bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Closing the loop’: re-audit of the diagnosis and management of vitamin B12 deficiency in general practice
Authors: O’Donnell O. , MacCarthy J. 
Published: July 2022

Abstract
Introduction
Vitamin B12 deficiency is common in Ireland, The Irish Longitudinal Study on Aging (TILDA) survey indicates 12% of over 50s in Ireland are low or deficient. The condition is commonly managed exclusively in general practice.

Aim
The intention of this audit was to establish whether B12 deficiency is diagnosed correctly and whether there was over-treatment of patients.

Methods
The audit was conducted in an urban general practice in midwest Ireland. The primary limitation was the low number of patients. Thirty-five patients were included after practice database searches. An initial audit was performed which compared with the standard, Royal University of Bath: ‘Guidelines for the Investigation & Management of B12 deficiency’.

Results
The recommendations from this audit were to complete follow-on investigations and to switch over patients from IM to oral replacement. Twenty-one patients were then recalled, and investigations were performed. Ten patients were then switched from IM replacement to oral therapy. A re-audit was then completed. The re-audit showed marked improvement in compliance, from 17% (n = 6) to 83% (n = 29). The reduction in patients on IM therapy will decrease practice burden, with an annual reduction of nurse consultations by 46, representing a 30% decrease in nurse consultations for IM vitamin B12. This equates to an annual cost reduction of €1,340.

Conclusion
This closed loop audit demonstrated that there was over treatment and under investigation of patients with B12 deficiency in general practice and that auditing of this process could both reduce risk for patients and save money and time.
Green synthesis of (CS/OLE) AgNPs and evaluation of their physico-chemical characteristic
Authors: Sarhan Afaf Sarhan , Abdel-Hamid Maysa I. , Hanie Rehab 
Published: July 2022

AbstractThe present article involves the bio-synthesis of (Chitosan/olive leaf extract) silver nanoparticles (CS/OLE) AgNPs using a simple green electrochemical procedure followed by UV-irradiation time. The properties and structure of the resulting (CS/OLE) AgNPs were characterized by employing several analytical techniques including, Infrared spectrum (FT-IR), UV–VIS spectroscopy, X-ray analysis (XRD), energy-dispersive X-ray (EDX) and degredation. Besides, the studying of the thermal characteristics of the (CS/OLE) AgNPs electrets were also investigated. Formation of Ag nanoparticles was observed upon varying the solution color from faint yellow into yellowish brown and was achieved by the appearance of absorption peak at about ~ 410 nm of the resulting AgNPs corresponding to the surface plasmon resonance (SPR). The sharp peaks appear at 32.16°, 46.19°, 54.75°, 57.59°, and 76.7°, indicating the presence of AgNPs as shown from XRD. With comparing the anti-bacterial efficiency of (CS/OLE) AgNPs and (CS/OLE) we found that the AgNPs display a relatively high anti-bacterial activity than in plant extract and chitosan alone. The electrical properties of (CS/OLE) AgNPs films were studied by global thermally stimulated depolarization current (TSDC) spectra for explaining the relaxation phenomena of the samples. In addition, the molecular parameters (The activation energy Ea and pre-exponential time τo), have been evaluated by the Arrhenius equation. The Ea was found in ~ (0.39–0.62 eV) for (CS/OLE).
Immune checkpoint inhibitor-associated new-onset primary adrenal insufficiency: a retrospective analysis using the FAERS
Authors: Lu D. , Yao J. , Yuan G. , Gao Y. , Zhang J. , Guo X. 
Published: July 2022

Abstract
Background
Our study aimed to investigate the prevalence and demographic characteristics of immune checkpoint inhibitor-associated primary adrenal insufficiency (ICI-PAI) and to explore the risk factors of its clinical outcome using data from the US FDA Adverse Event Reporting System (FAERS).

Methods
This was a retrospective study. All cases of new-onset or newly diagnosed primary adrenal insufficiency associated with FDA-approved ICIs from 1 January 2007 to 31 December 2020 were identified and collected using FAERS. Data on age, sex category, body weight of the participating individuals, the reporting year and the prognosis of cases, and other accompanying endocrinopathies related to ICIs, were analysed.

