bluuebunny/crossref_metadata_2025_split huggingface dataset:
3D imaging assistance impact on atrial fibrillation cryoablation efficiency, a method validation study
Authors: Solana Munoz J , Teres C , Luca A , Herrera-Siklody C , Leupi H , Domenichini G , Pascale P , Pruvot E , Le Bloa M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): CGRA: CARD; CGRB: 31’297

Background
Pulmonary vein isolation (PVI) by cryoballoon ablation is a well-known therapy for the treatment of atrial fibrillation (AF). Current 3D-navigation technologies usually used with RF ablation allow for a drastic reduction of intra-procedural X-ray exposure and imaging aided/guided methods allow for better anatomical characterization improving acute and long-term procedural results. 3D imaging fusion on real-time fluoroscopy is a well-known technology but the incremental value of 3D imaging fusion as a guiding tool on AF cryoballoon ablation therapy has not been studied yet.

Purpose
To increase procedural efficiency by integration of 3D imaging guidance in conventional cryoballoon PVI.

Methods
Using semi-automatic segmentation (Alphenix, Canon Medical Systems Corporation) obtained from pre-procedural cardiac computed tomography (CT); two anatomic volumes were fused on the real-time fluoroscopy display: left atrium (LA), including pulmonary veins (PV) and spine with proximal rib section (most radio-opaque body part in the thoracic area). The merging was performed by 3D registration of the bone segment with fluoroscopic acquisitions in three standard positions (AP, LAO, RAO), acquired at the beginning of the procedure. To standardize treatment workflow, the study was restricted to patients with paroxysmal atrial fibrillation.

Results
Twenty patients were included in the study: 10 in the control group (conventional fluoroscopy based cryoballoon ablation), and 10 in the 3D assisted group. Mean age was 59±15 SD years for the conventional group and 61.3±15.1 SD years for the 3D group with an 80% male population, in both groups. Acute PVI was achieved in all 20 patients. A decrease of both procedure time 86.8±16.1 SD in the control group Vs. 78.4±15.32 SD in the 3D group, and left sided dwelling time 69.7±14.31 SD in the control group Vs. 63.9±13.96 SD in the 3D group, although this trend did not reach statistical significance, while radiation time and cryo application time remained similar.

Conclusions
3D imaging integration is feasible and safe and allows for an exact PV anatomy depiction on fluoroscopy. The assistance workflow might help increase AF cryoablation efficiency and safety (lower left sided dwelling time). Further research is needed to evaluate the incremental value of 3D imaging to assist fluoroscopy-based cryoballoon ablation. This could also impact long-term results since 3D Imaging assistance could reduce the likeability of missing intermediate PVs during AF ablation procedures.
Peak frequency mapping to differentiate near-field from far-field electrograms for ventricular tachycardia ablation: initial results
Authors: Yamaguchi T , Merino Llorens J L , Kim S , Martinez Cossiani M , San Roman M , Relan J , Castrejon Castrejon S , Jauregui Abularach M , Guido Lopez L E , Merino D , Carton Sanchez A J , Escobar Cervantes C , Martinez Maldonado M E , Ugueto Rodrigo C , De La Vieja Alarcon J J 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Abbott Laboratories

Background
Ablation of ventricular tachycardia (VT) in patients with structural heart disease is challenging. Localization of the critical isthmus of conduction may be difficult because is commonly located within low voltage (LV) areas where far-field (FF) and near-field (NF) electrograms (EGMs) may be present and merged. The peak frequency (PF) associated with bipolar EGMs is a novel parameter which may serve to distinguish NF from FF EGM components. The potential value of PF to identify the critical isthmus of conduction in this setting has never been evaluated.

