identified publications were screened against selection criteria following the PRISMA guidelines.

Results
Characteristics or psycho-social and sexual outcomes of cancer were examined and associated management charted in an excel framework with the 6 studies that met the eligibility criteria. There is need to strengthen capacities of health care providers in the African health care system regarding the management of psychosocial and sexual complications associated with cancer disease.

Conclusions
The study proposes a psychosocial and sexual algorithm of care to be utilized by health care providers for the management of psychosexual complications associated with cancer disease. The algorithm can assist and facilitate the integration of psychosocial and sexual cancer programs into existing health care services in primary health-care facilities making it accessible to most patients.

Disclosure
No
(030) Mental Health and Unmet Healthcare Needs of Female Sex Workers in Baltimore, Maryland
Authors: Krishnamoorthi M , Alarcon Basurto S , Sherman S , Tomko C 
Published: May 2023

Abstract

Introduction
Female sex workers (FSW) experience unique mental health and well-being challenges that intersect with their sex work and sexual health. Further, they often experience discrimination and stigma within healthcare settings, leading to delayed or forgone healthcare. Throughout the COVID-19 pandemic, FSW faced unique limitations on their ability to gain financial compensation, which can amplify existing social inequities and morbidities (i.e. poor mental health) among this marginalized population.

Objective
As poor mental health is associated with increased risk of acquiring HIV and other sexually transmitted infections (STI), it is critical to understand the unique mental health strains of FSW in order to improve their engagement in and quality of mental and sexual healthcare.

Methods
Participants were purposively sampled for in-depth qualitative interviews to ensure a diversity of experience from an existing cohort study of COVID-19 testing in Baltimore, Maryland. The semi-structured interview includes questions about aspects of sex work most salient for mental health (and their changes during COVID) including: their relationship with street-based sex work, police interactions, violence, safety, substance use and overdose. Two independent coders conducted a thematic analysis using inductive and deductive codes.

Results
Preliminary results from qualitative interviews (n=14) with FSWs demonstrate a diversity of experience throughout the COVID-19 pandemic and its impact on mental health, self-management practices, stigmatizing and unsafe experiences, and barriers to healthcare. Despite many having a primary care physician, many participants did not report receiving care that was respectful or culturally sensitive to their sex work; participants who did not report having a primary care physician had a harder time seeking care. Multiple FSWs described formal psychiatric diagnoses but often noted that they were not on consistent medication due to financial instability and prescription side-effects. Moreover, self-medication through drugs was a prevalent theme, as barriers to accessing treatment for mental illness required that they find alternate means to address their symptoms. Cultivating self-management strategies (e.g., getting high, writing in a journal, finding a place to release emotions, focusing on work) that serve as alternatives to primary care treatment was common. Themes also included isolation during COVID, and a lack of a strong support system to discuss feelings of stress, depression, and anxiety.

Conclusions
Results show that FSW have a unique constellation of factors that negatively impact their mental health, but often lack access to culturally sensitive and non-stigmatizing care. Healthcare providers must be educated on the healthcare concerns of FSWs and their intersections with the unique social determinants they face.

Disclosure
No
(044) Identifying Challenges Experienced by Transgender Individuals Seeking Urologic Care
Authors: Denisenko A , Bulafka J , Spigner S , Swaminathan V , Stauffer P , Frasso R , Chung P H 
Published: May 2023

Abstract

Introduction
Providers will encounter transgender individuals in their practice, and it is important that they understand the unique challenges that these individuals face.

Objective
We sought to characterize the challenges transfeminine individuals face in seeking urological care through a developed questionnaire.

Methods
IRB approval was obtained to develop (with transgender community feedback) and administer a 58-item questionnaire assessing urinary and sexual health. Participants were recruited from the local community and the Philadelphia Trans Wellness Conference. We assessed the urologic care experiences of participants while comparing vaginoplasty (VP) and non-vaginoplasty (NVP) respondents.