Results
The incidence of ICI-PAI was 1.03% (1180/114121). Of the 1180 cases of PAI, 46 were “confirmed PAI”, and 1134 were “suspected PAI”. Combination therapy with anti-CTLA-4 and anti-PD-1 was related to a higher risk of PAI compared with the anti-PD-1-only group (χ2 = 92.88, p < 0.001). Male and elderly individuals showed a higher risk of ICI-PAI (male vs. female, 1.17% vs. 0.94%, χ2 = 12.55, p < 0.001; age < 65 vs. ≥ 65, 1.20 vs. 1.41%, χ2 = 6.89, p = 0.009). The co-occurrence rate of endocrinopathies other than PAI was 24.3%, which showed a higher trend in patients on nivolumab-ipilimumab treatment than in those on PD-1 inhibitors (χ2 = 3.227, p = 0.072). Body weight was negatively associated with the risk of death in the study population [p = 0.033 for the regression model; B = – 0.017, OR 0.984, 95% CI (0.969–0.998), p = 0.029].

Conclusion
ICI-associated PAI is a rare but important irAE. Male and elderly patients have a higher risk of ICI-PAI. Awareness among clinicians is critical when patients with a lower body weight develop PAI, which indicates a higher risk of a poor clinical outcome.
Time-series forecasting of ships maneuvering in waves via dynamic mode decomposition
Authors: Diez Matteo , Serani Andrea , Campana Emilio F. , Stern Frederick 
Published: July 2022

AbstractA data-driven and equation-free approach is proposed and discussed to forecast responses of ships maneuvering in waves, based on the dynamic mode decomposition (DMD). DMD is a dimensionality-reduction/reduced-order modeling method, which provides a linear finite-dimensional representation of a possibly nonlinear system dynamics by means of a set of modes with associated oscillation frequencies and decay/growth rates. This linear representation is entirely derived from available data and does not require the knowledge of the underlying system equations, which are and remain unknown. Based on the linear representation, DMD allows for short-term future estimates of the system state, which can be used for real-time prediction and control. Here, the objective of the DMD is the analysis and forecast of the trajectories/motions/forces of ships operating in waves, offering a complementary efficient method to equation-based system identification approaches. Results are presented for the course keeping of a free-running naval destroyer (5415M) in irregular stern-quartering waves and for the free-running KRISO Container Ship performing a turning circle in regular waves. Results are overall promising and show how DMD is able to identify the most important modes and forecast the system state with reasonable accuracy upto two wave encounter periods.
Tool wear mechanism, monitoring and remaining useful life (RUL) technology based on big data: a review
Authors: Zhou Yang , Liu Changfu , Yu Xinli , Liu Bo , Quan Yu 
Published: July 2022

AbstractTool wear is a key factor affecting many aspects of metal cutting machining, including surface quality, machining efficiency and tool life. As machining continues to evolve towards intelligence, hot spots and trends in tool wear-related research are also changing. However, in the current research on tool wear, there are still no recognized most effective tool wear suppression methods, signals are easily disturbed, low efficiency of signal processing methods and poor model generalization ability, etc. Therefore, a comprehensive summary and outlook of tool wear-related research is urgently needed, on the basis of which it is important to predict the hot spots and trends in tool wear research. In this paper, the current state of research on tool wear is systematically described from three aspects: tool wear mechanism, online monitoring and RUL (remaining useful life) prediction, and the shortcomings of tool wear-related research are pointed out. After an in-depth discussion, this paper also foresees the development trends of tool wear related research: (1) tool wear suppression research based on new technologies; (2) online monitoring and RUL prediction technology based on the fusion of data, features and pattern recognition; (3) intelligent, self-learning and self-regulating intelligent machining equipment that integrates multiple objectives (e.g. tool wear, chatter and remaining bearing life, etc.); (4) based on big data, the application of data-driven algorithms in tool wear mechanism, online monitoring and RUL prediction.
The Tenuous Role of Distress in the Diagnosis of Premature Ejaculation: A Narrative Review
Authors: Rowland David L. , Cooper Stewart E. 
Published: July 2022