Purpose
To compare the ability of LV vs. LVHF to discriminate the VT termination region

Methods
Bipolar voltage and activation maps were generated with a 16-pole grid catheter (Advisor HD Grid) during VT. Peak frequency maps were retrospectively computed. VTs were included if acute termination could be achieved through application of a focal RF lesions set restricted to a boundary &lt;1.5cm diameter. The ventricular LV mapped surface was sub-regioned into the termination (T-ZONE) and non-termination (NT-ZONE) zones. The T-ZONE surface was centered about the site of termination and was allowed to extend to a rectangular kernel &gt;0.5cm and &lt;1.5cm across perpendicular axes, with the NT-ZONE encompassing the remainder of the mapped surface area (SA). Sensitivity (SE) and specificity (SP) of discrimination of the T-ZONE vs. NT-ZONE was measured according to the %T-ZONE vs. %NT-ZONE SA occupied at LV thresholds ranging from 0.1-1.0mV in increments of 0.1mV (Panel E). In addition to LV, LVHF at peak frequency cutoffs of 200Hz (LVHF200), 250Hz (LVHF250), 300Hz (LVHF300) and 400Hz (LVHF400) were also assessed for T-ZONE discrimination.

Results
8 patients with sustained monomorphic VT and structural heart disease (ischemic and non-ischemic) were enrolled. All of them had VT terminated with limited ablation by focal ablation at a discrete region. All areas of VT termination were located in a LV and high PF zone (figure 1). The best area under the curve to identify them was using the 250 Hz cuttoff (AUC 0.91) which was also better that using omnipolar optimized voltage alone (AUC 0.84) (Figure 2).

Conclusion
PF mapping apparently identifies slow conduction isthmus and provides complementary information to bipolar voltage mapping which can be displayed with emphasis on the electranatomical map.
Global Regularity of Skew Mean Curvature Flow for Small Data in d ≥ 4 Dimensions
Authors: Huang Jiaxi , Li Ze , Tataru Daniel 
Published: May 2023

Abstract
The skew mean curvature flow is an evolution equation for a $d$ dimensional manifold immersed into $\mathbb {R}^{d+2}$, and which moves along the binormal direction with a speed proportional to its mean curvature. In this article, we prove small data global regularity in low-regularity Sobolev spaces for the skew mean curvature flow in dimensions $d\geq 4$. This extends the local well-posedness result in [7].
Susceptibility to SARS-CoV-2 Infection and Immune Responses to COVID-19 Vaccination Among Recipients of Solid Organ Transplants
Authors: Subramanian Vijay 
Published: May 2023

Abstract
Solid organ transplant recipients (SOTRs) are at high risk for infections including SARS-CoV-2, primarily due to use of immunosuppressive therapies that prevent organ rejection. Furthermore, these immunosuppressants are typically associated with suboptimal responses to vaccination. While COVID-19 vaccines have reduced the risk of COVID-19–related morbidity and mortality in SOTRs, breakthrough infection rates and death remain higher in this population compared with immunocompetent individuals. Approaches to enhancing response in SOTRs, such as through administration of additional doses and heterologous vaccination, have resulted in increased seroresponse and antibody levels. In this article, safety and immunogenicity of mRNA COVID-19 vaccines in SOTRs are explored by dose. Key considerations for clinical practice and the current vaccine recommendations for SOTRs are discussed within the context of the dynamic COVID-19 vaccination guideline landscape. A thorough understanding of these topics is essential for determining public health and vaccination strategies to help protect immunocompromised populations, including SOTRs.
Interpreting cancer incidence trends: challenges due to the COVID-19 pandemic
Authors: Mariotto Angela B , Feuer Eric J , Howlader Nadia , Chen Huann-Sheng , Negoita Serban , Cronin Kathleen A 
Published: May 2023

