Initial Results Research Articles

Teacher RePlay and Children ReAct: pilot testing a formative toolkit to support playful learning in the classroom

Playful learning has seen a resurgence of interest in the past decade, particularly in contexts where play is not traditionally part of a teacher’s repertoire. Teachers interested in exploring the integration of play in their classrooms need formative tools and resources that help them to reflect and assess their own practice and their ability to create a playful learning experience for their students. This study presents the results of two rounds of pilot testing in three countries for Teacher RePlay, a new open-source toolkit designed to support teachers interested in reflecting on and deepening their learning through play practice. The toolkit includes the main Teacher RePlay observation protocol for teachers, as well as Children ReAct, a complementary protocol for a photo-elicited focus group discussion with children, intended to directly assess children’s experiences and reflections on learning through play. Upon observation, teachers receive customized coaching suggestions and tips designed to strengthen their learning through play practice. Initial results from the piloting indicate that the toolkit holds strong potential for teachers interested in better understanding and deepening their playful learning practice. This paper discusses the development, validation, successes, and challenges of the Teacher RePlay toolkit, and identifies future directions for its use.

New breakthrough in rapid degradation of lignin derivative compounds · A novel high stable and reusable green organic photocatalyst

The pulp and paper sectors are thriving yet pose significant environmental threats to water bodies, mainly due to the substantial release of pollutants. Lignin-derived compounds are among the most problematic of these contaminants. To address this issue, we present our initial results on utilizing organic semiconductor photocatalysis under visible light for treating lignin-derived compounds. Our investigation has been centered around creating a green and cost-effective organic semiconductor photocatalyst. This catalyst is designed using a structure of bagasse cellulose spheres to support PM6 (poly[(2,6-(4,8-bis(5-(2-ethylhexyl)-4-fluorothiophen-2-yl)benzo[1,2-b:4,5-b’]dithiophene))–co-(1,3-di(5-thiophene-2-yl)-5,7-bis(2-ethylhexyl)-benzo[1,2-c:4,5-c’]dithiophene-4,8-dione))]: MeIC (3,9-bis(2-methylene-(3-(1,1-dicyanomethylene)-cyclopentane-1,3-dione[c]-1-methyl-thiophe))-5,5,11,11-tetrakis(4-hexylphenyl)-dithieno[2,3-d:2′,3′-d’]-s-indaceno[1,2-b:5,6-b’]-dithiophene)). This photocatalyst demonstrates remarkable efficiency, achieving over 91 % degradation of lignin-derived compounds. The superior photocatalytic performance is attributed to three main factors: (1) The ability of PM6 to broaden MeIC's absorption range from 300 to 800 nm, allowing for effective utilization of visible light; (2) the synergistic interaction between PM6 and MeIC, which ensures compatible energy levels and a vast, evenly spread surface area, promoting charge mobility and extensive donor/acceptor interfaces. This synergy significantly enhances the generation and transport of carriers, resulting in a high production of free radicals that accelerate the decomposition of organic materials; (3) The deployment of PM6:MeIC on biomass-based carriers increases the interaction surface with the organic substances. Notably, PM6: MeIC showcases outstanding durability, with its degradation efficiency remaining between 84 % and 91 % across 100 cycles. This study presents a promising approach for designing advanced photocatalysts aimed at degrading common pollutants in papermaking wastewater.

Partial nephrectomy series using Versius robotic surgical system: technique and outcomes of an initial experience.

Partial nephrectomy (PN) represents a procedure where the use of a robot has further enabled successful completion of this complex surgery. The results of this procedure using Versius Robotic Surgical System (VRSS) still need to be evaluated. Our working group described the technique and reported the initial results of a series of PN using VRSS. We presented our setting, surgical technique and outcomes for PN, using VRSS. Between 2022 and 2023, 15 patients underwent PN performed by two surgeons in two different centers. Fifteen patients underwent PN. The median lesion size identified on preoperative imaging was 4 (IQR 2.3-5) cm. Median PADUA score was 8 (IQR 7-9). Two procedures were converted to radical nephrectomy for enhanced oncological disease control. Of the 13 nephrectomies that were completed as partial, 7 were performed clampless and 6 with warm ischemia clamping. Median clamping time was 10 (IQR 9-11) minutes. No procedure was converted to open. Median blood loss was 200 (IQR 100-250) mL. Median total operative time was 105 (IQR 100-110) minutes. Median console time was 75 (IQR 66-80) minutes. Median set-up time was 13 (IQR 12-14) minutes. No intraoperative complications were reported. The median hospitalization time was 4 (IQR 3.5-4) days. None of the patients were transfused and none of the patients required readmission. In a pathology report, one patient had a positive surgical margin. Our initial experience suggests that performing PN using VRSS is feasible with good short-term outcomes.

