bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proposing a Model of Proactive Outreach to Advance Clinical Research and Care Delivery for Patients Who Use Tobacco
Authors: Burris Jessica L. , Borger Tia N. , Baker Timothy B. , Bernstein Steven L. , Ostroff Jamie S. , Rigotti Nancy A. , Joseph Anne M. 
Published: April 2022

AbstractThere are evidence-based treatments for tobacco dependence, but inequities exist in the access to and reach of these treatments. Traditional models of tobacco treatment delivery are “reactive” and typically provide treatment only to patients who are highly motivated to quit and seek out tobacco treatment. Newer models involve “proactive” outreach, with benefits that include increasing access to tobacco treatment, prompting quit attempts among patients with low motivation, addressing health disparities, and improving population-level quit rates. However, the definition of “proactive” is not clear, and adoption has been slow. This commentary introduces a comprehensive yet flexible model of proactive outreach and describes how proactive outreach can optimize clinical research and care delivery in these domains: (1) identifying the population, (2) offering treatment, and (3) delivering treatment. Dimensions relevant to each domain are the intensity of proactive outreach (low to high) and the extent to which proactive outreach activities rely on human interaction or are facilitated by information technology (IT). Adoption of the proposed proactive outreach model could improve the precision and rigor with which tobacco cessation research and tobacco treatment programs report data, which could have a positive effect on care delivery and patient outcomes.
Asymptomatic bacteriospermia and infertility—what is the connection?
Authors: Volz Yannic , Ebner Benedikt , Pfitzinger Paulo , Berg Elena , Lellig Ekaterina , Marcon Julian , Trottmann Matthias , Becker Armin , Stief Christian G. , Magistro Giuseppe 
Published: April 2022

Abstract
Objective
To determine the impact of asymptomatic bacteriospermia on semen quality in subfertile men.

Methods
We conducted a retrospective, single-centre cohort study in 1300 subfertile men. In those diagnosed with asymptomatic bacteriospermia we performed univariate and multivariate logistic regression models to evaluate the strain-specific association with semen parameters.

Results
Asymptomatic bacteriospermia was diagnosed in 3.2% of patients. The microbiological semen analysis revealed a poly-microbial result in 60%. The most common bacterial species were coagulase-negative Staphylococci species (71.4%), Streptococcus viridans (50.0%) and Enterococcus faecalis (26.2%). Sexually transmitted pathogens were identified in 11.9% of semen samples. The detection of Streptococcus viridians or Haemophilus parainfluenzae correlated with impaired sperm morphology (p < 0.05). The presence of coagulase-negative Staphylococci species or Enterococcus faecalis was associated with pathological low counts of live spermatozoa (p < 0.05). In multivariate analysis only Enterococcus faecalis showed a significant impact on sperm concentration (OR 4.48; 95% CI 1.06–22.10; p = 0.041).

Conclusions
Asymptomatic bacteriospermia has always been a subject of great controversy. There is still an ongoing debate whether to treat or not to treat. Here, we demonstrate that asymptomatic bacteriospermia is clearly associated with impaired semen quality. Our findings speak in favour of strain-specific interactions with semen parameters. Especially Enterococcus faecalis seriously affects sperm concentration.
Spülung mit Leitungswasser oder Natriumchlorid nach Augenkontamination
Authors: Schuster Michael , Frambach Daniel , Oberlinner Christoph , Simons Franz-Josef , Claus Matthias 
Published: April 2022

Zusammenfassung
Hintergrund
Ziel des Beitrags war es, die Verwendung von Leitungswasser und/oder Natriumchlorid als Augenspüllösung nach Augenkontaminationen anhand von Sehtestergebnissen zu untersuchen und ggf. Empfehlungen sowie Optimierungsmaßnahmen hinsichtlich der Notfallversorgung abzuleiten.

Material und Methoden
Es handelt sich um eine retrospektive Auswertung aller zwischen dem 01.01.2011 und 31.12.2020 dokumentierten Augenkontaminationen in einem Großunternehmen der chemischen Industrie. Verglichen wurde als Zielgröße die Sehschärfe (Visus) vor und nach Produktkontamination mittels Wilcoxon-Vorzeichen-Rang-Tests.