AbstractThe considerable deficit in cancer diagnoses in 2020 due to COVID-19 pandemic disruptions in health care can pose challenges in the estimation and interpretation of long-term cancer trends. Using Surveillance, Epidemiology, and End Results (SEER) (2000-2020) data, we demonstrate that inclusion of the 2020 incidence rates in joinpoint models to estimate trends can result in a poorer fit to the data and less accurate or less precise trend estimates, providing challenges in the interpretation of the estimates as a cancer control measure. To measure the decline in 2020 relative to 2019 cancer incidence rates, we used the percent change of rates in 2020 compared with 2019. Overall, SEER cancer incidence rates dropped approximately 10% in 2020, but for thyroid cancer the decrease was as large as 18% after adjusting for reporting delay. The 2020 SEER incidence data are available in all SEER released products, except for joinpoint estimates of trends and lifetime risk of developing cancer.
Cecal bascule in pregnancy: a case report and review of the literature
Authors: Kreinces Jason , Robbins Alicia I , Kim Daniel E 
Published: May 2023

Abstract
A 36-year-old female at 36 weeks’ gestation presented with right upper quadrant abdominal pain. She had no prior surgeries. Her pregnancy had been uncomplicated up until her presentation. Abdominal ultrasound was negative for cholecystitis or cholelithiasis, and the appendix was not visualized. During the second day of her hospital course, an abdominal magnetic resonance imaging (MRI) was performed revealing dilated small intestine with air-fluid levels and an inverted-appearing, prominent cecum. She was urgently taken to the operating room for cesarean section followed by abdominal exploration. After delivery of the child, a cecal bascule was found, with a severely distended cecum. To our knowledge, this is the first report of a cecal bascule diagnosed by MRI, and the first diagnosis of cecal bascule in a pregnant patient requiring surgical intervention. We discuss the pathophysiology, diagnosis and treatment of cecal bascule and review the current literature of reported cases.
(038) Adherence Patterns And Costs For Flibanserin: A Single Practice Experience
Authors: Myers M C , Marantidis J , Mora B , Sussman R D , Rubin R S 
Published: May 2023

Abstract

Introduction
Flibanserin is a partial serotonin agonist/antagonist and has been approved for use in premenopausal females with hypoactive sexual desire disorder (HSDD). This medication has been used off-label in males and postmenopausal females in the management of low libido. There is a paucity of data on prescribing patterns for both on and off-label use.

Objective
This study aims to evaluate costs and refill patterns for flibanserin and to determine if adherence was affected by insurance coverage or off-label use.

Methods
This was a retrospective review of online pharmacy records for patients from one sexual medicine practice that were prescribed flibanserin. De-identified patient information was collected and included age, gender, menopause status, refill information, and out-of-pocket cost. All prescriptions for premenopausal and perimenopausal females met criteria for on-label use and all prescriptions for men and postmenopausal females were considered off-label.

Results
Data was available from 109 patients. Forty-nine premenopausal/perimenopausal women were included in the on-label group and 60 patients were assigned to the off-label group as they were males (n=31) or postmenopausal females (n=29). Twelve percent of patients never filled their prescription, 28% filled it once, and 60% filled it ≥2 times. There was no significant difference in the percentage of patients with 0, 1 and ≥2 prescriptions filled between the on and off-label groups (12%, 24%, 63% vs. 12%, 32%, 57%). Out-of-pocket cost of flibanserin without insurance coverage was $99 for a 30-day supply or $199 for a 90-day supply. Twenty-one percent of patients had insurance coverage and their cost was $0 or $20 for a 30-day supply. The average out-of-pocket cost was $67 per 30-day supply (SD=$34). There was no significant difference in the percentage of patients with 0, 1 and ≥2 prescriptions filled between patients with and without insurance coverage (0%, 24%, 76% vs. 3%, 34%, 64%). The percentage of patients with insurance coverage did not significantly differ between those with on and off-label prescriptions (25% vs. 19%).