AbstractBackgroundUnlike the other 2 criteria for diagnosing premature ejaculation (PE), namely lack of ejaculatory control and short ejaculation latency (EL), the role of bother/distress has received only minimal consideration and investigation.AimThe specific aim was to determine both why distress is included in the PE diagnosis and whether such inclusion is advantageous to achieving better diagnostic outcomes. To this end, the review explored the historical and theoretical underpinnings of the inclusion of “bother/ distress” in the diagnosis of PE, with reference to the larger role that distress has played in the diagnosis of mental disorders, in an attempt to understand the utility (or lack thereof) of this construct in making a PE diagnosis.MethodsWe reviewed the role of bother/distress across current professional definitions for PE and then expanded this discussion to include the role of distress in other sexual dysfunctions. We then included a brief historical perspective regarding the role that distress has played in the diagnosis of PE. This discussion is followed by a deeper look at 2 nosological systems, namely DSM and ICD, to allow perspective on the inclusion of the bother/distress construct in the diagnosis of mental and behavioral disorders, including the assumptions/arguments put forward to include or exclude bother/distress as an important criterion underlying various professional assumptions.OutcomeDetermination of the value and/or need of including bother/distress as a necessary criterion for the diagnosis of PE.ResultsBased on the research literature, bother/distress does not appear to be as critical for a PE diagnosis as either the lack of ejaculatory control or short EL. It is the weakest of the differences among men with and without PE, and recent evidence suggests that its inclusion is generally redundant with the severity of the 2 other criteria for PE, ejaculatory control and EL.Clinical TranslationBother/distress appears to serve little purpose in the diagnosis of PE yet its assessment may be important for the treatment strategy and for assessing treatment effectiveness.Strengths and LimitationsThis review did not provide a critical analysis of the literature regarding the role of bother/distress in PE, but rather focused on its potential value in understanding and diagnosing PE.ConclusionAlthough bother/distress appears to add little to the improvement of accuracy for a PE diagnosis, understanding and assessing the man's or couple's experience of distress has important implications for the treatment strategy and focus, as well as for assessing treatment success.
Trauma Informed Use of Sensate Focus With Survivors of Sexual Trauma
Authors: Weiner L 
Published: July 2022

ABSTRACT

Introduction
Since Masters & Johnson developed Sensate Focus touch in the 1960’s, many clinicians have devised modifications to this foundational technique in order to address client diversity and the range of sexual concerns. Sexual Trauma Survivors who may be over represented in our consultation rooms are some of our most challenging clients. Survivors may present with sexual phobias, avoidance, pain, lack of desire and/or responsiveness. and, too often, are not initially there for themselves. The literature is rich with publications about the potential emotional and sexual after effects of sexual trauma and there are many good self help books on emotional healing. However, very few authors have published detailed suggestions for working with the sexual healing of survivors (Cohn, 2016), and even fewer have published suggestions for the use of mindful and somatic strategies, including Sensate Focus.

Objective
To review the literature on the treatment of survivors of sexual trauma related to sexual trauma and sexual distress/disfunction, particularly related to mindful and somatic interventions.

Methods
The professional and self help literature was reviewed and combined with clinical experience and the input of other professionals with whom I consulted.

Results
There are a few authors who provide some detail about sexual healing through touch or somatic and mindful interventions (Haines, 2007; Maltz, 2002) and some recommended exercises, but no suggestions for the use of the updated Sensate Focus suggestions and sexual trauma survivors was detailed in the literature.

Conclusions
More studies and publications are needed to address the specific needs of patients who have a history of sexual trauma who want to address their sexual dysfunctions.

Disclosure
No
Estetrol, a Natural Estrogen with Selective Tissue activity (NEST)
Authors: Gerard C , Yost M , Oligschläger Y , Sweat M , Foidart JM 
Published: July 2022

ABSTRACT

Introduction
Current contraceptives can pose an increased risk of venous thromboembolism and breast cancer due to their pharmacological profile. Estetrol (E4) is a native estrogen produced by the human fetus during pregnancy, which has a pharmacological profile different from that of other estrogens.