Ergebnisse
Innerhalb des Beobachtungszeitraums erlitten, nach Ausschluss von Fremdfirmenmitarbeitenden, 393 Personen eine Augenkontamination. Darunter befanden sich 299 Fälle, für die Sehtestergebnisse vor und nach Produkteinwirkung zur Verfügung standen. Zwischen Produkteinwirkung und nachfolgendem Sehtest vergingen im Median (Interquartilsabstand) 0,3 Jahre (0,1–0,9). Der Visus betrug vor Produkteinwirkung 1,0 (0,8–1,0) auf beiden Augen und nach Produkteinwirkung ebenfalls 1,0 (0,8–1,0) auf beiden Augen. Zwischen dem Visus vor und nach Produkteinwirkung konnte sowohl bei einseitiger Augenbeteiligung (n = 180) auf dem betroffenen und nicht betroffenen Auge als auch bei beidseitiger Augenbeteiligung (n = 119) auf dem linken und rechten Auge kein signifikanter Unterschied festgestellt werden. Zu den Fällen, die extern weiterbehandelt wurden und eine Visusminderung aufzeigten, waren in der elektronischen Anamnese keine Langzeitschäden dokumentiert.

Diskussion
Im Rahmen der Notfallversorgung konnte nach chemischer Augenkontamination und anschließender Spülung mit Leitungswasser und/oder Natriumchlorid keine Visusminderung festgestellt werden. Maßnahmen und Investitionen in Prävention und Aufklärungsarbeit könnten zur Reduzierung von chemischen Augenkontaminationen führen.
The Current and Future Role of Technology in Respiratory Care
Authors: Honkoop Persijn , Usmani Omar , Bonini Matteo 
Published: April 2022

AbstractOver the past few decades, technology and improvements in artificial intelligence have dramatically changed major sectors of our day-to-day lives, including the field of healthcare. E-health includes a wide range of subdomains, such as wearables, smart-inhalers, portable electronic spirometers, digital stethoscopes, and clinical decision support systems. E-health has been consistently shown to enhance the quality of care, improve adherence to therapy, and allow early detection of worsening in chronic pulmonary diseases. The present review addresses the current and potential future role of major e-health tools and approaches in respiratory medicine, with the aim of providing readers with trustful and updated evidence to increase their awareness of the topic, and to allow them to optimally benefit from the latest innovation technology. Collected literature evidence shows that the potential of technology tools in respiratory medicine mainly relies on three fundamental interactions: between clinicians, between clinician and patient, and between patient and health technology. However, it would be desirable to establish widely agreed and adopted standards for conducting trials and reporting results in this area, as well as to take into proper consideration potentially relevant pitfalls related to privacy protection and compliance with regulatory procedures.
Quantitative Evaluation of Flood Control Measures and Educational Support to Reduce Disaster Vulnerability of the Poor Based on Household-level Savings Estimates
Authors: Nakamura Risa , Kawasaki Akiyuki 
Published: April 2022

AbstractIn developing countries, where budget constraints make it difficult to invest in disaster risk reduction, disasters worsen the poverty trap. To alleviate poverty by reducing the risk of disasters, not only the immediate direct impacts of disasters but also their long-term and indirect impacts should be considered. However, since the effects of individual policies are often evaluated based on the extent of damage reduction, the impact on the poor, who have few assets and thus small losses, is generally ignored. Here, we aimed to quantitatively evaluate the effects of flood control measures and educational support in terms of the flood vulnerability of the poor at the household level. We constructed a model to calculate the savings of individual households and used the flood damage-to-savings ratio to determine their flood vulnerability. Next, we estimated the extent to which the flood vulnerability is reduced by various policies. We found that educational support is suitable for reducing the flood vulnerability of the poor cost-effectively, especially when the budgets are small. Gini coefficient predictions confirmed that educational support is effective in reducing income inequality. The novelty of this study is that it quantitatively links flood damage, savings, and education, which are factors that affect the flood vulnerability of the poor, and it compares the effects of various flood control measures and educational support at the household level in terms of the flood vulnerability. While the model was developed using household survey data from Bago, Myanmar, the framework should be applicable to other regions as well.
Monolithic perovskite/c-Si tandem solar cell: Progress on numerical simulation
Authors: Gao Chao , Du Daxue , Shen Wenzhong 
Published: April 2022