Genomic attributes of airway commensal bacteria and mucosa

Microbial communities at the airway mucosal barrier are conserved and highly ordered, in likelihood reflecting co-evolution with human host factors. Freed of selection to digest nutrients, the airway microbiome underpins cognate management of mucosal immunity and pathogen resistance. We show here the initial results of systematic culture and whole-genome sequencing of the thoracic airway bacteria, identifying 52 novel species amongst 126 organisms that constitute 75% of commensals typically present in heathy individuals. Clinically relevant genes encode antimicrobial synthesis, adhesion and biofilm formation, immune modulation, iron utilisation, nitrous oxide (NO) metabolism and sphingolipid signalling. Using whole-genome content we identify dysbiotic features that may influence asthma and chronic obstructive pulmonary disease. We match isolate gene content to transcripts and metabolites expressed late in airway epithelial differentiation, identifying pathways to sustain host interactions with microbiota. Our results provide a systematic basis for decrypting interactions between commensals, pathogens, and mucosa in lung diseases of global significance.

Urine-Based Biomarker Test Uromonitor® in the Detection and Disease Monitoring of Non-Muscle-Invasive Bladder Cancer-A Systematic Review and Meta-Analysis of Diagnostic Test Performance.

Optimal urine-based diagnostic tests (UBDT) minimize unnecessary follow-up cystoscopies in patients with non-muscle-invasive bladder-cancer (NMIBC), while accurately detecting high-grade bladder-cancer without false-negative results. Such UBDTs have not been comprehensively described upon a broad, validated dataset, resulting in cautious guideline recommendations. Uromonitor®, a urine-based DNA-assay detecting hotspot alterations in TERT, FGFR3, and KRAS, shows promising initial results. However, a systematic review merging all available data is lacking. Studies investigating the diagnostic performance of Uromonitor® in NMIBC until November 2023 were identified in PubMed, Embase, Web-of-Science, Cochrane, Scopus, and medRxiv databases. Within aggregated analyses, test performance and area under the curve/AUC were calculated. This project fully implemented the PRISMA statement. Four qualifying studies comprised a total of 1190 urinary tests (bladder-cancer prevalence: 14.9%). Based on comprehensive analyses, sensitivity, specificity, positive-predictive value/PPV, negative-predictive value/NPV, and test accuracy of Uromonitor® were 80.2%, 96.9%, 82.1%, 96.6%, and 94.5%, respectively, with an AUC of 0.886 (95%-CI: 0.851-0.921). In a meta-analysis of two studies comparing test performance with urinary cytology, Uromonitor® significantly outperformed urinary cytology in sensitivity, PPV, and test accuracy, while no significant differences were observed for specificity and NPV. This systematic review supports the use of Uromonitor® considering its favorable diagnostic performance. In a cohort of 1000 patients with a bladder-cancer prevalence of ~15%, this UBDT would avert 825 unnecessary cystoscopies (true-negatives) while missing 30 bladder-cancer cases (false-negatives). Due to currently limited aggregated data from only four studies with heterogeneous quality, confirmatory studies are needed.

Cost-Effectiveness Analysis of HRD Testing for Previously Treated Patients with Advanced Ovarian Cancer in Italy.