Conclusions
This study is the first to explore medication adherence and cost of flibanserin. Sixty percent of patients filled ≥2 prescriptions and refill rates were not affected by off-label use or insurance coverage. Only 21% of patients had insurance coverage for the medication. The limitations of the study include a small sample size from one clinic. The results of this study will help clinicians to recognize costs and adherence with on and off-label use of flibanserin.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout Pharmaceuticals, Absorption Pharmaceuticals.
(039) Vaginal Orgasms: Really exists?
Authors: Dominguez-bali A , Hassan Z , Baqer A , Sharma R , Dominguez-bali C , Marquez L 
Published: May 2023

Abstract

Introduction
In 1948 Alfred Kinsey’s investigation of female and male sexuality found that 80% of women reached orgasm mainly through non-coital sexual experiences, such as oral and physical manipulation of the genitals or through sex toys. After that many peer-reviewed studies confirmed these data as well as in our practice. However, the question remains; what happened with the other 20% that reached orgasm through vaginal penetration.

Objective
To describe the epidemiological sexual characteristics of the 20% of women who reached orgasm mainly through vaginal penetration.

Methods
Over 3000 sexual histories were done in our medical center and were used to collect data regarding the reasons for the orgasm obtained through vaginal penetration. This study includes retrospective and prospective questionnaires applied to all patients seen in our centers.

Results
The epidemiological sexual characteristic of this specific group of women are: - 75% have had only one sexual partner in their lives - 20% of them have had two sexual partners in their life and - 5% of them have more than two. It has been very scantly found that women with a history of multiple sexual partners enjoy sexual penetration. The orgasmic response resulting from coital sex was more persistent and presently found while the number of sexual partners was less. Increased orgasmic responsiveness was also present when the initiation of the sexual activity with the partner was earlier in life.

Conclusions
When the sexual development of a woman is allowed to mature in the presence of a lifelong partner. Their response to penetrative vaginal stimuli is better and the obtention of sexual pleasure and orgasm reinforce this response that persists throughout life and is more attainable over any other form of vaginal stimulation.

Disclosure
No
(069) Vaginal Lubrication: Equally Important for Orgasm in Premenopausal and Postmenopausal Women?
Authors: Dubinskaya A , Dallas K , Harper L , Shoureshi P , Krychman M , Eilber K 
Published: May 2023

Abstract

Introduction
The female sexual response cycle is complex with interconnected domains. Studies have shown that vaginal lubrication is affected by age and hormonal changes; however, the relationship between lubrication and orgasm has not been well described in premenopausal women, women who are postpartum, and postmenopausal women.

Objective
The objective of this study is to evaluate the relationship between vaginal lubrication and orgasm among premenopausal, postpartum, and postmenopausal women.

Methods
A post-market analysis was performed of all women who had utilized the sexual wellness application Rosy between February 2022 and November 2022. Application users complete the Female Sexual Function Index (FSFI) short form (6-item) upon initial use of the application. We utilized multivariable linear regression models to determine significant effects between lubrication score and orgasm scores score controlling for whether the patient was on birth control, postpartum, or menopausal.

Results
We reviewed a large database of 30,358 women from across the United States. Among these, 2,599 women were menopausal, 2, 011 were premenopausal women, and 795 were postpartum. The mean lubrication scores on FSFI -6 were: menopausal = 1.93, premenopausal = 2.68, postpartum = 2.73. Mean scores for orgasm were 2.2, 2.62, 2.31 respectively. Premenopausal women had higher overall scores on FSFI- 6, with orgasm scores improving with age. Higher scores in lubrication domain had less impact on orgasm domain in pre-menopausal women compared to post-menopausal women (p=0.04). No correlation between improvement in lubrication and orgasm noted among post-partum women when compared to post-menopausal women (p=0.87).

Conclusions
Lubrication has a higher impact on orgasm among post-menopausal women compared to pre-menopausal women and not correlated with orgasmic function among women in the post-partum period. These findings enhance our knowledge and refine current management of anorgasmia.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Abbvie, Coloplast, Rosy.
(081) The Psychosocial Barriers Associated with Vulvodynia and Vestibulodynia
Authors: Niedenfuehr J , King L , Edwards M 
Published: May 2023

Abstract

Introduction
At least 8-16% of people with a vulva are affected by generalized vulvodynia and vestibulodynia. These conditions impact interpersonal relationships, individual behaviors, and the psychological health of couples and individuals. Recent reviews suggest there is no comprehensive understanding on how psychosocial factors impact patients with these conditions.