AbstractPerovskite/c-Si tandem solar cell (TSC) has gradually become the hottest research topic in photovoltaic field for global carbon neutrality. Here we review the recent progress of numerical simulation studies of monolithic perovskite/c-Si TSC in terms of the methodology, light harvesting management, and energy yield aspects. It is summarized that the integration of physical fundamentals of the methodology, optimization of modeling and parameter correction can bring simulation results closer to experiments. Based on theoretical analysis of light harvesting management, we have demonstrated that textures can enhance light trapping capability and resonance absorption. The advances of bifacial perovskite/c-Si TSC have been particularly reviewed in simulation calibration (current matching loss approach) and low-cost strategy (ultrathin Si). Finally, through the energy yield analysis of the monofacial and bifacial TSC, we have innovatively proposed that spectral variables, effective albedo and top-cell bandgap should be integrated into cell preparation and module installation. This in-depth numerical simulation review provides a guidance for experimental preparation of low-cost and high-efficiency perovskite/c-Si TSC.
Drug flibanserin–in hypoactive sexual desire disorder
Authors: Thangaraju Pugazhenthan , Velmurugan Hemasri , TY Sree Sudha 
Published: April 2022

AbstractHypoactive sexual desire disorder (HSDD) is a widely known type of female sexual dysfunction that could also cause emotional distress and relationship problems. Flibanserin, a benzimidazole, was being studied as a treatment for premenopausal women with hypoactive sexual desire disorder because there was no accurate drug therapy available at the time (HSDD). The US Food and Drug Administration (FDA) approved Flibanserin in 2015 for the treatment of generalised acquired HSDD in premenopausal women. It has a high affinity for postsynaptic 5-HT-1A receptors (agonist) and 5-HT-2A receptors (antagonist), and it tends to work by increasing dopamine and noradrenaline levels in the brain while decreasing serotonin levels. This review was to assess Flibanserin efficacy and safety and it is found the drug Flibanserin benefits did not outweigh the risks in premenopausal and postmenopausal women.
9 Safety of Human Chorionic Gonadotropin Monotherapy for Men with Hypogonadal Symptoms and Testosterone &gt;300 ng/dL
Authors: Rainer Q , Pai R , Masterson T 
Published: April 2022

ABSTRACT

Introduction
Human chorionic gonadotropin (hCG) is homologous to luteinizing hormone (LH) and is known to stimulate endogenous testosterone (T) production and may be an option for testosterone replacement therapy (TRT). Current guidelines recommend TRT for men with two T levels &lt;300 ng/dl and symptoms of low T. A challenging patient population are men with symptoms of low T who do not meet biochemical criteria for TRT as there are not current treatment recommendations. We hypothesize that hCG may be a safe and effective therapy for men with hypogonadal symptoms and T &gt;300ng/dl.

Objective
Our objective was to evaluate for symptom improvement and side effects of hCG monotherapy in men with hypogonadal symptoms and T &gt;300 ng/dL.

Methods
We retrospectively reviewed the charts of 31 men treated with hCG monotherapy for hypogonadal symptoms with a T average (latest two lab results) &gt;300 ng/dL who had follow-up labs at least 1 month after initiation of hCG therapy. We evaluated changes in hormones [T, LH, follicle stimulating hormone (FSH), and estradiol], hematocrit (HCT), glycated hemoglobin (A1c), and prostate specific antigen (PSA). Results presented as means standard deviation. Student t-test was used to compare pre- and post-treatment values, significance was set at p=0.05. We also evaluated for incidence of thromboembolic events, including stroke, deep vein thrombosis, and myocardial infarction.