Ovarian cancer (OC) is the eighth most common cancer among women, and homologous recombination deficiency (HRD) is present in approximately 50% of these patients. For this group, poly(ADP-ribose) polymerase (PARP) inhibitors are more likely to be effective. The aim of the study was to investigate the cost-effectiveness of HRD testing versus BRCA testing (which identifies mutations present only in 25% of patients) in Italy to optimize the treatment management, possibly with PARP inhibitors. A cost-effectiveness partition survival model was developed to estimate the expected costs and outcomes (life years, LYs; quality-adjusted life years, QALYs) with lifetime horizon of HRD testing versus BRCA testing alone in women with high-grade serous or endometrioid advanced ovarian cancer. The option to perform the tests in sequence, that is, the BRCA test followed by the HRD test, in patients with BRCA-negative test was also considered, and the model accounted for the National Healthcare Service (NHS) perspective in Italy. The treatments represented the best available options according to the initial test results and according to PARP inhibitors available in Italy. A 3% discount rate was applied. Both deterministic and probabilistic sensitivity analyses were performed to test the robustness of the model results. HRD testing was shown to be a cost-effective strategy compared to BRCA testing (incremental cost-utility ratio 22,610€/QALY) and a cost-saving strategy compared to the sequence of tests. The probabilistic sensitivity analysis showed that the HRD test is cost-effective compared to BRCA testing in 98.5% of model simulations considering a willingness-to-pay threshold of 50,000€/QALY. The identification of genetic anomalies in patients with advanced OC is a costly process. Regardless, HRD upfront testing compared to BRCA testing had a cost-effective profile, allowing the efficient use of healthcare resources and better life expectancy and quality of life for patients.

Examining correlates of police officers’ attitudes towards seeking mental health support: A scoping review

Police officers are often unwilling to seek psychological support when needed. This scoping review explored research into the correlates of police help-seeking attitudes. Searches returned 1754 initial results, with 21 quantitative, peer-reviewed studies retained (published 1995–2022 across six countries; of moderate quality). The most consistent positive associates of police help-seeking attitudes were past help-seeking, perceived service availability, and having a mental health diagnosis. Current PTSD symptoms were the most consistent negative associate. However, of the 102 correlates identified, most were under-researched and/or had inconsistent findings. The operationalisation of terms also varied greatly. High-quality replication of current research is now needed.

Participant Perspectives on the Implementation of a School-Linked Text-Message Intervention to Improve Pediatric Asthma Medication Adherence.

Background: Poor adherence to inhaled corticosteroids (ICS) is a significant challenge in pediatric asthma, contributing to health inequities. Text-message reminders for ICS therapy are an evidence-based approach that improves pediatric asthma medication adherence, yet has not been widely adopted into practice, partly due to lack of (1) participant input on design and implementation and (2) use of sustainable community linkages. Remote Asthma Link™ (RAL) seeks to fill this gap as a school-linked text-message intervention wherein parents of children with poorly controlled asthma received daily, 2-way text-message reminders for preventive inhaler use. Responses were shared with school nurses who conducted remote check-ins with families. Enrolled children, largely from underserved backgrounds, experienced improvements in medication adherence and asthma health outcomes. While initial results were promising, we have yet to elicit participant input to refine the protocol for more widespread implementation. Objective: Examine participant perspectives on barriers and facilitators of RAL implementation. Methods: Semistructured interviews were conducted May-June 2022 with intervention participants: 10 parents, 7 school nurses, and 4 pediatric providers (n = 21) until thematic saturation was reached. Interview transcripts were coded using thematic analysis. Results: Several facilitators for RAL implementation were identified, including ease of use and accessibility, personal connection to the school nurse, and receipt of a visual notification for habit formation. Barriers included challenges with school nurses reaching parents, poor understanding of program expectations, and lack of reimbursement structure. Participant-proposed solutions to barriers included utilizing alternate communication methods (eg, social media), educational sessions, and meeting with payors to consider reimbursement models. Conclusion: RAL is a school-linked text-message intervention demonstrating promise in improving outcomes and equity in asthma care. Key implementation facilitators, barriers, and proposed solutions will inform protocol adaptations to promote successful implementation of this and other text-message interventions into clinical practice.