Results
A total 32% of participants (n=17) sought care from a medical provider for GU/sexual symptoms in the past year. 41% of respondents (n=7) who sought medical care saw a urologist, with the majority having seen a urologist based on a referral or recommendation from another physician (n=5, 71%). Among all participants who had been to a urology practice in the past, 57% reported that they experienced a lack of knowledge about transgender health needs from a provider and/or office staff. 14 (26%) participants reported choosing not to see a urologist for one or more of the following reasons: 12 (85.7%) due to fear of being mistreated, disrespected, and/or misgendered, 10 (71.4%) due to discomfort around discussing urinary or sexual function issues as a transgender or gender nonconforming, 3 (21.4%) due to issues with insurance coverage, 3 (21.4%) due to issues with transportation or missing work, and 1 (7.14%) indicated “Other”. With respect to specific patterns of care between VP and NVP participants, we noted that NVP individuals were more likely to seek care for genitourinary issues (p=0.02) than NVP individuals. We also found that a higher proportion of VP compared to NVP individuals (45.5% vs 28.6%) sought general urologic care.

Conclusions
Transfeminine individuals experience a range of socio-economic barriers to urologic care. Participants indicated a reluctance to seek care because of discomfort and fear, and most reported inexperience from staff regarding transgender care. We noted that VP individuals were more likely to seek care from a urologist than NVP individuals, which may reflect a greater familiarity with the medical system. It is important for providers to be aware with these issues and communicate in a compassionate and affirming manner with their transgender patients.

Disclosure
No
(049) Project SEXUS – Baseline Findings from a Nationwide Cohort Study on Sexual Behavior and Health in Denmark
Authors: Graugaard C , Frisch M 
Published: May 2023

Abstract

Introduction
Project SEXUS (www.projectsexus.dk) is a nationwide cohort study on sexual behavior and health in Denmark that was initiated in 2017 by two state research institutions. The aim of this presentation is to introduce the methodology of the study and to present key findings from its baseline data collection.

Objective
The objectives of the Project SEXUS study were 1) to provide a thorough insight into the sexual landscapes of the general Danish population, 2) to shed light on the sexual health of understudied groups such as elderly people, chronically ill individuals and LGBT+ persons and 3) to investigate the interplay between sex lives, lifestyles and general health.

Methods
The cohort was created using a probability-based sampling frame, and the questionnaire comprised more than 600 items, including brief versions of validated measurement instruments such as the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI). Due to strategic filter questions, the median number of items addressed by respondents was 180. Between September 2017 and August 2018, 187,084 Danes aged 15-89 years were invited to participate in the study by filling out an online questionnaire. 64,706 individuals gave complete or almost-complete responses (AAPOR response rate 1: 34.6%). Individual weighting procedures ensured exact national representativeness regarding sex, birth year, region of residence, marital status, cultural background and twin status, and logistic regression analyses provided age-adjusted odds ratios as measures of relative risk at baseline.

Results
Based on complete and validated questionnaire data from 62,675 participants, key findings concerning sexual orientation, needs, experiences, satisfaction and current behaviors will be presented, and various dimensions of sexual health in the Danish population will be discussed. Moreover, topics such as relationship satisfaction, pornography consumption, risky sexual behavior, body contentment and childhood gender non-conformity will be addressed. Further, noteworthy associations between general and sexual lifestyles and health will be emphasized, and main findings regarding general and sexual wellbeing in strata of different sexual and gender identities will be shown.

Conclusions
The presented baseline findings from Project SEXUS provide a detailed account of the sex life situation in contemporary Denmark. Due to its huge size, national representativeness and ability to follow individual cohort members over time through identity-secure linkage with information in national health registers, the study offers internationally unique opportunities for detailed prospective assessments of the complex interplay between sex life, lifestyles and health. This is of obvious relevance to sexologists, sexual health promoters and general health-care providers around the world.

Disclosure
No
(052) The Relationship between Sexual Empowerment and Women's Sexual Pleasure
Authors: Blauenstein L , Reyes M , Cantrick M , Harvey P 
Published: May 2023

Abstract

Introduction
It is debated whether feelings of sexual empowerment are intrinsically derived or whether they are a guise for the positive feelings associated with conforming well to society’s standards. The nexus of sexual empowerment and sexual performance can be examined through the experience of sexual pleasure. The link between sexual empowerment and sexual performance and sexual pleasure has not been explored in depth.

Objective
This study aims to identify the association between sexual pleasure and sexual performance, sexual pleasure and sexual empowerment, and sexual empowerment and sexual performance. The association between sexual empowerment levels and experiences of sexual pleasure with partners among women is investigated.