Results
The average age of patients was 49.0±15.8 years with a BMI of 28.6±4.8 kg/m2. Average follow-up after starting hCG therapy was 292 days, range 77 to 857 days. Average weekly hCG dosage was 1500 IU. Serum T increased from 431.27±117.22 ng/dL to 461.05 ±185.19 ng/dL (p=0.61, n=31). No change was seen in FSH (6.79±10.85 to 7.12±12.07 mIU/mL, n=8), PSA (1.55±1.44 to 1.90±1.81 ng/mL, n=10), HCT (43.43±2.27 to 44.48±2.86 %, n=12), estradiol (27.44±6.92 to 30.63±10.25 pg/mL, n=8), or A1c (6.15±0.95 to 6.33±0.93 %,n=4). A statistically significant decrease was seen in LH (4.93±1.98 to 3.66±1.85 mIU/mL,n=11). When evaluated for improvement of erectile dysfunction (ED, n=22), low libido (n=25), and low energy (n=19), 86%, 80%, and 79% of patients reported improvement of each symptom, respectively. All patients with ED were noted to be on another medication or therapy specifically for ED. No thromboembolic events were observed.

Conclusions
Weekly hCG dosing appears to safely improve hypogonadal symptoms even with baseline T levels &gt;300 ng/dL. No changes were noted in HCT, PSA, A1c and no thromboembolic events were recorded.

Disclosure
No
11 Prevalence and Severity of Obstructive Sleep Apnea (OSA) in Men with Testosterone Deficiency (TD)
Authors: Salter C , Flores J , Schofield E , Tan M , Mulhall J 
Published: April 2022

ABSTRACT

Introduction
OSA is a common condition in the general population. Since untreated OSA can contribute to elevated hematocrit (HCT) levels and other negative health consequences, there may be value to screening men prior to initiation of testosterone therapy (TTH).

Objective
The purpose of this study was to describe OSA rates in men with TD prior to initiation of TTH.

Methods
This ongoing study included men seen in a sexual medicine clinic with TD. They were asked to complete two screening questionnaires for daytime sleepiness and OSA, respectively: the Epworth Sleepiness Scale (ESS) and the STOP-BANG (SB). ESS ranges from 0-24 and SB 0-8. Men whose scores indicated intermediate to high risk of OSA were advised to undergo a diagnostic sleep study which evaluated apnea hypoxia index (AHI, normal &lt;5 events/h), total duration SpO2 saturation &lt;88% and SpO2 nadir. Descriptive statistics are presented.

Results
152 men have completed the questionnaires with a mean age of 62±10 years. Baseline total T level was 296±103 ng/dL, baseline HCT was 43±4%. Median SB score was 4 (IQR 3-6). Median ESS score was 5 (IQR 3-8). 58% screened positive for OSA and were referred for sleep study; 88% of sleep studies resulted in a diagnosis of OSA. Mean AHI of the group was 19±14 events/hour (range 0.7-54.3 events/hour) with 52% having moderate or severe OSA (AHI &gt;15/hour). SpO2 nadir was 80±7% (range 63-90%) with 67% having a nadir in the 80s, 24% in the 70s and 10% in the 60s. Mean total duration SpO2 ≤88% was 25±32 minutes (range 0.1-151.6 minutes) with 47% of men &lt;10 minutes and 6% &gt;80 minutes.

Conclusions
These data demonstrate that about half of men with TD screen positive for OSA using the SB questionnaire and the vast majority of them were formally diagnosed with OSA. Given the health risks associated with untreated OSA, especially developing polycythemia on TTH, we advocate screening such men for OSA prior to commencement of TTH.