Objective
The aim of this review is to analyze, evaluate, and synthesize vulvodynia and vestibulodynia research regarding psychosocial barriers present in the literature from 2012-2022 in the United States and Canada. In addition to psychosocial barriers, structural determinants and environmental barriers were included to comprehensively evaluate all aspects.

Methods
We searched PubMed, CINAHL, Embase, Web of Science, APA PsychInfo, and Academic Search Premier to retrieve eligible journal articles in March of 2022. A search string of key terms and subject headings including Medical Subject Headings were used systematically to search these databases. The reference list was reviewed with an additional reviewer to reduce bias.

Results
A total of 671 papers were discovered and narrowed down to 74 papers that explored at least one psychosocial barrier for patients or providers in the United States and Canada. The findings of the literature search revealed the various psychosocial barriers that patients commonly face such as pain, anxiety, depression, catastrophization, fear, lack of self-efficacy, low desire and arousal, negative body image, stigma, distress, post-traumatic stress disorder (PTSD), child maltreatment and abuse, mistrust, invalidation and isolation, low levels of self-compassion, negative partner support, low relationship satisfaction, lack of physical affection, emotional regulation, and avoidance and lack of approach goals. In addition to psychosocial barriers, structural determinants, and environmental barriers, such as delayed diagnosis, low health literacy, cost, transportation, and racial disparities also adversely impacted individuals with vulvodynia.

Conclusions
This review serves to educate and inform providers and physicians of the unique barriers that patients experience when navigating health care services and treatments for vulvodynia and vestibulodynia. More research is needed to understand and better educate patients and providers on vulvar pain conditions to improve outcomes.

Disclosure
No
(110) Characterizing Sexuality and Assessing Predictors of Sexual Satisfaction in Patients with Multiple Myeloma
Authors: Henkelman M , Toivonen K , Tay J , Beattie S , Walker L 
Published: May 2023

Abstract

Introduction
There is a paucity of literature documenting cancer-related sexual concerns among patients with multiple myeloma (MM). Despite profound sexual changes being reported in other types of hematological cancer (i.e., lymphoma, leukemia), all types of hematological cancer patients tend to be grouped together, potentially overlooking the unique concerns of patients with MM.

Objective
This study is the first to characterize sexuality uniquely in the MM population, and to examine predictors of sexual satisfaction for MM, comparatively with participants with other hematological cancer types.

Methods
We performed a mixed modality self-report survey of patients with hematological cancer, recruiting both in-person and online. Men and women with MM (N=89) and other hematological cancers (N=84) participated in our survey. The survey included demographics and health information, as well as several quantitative sexuality measures including sexual distress, sexual function, sexual flexibility, sexual interest, sexual communication, and sexual satisfaction.

Results
MM survivors exhibited poor sexual function but low sexual distress, and endorsed mid-high scores on measures of sexual interest, sexual flexibility, sexual communication, and sexual satisfaction. Results indicate that for MM and other hematological cancer survivors, lower sexual distress and higher sexual communication were associated with higher sexual satisfaction (b = .428, p &lt; .001; b = -.299, p = .001) while sexual flexibility, sexual interest, and sexual function did not explain significant variance in sexual satisfaction. Thematic analysis on open-ended questions indicates that potentially unique to MM, consequences of bone disease (i.e., bone pain, bone fracture, and spinal cord compression) affected sexual expression and resulted in reduced mobility impacting sexual activity, as well as painful sexual experiences, or anxiety relating to sex.

Conclusions
This study supported the need for sexual health interventions for those diagnosed with MM. Further, it demonstrated that sexual interventions that are used for other hematological cancer patients may be similarly effective for those with MM. Special consideration regarding the impact of bone disease on sexual expression in MM patients should be taken.

Disclosure
No