Objective
Additional studies were conducted to better characterize the unique pharmacological and pharmacokinetic profile of E4.

Methods
E4 has been characterized in nonclinical studies, investigated in clinical trials as a component of contraceptives and is being evaluated for treatment of menopausal symptoms.

Results
E4 is quickly absorbed after oral administration and does not exhibit an extensive binding to plasma proteins in contrast to other estrogens. It has a half-life of at least 24h. It is transformed into inactive sulfo- and glucurono-conjugates, primarily excreted in urine. No potentially carcinogenic metabolites have been identified after E4 metabolization. E4 does not significantly affect CYP450 liver enzymes and has minimal impact on hemostatic parameters, plasma levels of lipids and glucose. In cell, human and animal studies, E4 has limited effects on normal and malignant breast tissue. At the cellular level, E4 like other estrogens, binds and activates the nuclear estrogen receptor α (ERα) and recruits the same coregulators, while selective estrogen receptor modulators (SERMs) recruit other coregulators. However, unlike the other estrogens, E4 induces very limited activity on membrane ERα and antagonizes this pathway in the presence of estradiol, thereby uniquely uncoupling nuclear and membrane activation.

Conclusions
Based on its unique structure, pharmacokinetic/dynamic properties and distinctive mode-of-action, E4 is considered a Natural Estrogen with Selective Tissues activity (NEST), with a favorable benefit-to-risk ratio.

Disclosure
Yes, this is sponsored by industry/sponsor: Estetra SRL (an affiliate company of Mithra Pharmaceuticals, Belgium; Publication support by Mayne Pharma

Clarification
Industry initiated, executed and funded study
Any of the authors act as a consultant, employee or shareholder of an industry for: Estetra SRL (an affiliate company of Mithra Pharmaceuticals, Belgium; Publication support by Mayne Pharma
Introducing a Guide in Physical Therapy Addressing Sexual Function in Adults with Neuromuscular Disorders
Authors: Fisette-Paulhus I , Morin M , Fortin J , Girard-Côté L , Gagnon C 
Published: July 2022

ABSTRACT

Introduction
Physical therapists are part of the rehabilitation team following individuals with neuromuscular disorders (NMD). Due to their impairments, people with NMD can have difficulties engaging in sexual activities. One study reported that 70% of people living with chronic disorders present difficulties related to sexuality and only 18% can overcome them by themselves [1].

Objective
The guide has 3 main objectives: 1) To document interventions regarding sexual impairments in people with NMD that can be applied by physical therapists in clinical practice; 2) To propose approaches for addressing sexuality with their clients; 3) To highlight issues that require advanced physical therapy expertise in pelvic floor rehabilitation.

Methods
The guide is based on a review of the literature and the clinical experience of physical therapists with expertise in NMD or sexuality in Canada. It was developed using the “Rare knowledge mining methodological framework” [2]. Two frameworks were also followed: “Essential Competency Profile for Physiotherapists in Canada (2017)” [3] and the “EX-PLISSIT model” [4, 5].

Results
A total of 75 articles retrieved were considered in our review. Twelve physical therapists and four other health professionals were consulted for this guide. It is recommended to introduce the topic of sexuality early in therapy and follow the steps of the EX-PLISSIT model [4, 5] before offering specific suggestions. Physical therapists should address different aspects in their assessment: interpersonal relationships, assistance required or not during sexual activities, urinary, vaginal or anorectal symptoms, erectile dysfunction, pain, fatigue and impact of the disease on sexuality. Some of the impairments or limitations that may be identified during an objective assessment can have an impact on sexual function and it is important to be aware of these issues: strength, grip, dexterity, sensibility, pain, bed mobility, motor control, etc. Interventions are presented in detail in the guide regarding physical activity, positioning, muscle weakness, fatigue, decreased mobility, erectile dysfunction, sensitivity disorders, lubrication, pain, incontinence, and cardio and respiratory implications.