Disclosure
No
22 Drain Volume Output Following IPP Implantation: An Analysis by Surgical Approach
Authors: Tonzi M , Shridharani A 
Published: April 2022

ABSTRACT

Introduction
Inflatable penile prosthesis (IPP) is the gold standard therapy in the surgical treatment of erectile dysfunction. Hematoma and seroma formation have been described following implantation. These fluid collections may be a significant source of patient pain and infection. Use of closed system drains after penile implantation has been described previously to manage these proactively, and are typically removed on post-op day one. Upon previous analysis, we demonstrated that an extended, three-day postoperative drain course resulted in a modest but significant decrease in postoperative use of pain medication without changing infection rates.

Objective
Herein, we evaluated post-operative drain output volumes to detect differences based on operative approach.

Methods
A total of 151 patients had IPP placement by a single surgeon between November 2017 and November 2019. After excluding patients who underwent additional procedures for Peyronie's disease, those who had a concomitant procedure for post-prostatectomy stress urinary incontinence, or those who underwent a revision procedure, 133 patients remained. 104 of these had their drain removed on postoperative day three. Of these, drain output data was available for 37 patients. Drain output volumes were evaluated based on surgical approach and compared using a one-way ANOVA statistical analysis.

Results
Granular drain output data was available for 37 patients. 8 of these patients underwent IPP placement by infrapubic approach, 13 underwent IPP placement by penoscrotal approach, and 16 patients underwent IPP placement by subcoronal approach. Patients who underwent infrapubic IPP placement trended towards increased drain output compared to those who underwent placement via a penoscrotal or subcoronal approach. These observations did not achieve statistical significance. At 72 hours post-op, drain output among all three groups was comparably low.

Conclusions
As previously demonstrated, an extended post-operative drain duration of three days is not associated with an increased risk of infection in patients undergoing IPP implant. Especially in patients undergoing IPP placement via infrapubic approach, drain output was significant until approximately 72 hours post-op. This data supports the utility in keeping a post-surgical drain for three days in order to maximize drainage and minimize postoperative discomfort. Given the low volume output across all three groups at 72 hours post-op, post-surgical drainage for greater than 3 days is not likely to provide additional benefit.

Disclosure
No
23 Does Medicaid Cover Penile Prosthesis Surgery? A State-by-State Analysis
Authors: Barnard J , Grimaud L , Yafi F 
Published: April 2022

ABSTRACT

Introduction
Malleable [MPP] and inflatable [IPP] penile prosthesis surgery for the management of erectile dysfunction is a reliable treatment option with high success rates and excellent patient satisfaction; however, Medicaid coverage transparency is poor leaving a knowledge gap in this population.

Objective
The present study seeks to assess Medicaid coverage for MPP and IPP by state as evidenced by inclusion in publicly available physician fee schedules.

Methods
State Medicaid websites were utilized to access public physician fee schedules. Individual search queries were performed for CPT codes 54400 and 54405 which represent insertion of MPP and IPP, respectively. Data were recorded for each device including the coverage status, physician fees, and the presence of clear documentation of a prior authorization requirement.

Results
Medicaid physician fee schedules were accessible for 49 out of 50 US states, and 28 states reported coverage for at least one type of penile prosthesis (Figure). Two states reported coverage for MPP only, one state reported coverage for IPP only, and 24 states reported coverage for both devices. One state reported that it did not cover either device, but listed coverage for a self-contained IPP (CPT 54401) only. Mean physician reimbursement was $477.15 (290.82–$1175.50) for MPP placement and $691.76 (421.68–$1794.27) for IPP (Table 1). Eleven states documented prior authorization requirements within their fee schedules, while the remaining 17 states did not. Criteria for approval for prior authorization were not clearly stated in any fee schedule.

Conclusions
Efforts to clearly document approval criteria and educate Men's Health providers on available coverage could result in a significant improvement in sexual satisfaction in the Medicaid population. Graphical representation of states offering Medicaid penile prosthetic coverage and physician reimbursement ranges are provided with comparison to Medicare rates (Figure). Limitations include heterogeneity in fee schedules, lack of prior authorization requirement details, inability to correlate to successful claims data, and the evolving nature of Medicaid coverage for the given procedures. Medicaid coverage exists for penile prosthetic surgery in 28 states, although often with significant non-transparent prior authorization criteria.

Disclosure
No