Methods
Using a purposive convenience sample, data from 1,183 millennials (642 women) from The Pleasure Study (2021-2021) were used, which examined gender and sexual experiences among six gender identity groups. Data on the frequency of orgasm experience, the frequency of orgasm performance, the frequency of sexual pleasure performance, and sexual empowerment were analyzed for this study.

Results
Analyses determined a significant indirect effect of communication about sexual initiation and satisfaction on frequency of experiencing orgasms with partners through frequency of sexual pleasure performance, b = -0.049, 95% CI [-0.099, -0.021]. There was also a significant indirect effect of unwanted sex refusal on frequency of experiencing orgasms with partners through frequency of orgasm performance, b = -0.037, 95% CI [-0.085, -0.022]. Furthermore, there was a significant indirect effect of unwanted sex refusal on frequency of experiencing orgasms with partners through frequency of sexual pleasure performance, b = -0.053, 95% CI [-0.087, -0.022].

Conclusions
This study demonstrates that sexually empowered women perform sexual pleasure less, and this decreased performance of sexual pleasure mediated the association between their sexual empowerment levels and their more frequent orgasm experiences. Higher levels of sexual communication and the ability to refuse unwanted sexual relations predicted performing sexual pleasure less, and decreased performance of sexual pleasure in turn predicted more frequent orgasm experiences. Interestingly, sexual history communication was not associated with decreased performance of sexual pleasure nor more frequent orgasm experiences. Thus, the results suggest that women increase their sexual pleasure with partners when focusing on communicating about their sexual needs and preferences.

Disclosure
No
(062) Testosterone Therapy Improves Mortality after Solid Organ Transplant
Authors: Omil-Lima D , Perez J A , Thompson A , Callegari M , Khera M , Chavin K , Thirumavalavan N 
Published: May 2023

Abstract

Introduction
Low testosterone has been suggested as a contributor to mortality and rejection after solid organ transplant. Whether testosterone therapy specifically improves these outcomes is unknown.

Objective
To determine whether treatment of low testosterone with testosterone therapy is associated with improved rejection or mortality after solid organ transplant using TriNetX, a large deidentified, multi-institutional database.

Methods
We compiled all clinical data from the TriNetX research network, a globally federated health research network (with waiver from Western IRB) that provides de-identified clinical information from 58 heath care organizations, and over 80 million patients located within the United States. We selected male patients (aged ≥ 18) with a history of lung, kidney, liver, heart, or pancreas transplant. We categorized patients into two groups, based on prescription for testosterone therapy. For all patients, we collected clinical information including demographics, comorbidities, laboratory findings, and medication use. Our outcomes of interest were 1-year, 3-year, and all-time mortality, as well as allograft rejection. We evaluated differences in baseline characteristics between testosterone level (Normal T, or Low T), using chi-square or Fisher’s exact test for categorical data (presented as frequencies and percentages), and independent t-test for continuous data. To address potential confounders that could bias our results, we used a propensity score weighted regression (inverse probability of treatment weighting), matched on age, race/ethnicity, comorbid conditions, multiple transplant status, and immunosuppressant use. Multivariable logistic regression was used to model outcome of transplant rejection, on the predictors of testosterone level, testosterone therapy, and their interaction, while a cox regression model was used to determine probability of mortality.

Results
A total of 1,762 men were identified with solid organ transplants. 262 (14.9 %) met criteria for low testosterone and had a history a prescription of testosterone therapy. Baseline characteristics were similar between the two groups (Table 1). After matching for existing patient characteristics, outcomes showed that a prescription for testosterone therapy was associated with improved mortality after organ transplant. The risk of mortality was reduced at 1 year (HR 0.33), 3 years (HR0.57) and for all time mortality (HR 0.61) among patients treated with testosterone therapy. No effect of testosterone treatment was seen with regards to allograft rejection (data not shown).

Conclusions
Testosterone therapy may improve mortality in men with low serum testosterone following solid organ transplant. Further studies are required to determine when and what patients derive most benefit from testosterone therapies, particularly as the result does not appear to be driven by reduced allograft rejection.