Conclusions
To the best of our knowledge, this is the first guide on the role of physical therapists in sexuality. Physical therapists should integrate sexual function into their assessments and interventions. They are an essential part of the rehabilitation team, and they should collaborate with other health professionals to have a multidisciplinary approach, especially in NMD patients. More studies are needed to evaluate the effects of intervention on sexual function in this population.

Disclosure
No
A Multidimensional Evaluation of Intimacy
Authors: Sears M , Crosby C , Freihart B , McMahon L , Meston C 
Published: July 2022

ABSTRACT

Introduction
Intimacy is crucial for developing successful relationships as it strengthens bonds between partners. Intimacy has been hypothesized to comprise four central components: self-disclosure, love and affection, validation, and trust. Despite the importance of intimacy in developing strong relationships, to our knowledge, there is not a widely accepted measure that captures the full spectrum of intimacy. Popular measures like the Miller Social Intimacy Scale (MSIS), the Personal Assessment of Intimacy in Relationships (PAIR), and the Fear of Intimacy Scale (FIS) each address only some facets of this multidimensional construct. As such, the development of a more inclusive relational intimacy scale would benefit both researchers and clinicians and help advance our understanding of this construct.

Objective
The current study had two primary aims: (1) to identify what acts and experiences elicit feelings of intimacy among individuals in order to develop a more nuanced, complete measure for use in future research and clinical practice; and (2) to evaluate how the factor structure of these items compares to pre-existing measures of intimacy.

Methods
In Study 1, participants nominated over 2,700 items that “elicited feelings of intimacy” for them. Examples of nominations included: trust, communication, touch, attraction, and sex. Trained raters condensed duplicate items and created a final list of unique nominations for use in Study 2. Five experts in the field of sex research submitted additional items for consideration in Study 2 based on previous conceptualizations of this construct. Study 2 identified the factor structure of these items and validated the measure.

Results
Data collection for Study 2 is ongoing, but will be completed in January 2021. Results will be updated with an addendum after data analysis.

Conclusions
Discussion will focus on individual differences in the factor structure of intimacy based on gender, age, and relationship duration and status. We will conclude by positioning our new model of intimacy within the existing theoretical framework of this construct, and elucidate how our measure can improve psychological and clinical research.

Disclosure
No
Misrepresentation of Female Sexual Behavior in Pornography
Authors: Dubinskaya A , Dallas K , Scott V , Anger J , Eilber K 
Published: July 2022

ABSTRACT

Introduction
Female sexual wellness is a highly complex condition that builds not only on biological factors, but also on social norms, background, religion, education, and social media. One source where both women and men learn about sexual behavior, interactions, and expectations is pornography. This resource has become widely available to anyone with access to the internet. While pornography is a way of expanding sexual horizons, like any media it may misrepresent more common behaviors and expectations for both genders.

Objective
The purpose of this review is to evaluate how women's sexuality is portrayed in the most commonly viewed pornography videos in order to understand its role in female sexual health.

Methods
Videos from the category “most viewed videos” based on internet ratings were viewed. We analyzed the content and female and male sexual behaviors portrayed.

Results
We reviewed the 25 most viewed videos by the general public from the five most popular free pornography websites. The two most commonly viewed contexts were sexual encounters between step relatives (16%) and during casting sessions (16%). With the majority of videos having two participants (92%), two videos included three and five participants. Overall, only 9 (36%) videos demonstrated at least one female orgasm with 5 (20 %) videos showing clitoral stimulation before reaching orgasm. Only 4 (16%) videos did not demonstrate male orgasm. Similarly, only 8 (32%) videos pictured a female as the recipient of oral sex, whereas all but 3 (12%) videos showed the male as the recipient. Only in one (4%) video did a woman have more than one orgasm. Anal sex was represented in 4 (16%) of videos, with novelty toy uses in one (4%) video.

Conclusions
We found that he most viewed videos on popular pornography sites did not represent the most common real life sexual scenarios and were predominantly male-pleasure centered.Inaccurate portrayal of female sexuality can contribute to sexual performance anxiety, unfulfilled expectations among both partners, and sexual dysfunction. More research is needed to determine the best referral websites and categories for women and their partners, representing more realistic female sexual behavior.

Disclosure
No