Study and methodology exploration of high-potassium glass and lead-barium glass classification patterns based on cluster analysis and decision tree

This study aims to analyze the classification patterns of high-potassium glass and lead-barium glass. It involves preprocessing the data through cluster analysis and employing machine learning decision trees and K-means clustering models for in-depth analysis. In the clustering analysis model, we start by performing a cluster difference analysis on the feature attributes of high-potassium glass and lead-barium glass to obtain initial classification results. Subsequently, we use machine learning decision tree models to partition the data into training and testing sets to explore the classification patterns. Construct a K-means clustering model by iteratively determining the initial cluster centroids' positions using an algorithm and calculating the silhouette coefficient for different numbers of clusters.This process aids in determining the appropriate number of clusters and the initial cluster centroids' positions. The results indicate significant differences in various features between high-potassium glass and lead-barium glass, and the employment of decision trees and K-means models successfully classifies artifacts. In conclusion, this study provides a robust method for the classification of high-potassium glass and lead-barium glass, offering valuable insights for research and application in related fields.

Exploring the feasibility of autonomous forestry operations: Results from the first experimental unmanned machine

AbstractThis article presents a study on the world's first unmanned machine designed for autonomous forestry operations. In response to the challenges associated with traditional forestry operations, we developed a platform equipped with essential hardware components necessary for performing autonomous forwarding tasks. Through the use of computer vision, autonomous navigation, and manipulator control algorithms, the machine is able to pick up logs from the ground and manoeuvre through a range of forest terrains without the need for human intervention. Our initial results demonstrate the potential for safe and efficient autonomous extraction of logs in the cut‐to‐length harvesting process. We achieved a high level of accuracy in our computer vision system, and our autonomous navigation system proved to be highly efficient. This research represents a significant milestone in the field of autonomous outdoor robotics, with far‐reaching implications for the future of forestry operations. By reducing the need for human labor, autonomous machines have the potential to increase productivity and reduce labor costs, while also minimizing the environmental impact of timber harvesting. The success of our study highlights the potential for further development and optimization of autonomous machines in the forestry industry.

Observations of interstellar scattering of six pulsars using Polish LOFAR station PL611

ABSTRACT We present the preliminary results of 4 yr of observations of the scattering of pulsar radiation in the interstellar medium using the Low Frequency Array (LOFAR) PL611 station located in Lazy near Krakow. In this work we show the initial results for six pulsars from our observing campaign. We used the HBA antennas of the station, with a central frequency of 154 MHz and a 72 MHz bandwidth and we were able to detect the frequency-dependent change in the pulse profiles. Splitting the bandwidth into a number of separate sub-bands we obtained independent scatter time estimates, which allowed for the estimation of the scattering frequency scaling slope for each individual observation. Our project has been accumulating data for more than 4 yr and as a result we are in a position to study the time variability of the scattering parameters over this period. We detected significant changes in the scatter time and its frequency scaling for at least two of pulsars. The average values of the frequency scaling index for the six pulsars selected for this work are below the range of values predicted by the simple thin screen model of interstellar scattering. This is in accordance with previous results shown for both higher dispersion measure pulsars observed in the past, as well as the more recent LOFAR observations and other projects similar in the observing frequency. We also discuss the advantages of using individual LOFAR stations (or similar instruments) for this kind of research.

Feasibility, Acceptability, and Preliminary Effectiveness of a Combined Digital Platform and Community Health Worker Intervention for Patients With Heart Failure: Protocol for a Randomized Controlled Trial.