Disclosure
No
(064) Pharmacokinetics and Safety Outcomes of Compounded Versus Branded Testosterone Pellets in Men with Testosterone Deficiency: A Single-Center, Open-Label, Randomized Trial
Authors: Kresch E , Fernandes Negris Lima T , Molina M , Reddy R , Patel M , Loloi J , Carto C , Gonzalez D , Ory J , Ramasamy R 
Published: May 2023

Abstract

Introduction
Testosterone deficiency (TD) is a prevalent condition, especially in men ≥ 45 years old, and testosterone therapy (TTh) can improve quality of life in these patients.

Objective
In this abstract, we aim to evaluate the safety profile of compounded subcutaneous testosterone pellets and to compare the pharmacokinetics between compounded and FDA approved testosterone pellets (Testopel®) for TTh.

Methods
This was a prospective, Phase 3, randomized, non-inferiority clinical trial. We enrolled 75 men diagnosed with TD and randomized them 1:1 ratio to Testopel® and a 100mg compounded pellet group. The patients were implanted with their respective treatment: Testopel® (10 pellets of 75mg) or compounded testosterone pellets (8 pellets of 100mg).

Results
After randomization, there were 35 participants enrolled in the Testopel® 75mg arm and 40 participants in E100 arm. Serum T levels were similar between the groups at 2, 4 and 6 months, with most men (82%) dropping below 300 ng/dL by the end of the trial. Adverse events such as elevations in prostate specific antigen, estrogen and hematocrit in each group were similar. Most dropouts were related to persistent TD symptoms and serum T &lt; 300ng/dL, with similar rates between the two groups in the study.

Conclusions
Men treated with Testopel® and compounded pellets had comparable serum testosterone levels and similar adverse events rates. Compounded testosterone pellets can provide an effective choice of long term TTh among men with TD comparable to Testopel®.

Disclosure
Yes, this is sponsored by industry/sponsor: Empower Pharmaceuticals.

Clarification
Industry funding only - investigator initiated and executed study.
Any of the authors act as a consultant, employee or shareholder of an industry for: Empower Pharmacy.
(072) What Kind of Specialists Should Know About HRT?
Authors: Dominguez-Bali A , Hassan Z , Shah P , Coburn A , Nani J , Dominguez-Bali C 
Published: May 2023

Abstract

Introduction
Hormone Replacement Therapy (HRT) use has recently been a topic of debate amongst clinicians. The discussion has been most prevalent in the fields of gynecology, urology, and endocrinology. Current research suggests HRT can prevent the development of lethal diseases such as myocardial infarction, osteoporosis, diabetes mellitus, Alzheimer's disease, Parkinson’s disease, and genitourinary syndrome of menopause.

Objective
To raise awareness of HRT as a prophylactic measure to treat a variety of diseases in multiple organ systems, we recommend providing this information across multiple medical specialties to warrant the use of HRT amongst patients. Specialists including obstetricians and gynecologists, urologists, cardiologists, neurologists, dermatologists, psychiatrists, ophthalmologists, orthopedics, wound care specialists, sexologists, sex therapists, psychologists, rheumatologists, immunologists, infectious disease specialists, cosmetic surgeons, endocrinologists, and geriatricians should be aware of the benefits of HRT and how they can incorporate it into patient care.

Methods
Based on our own experience, for more than 40 years and the continued management of postmenopausal women, we have realized the importance that physicians, in specialties other than obstetrics and gynecology must be aware of the use of this therapy in their specific field. For example, approximately 60% of depression diagnoses in perimenopausal years can be treated with greater efficacy with hormone replacement therapy rather than antidepressants prescribed by psychiatrists. These findings have been confirmed in the current literature, however awareness amongst the various specialties is very poor.

Results
HRT plays a significant role in treating silent killers such as myocardial infarction, osteoporosis, diabetes mellitus, Alzheimer’s disease, Parkinson’s disease, and Genitourinary syndrome of menopause.

Conclusions
Previously, the role of HRT was not clearly established. Current data suggests HRT provides many benefits including a reduction in mortality. Through recent research and published literature, the consensus of the benefits and strategies of HRT have been established. However, the use of HRT is currently under-prescribed. This creates an opportunity to bring awareness to clinicians, thereby improving the lives of patients.

Disclosure
No