Interventions focused on remote monitoring and social needs care have shown promise in improving clinical outcomes for patients with heart failure (HF). However, patient willingness to use technology as well as concerns about access in underresourced settings have limited digital platform implementation and adoption. There is little research in HF populations examining the effect of a combined digital and social needs care intervention that could enhance patient engagement in digital platform use while closing gaps in care related to social determinants of health. Here, we describe the protocol for a clinical trial of a digitally enabled community health worker intervention designed for patients with HF. This study aims to describe the protocol for a randomized controlled trial assessing the acceptability, feasibility, and preliminary effectiveness of an intervention that combines remote monitoring with a digital platform and community health worker (CHW) social needs care for patients with HF who are transitioning from hospital to home. Given the elevated morbidity and mortality, identifying comprehensive and patient-centered interventions at the time of hospital care transitions that can improve clinical outcomes, impact cost, and augment the quality of care for this cohort is a priority. This trial randomized adult inpatient participants (n=50) with a diagnosis of HF receiving care at a single academic health care institution to the 30-day intervention (digital platform+CHW pairing+usual care) or the 30-day control (CHW pairing+usual care) arms. All study participants completed baseline questionnaires and 30-day exit interviews and questionnaires. The primary outcomes will be acceptability, feasibility, and preliminary effectiveness. This clinical trial opened for enrollment in September 2022 and was completed in June 2023. Initial results are expected to be published in the spring of 2024, and analysis is currently underway. Feasibility outcome measures will include the use rates of the biometric sensor (average hours per day), the digital blood pressure monitor (average times per day), the weight scale (average times per day), and the completion of the symptoms questionnaire (average times per day). The acceptability outcome will be measured by the patients' response to the truthfulness of the statement that they would be willing to use the digital platform in the future (response options: very true, somewhat true, or not true). Preliminary effectiveness will be measured by tracking 30-day clinical outcomes (hospital readmissions, emergency room visits, and missed primary care and cardiology appointments). The results of this investigation are expected to contribute to our understanding of the use of digital interventions and the implementation of supportive home-based social needs care to enhance engagement and the potential effectiveness of clinically focused digital platforms. These results may inform the construction of a future multi-institutional trial designed to test the true effectiveness of this intervention in HF. ClinicalTrials.gov NCT05130008; https://clinicaltrials.gov/study/NCT05130008. DERR1-10.2196/55687.

The Conjunctival Microbiome and Dry Eye: What We Know and Controversies.

Dry eye disease is a common multifactorial condition that may be idiopathic or associated with autoimmune conditions, such as Sjogren syndrome. Commensal microorganisms modify immune responses, so it is relevant to understand how they modify such immune-mediated diseases. Microbiota in the gut regulate inflammation in the eye, and conversely, severe inflammation of the ocular surface results in alteration of gut microbiome. The conjunctiva microbiome can be analyzed using 16S or shotgun metagenomics. The amount of microbial DNA in ocular surface mucosa relative to human DNA is limited compared with the case of the intestinal microbiome. There are challenges in defining, harvesting, processing, and analyzing the microbiome in the ocular surface mucosa. Recent studies have shown that the conjunctiva microbiome depends on age, presence of local and systemic inflammation, and environmental factors. Microbiome-based therapy, such as the use of oral probiotics to manage dry eye disease, has initial promising results. Further longitudinal studies are required to investigate the alteration of the conjunctival microbiome after local therapy and surgery.

(262) Virtual Reality for Improved Vasectomy Experience: Insights from a Single-Center Clinical Trial

Abstract Introduction Vasectomy is a widely performed procedure for male sterilization, with an estimated 33 million procedures conducted annually worldwide. Although vasectomy is generally safe and associated with minimal complications, concerns over procedural pain and anxiety can deter patients from pursuing the procedure. To address these concerns, innovations such as no-needle and no-scalpel techniques have been adopted to minimize pain during vasectomy. However, anticipated pain and anxiety remain significant barriers for patients. Therefore, optimizing patient comfort during procedures performed under local anesthesia is crucial for improving outcomes and satisfaction. Virtual reality (VR) devices have emerged as a promising non-pharmacological intervention for pain modulation in various medical fields. VR technology has demonstrated pain reduction and anxiety alleviation in pediatric burn therapy, physical therapy, dental procedures, and more. The adult urologic community has also embraced VR, with positive results observed in surveillance cystoscopy and office-based prostate biopsy procedures. However, limited research exists on the use of VR headsets during vasectomy, with only one previous non-randomized trial reporting high patient satisfaction but no improvement in pain or anxiety. In this ongoing single-center, randomized, open-label clinical trial, we present interim data evaluating the effectiveness of the SmileyScope VR device in reducing anxiety and pain during in-office vasectomy performed with local anesthesia. Objective The primary objective of this study is to evaluate the efficacy of virtual reality (VR) devices in alleviating peri-procedure anxiety and pain during in-office vasectomy performed with local anesthesia. The secondary goal of this study is to compare the effectiveness of interactive VR, enabling patient control of the experience, with static VR, which does not provide patient control. Methods The study enrolled patients who were scheduled for in-office vasectomy with a single urologist. The patients were randomly assigned to one of three groups: the control group receiving standard in-office vasectomy without a VR headset, the static VR intervention group, or the interactive VR intervention group. The primary outcome measures included patient-reported pain and anxiety levels before and after the procedure, along with heart rate measurements recorded using a wearable device. Results Interim analysis of this ongoing study includes data from a total of 58 men. 20 men were in the control group, 19 in the static VR arm, and 19 in the interactive VR arm. There was no observed difference in subjective pain scores or heart rate variability during the procedure. However, patients who wore a VR headset reported a significantly lower level of pre-procedure anxiety (P = 0.0700). Conclusions Anticipation of periprocedural pain and anxiety are barriers to vasectomy utilization. Initial results from our ongoing randomized clinical trial indicate that the utilization of virtual reality is feasible, safe, and effective in reducing pre-procedure anxiety in patients undergoing vasectomy. Disclosure No.

(403) Pilot Study: Fractional CO2 Laser in the Treatment of Chronic Phase Peyronie’s Disease

Abstract Introduction Peyronie’s Disease (PD) is a fibrosing disorder of the penis which may result in penile curvature and deformity of the erect penis. Fractional CO2 laser therapy has been used to remodel severe skin scarring and more recently led to improvements in Dupytren’s contractures. Objective We sought to evaluate the safety of Fractional CO2 Laser Therapy in treating Peyronie’s disease. The assessment includes changes in penile curvature, Peyronie’s Disease Questionnaire (PDQ) Symptom bother score, and International Index of Erectile Function (IIEF) scores. Methods This pilot study examined the use of fractional CO2 laser therapy with adjuvant topical triamcinolone (10mg/cc) in patients with PD. Each patient underwent three treatment cycles with 6 weeks interval between each treatment. During the interval time period, patients were required to perform at-home penile modeling three times daily. Penile curvature assessments, self-reported questionnaires and any adverse events were collected at baseline, 24 weeks and 52 weeks. Results A total of 5 patients were included. The mean baseline curvature was 41.80 ± 10.57 degrees and at 24-week follow-up mean curvature was found to be 34.20 ±18.21 degrees, resulting in an 18.1% reduction in curve (p=0.44). Mean IIEF scores were 55.40 ± 14.26 vs. 61.40 ± 6.58, (p=0.234) at baseline and 24-week follow-up, respectively. Similarly, the IIEF erectile function domain scores were 24.40 ± 4.72 vs. 28.60 ±1.52, (p=0.061) at baseline and 24-week, respectively. PDQ symptom bother average scores were 7.6 vs. 5.4 at baseline and 24-week, respectively. Mild adverse effects such as temporary bruising and penile pain were reported. There were no significant adverse events noted. Conclusions Preliminary results, at 24 weeks, suggest that fractionated CO2 laser therapy may serve as a well-tolerated therapy for PD. While this pilot trial was not powered to assess effectiveness, initial results are encouraging. Based upon these findings, a dose escalating phase I clinical trial is warranted to further systematically evaluate the tolerability and utility of Fractional CO2 laser therapy in the treatment of PD. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific. Allergen/Abvie, Galderma, Johnson and Johnson, Leo, MetOptima, Pfizer.

(072) Comparing Risk of Post-Infection Erectile Dysfunction Following SARS Coronavirus 2 Stratified by Acute and Long COVID, Vasopressor Administration, and Hospitalization Status

Abstract Introduction While multiple studies have shown an association between acute COVID-19 infection and subsequent development of erectile dysfunction (ED), no study has yet assessed the risk of developing ED after a diagnosis of long COVID. It is unclear if there is an increased risk of ED in those with long COVID compared to only those diagnosed with acute COVID. In addition, the impact of vasopressor use and hospitalization for an acute COVID infection on ED development is uncertain. Objective This study sought to assess the risk of ED in individuals with acute COVID-19 when compared to individuals with long COVID-19, as well as risk of ED following more severe cases requiring vasopressors and hospitalization. Methods The TriNetX COVID-19 Research Network was queried from December 1st 2020 through June 2023. We included men aged ≥ 18-years old and analyzed cohorts comparing the following 1) men diagnosed with long COVID-19 (ICD-10: U09) were compared to those that were diagnosed with or had positive test for acute COVID-19 but no diagnosis of long COVID. Men were included if they had at least one outpatient follow-up visit 2 weeks after the initial positive test result and excluded if they received a prior ED diagnosis or treatment, prostatectomy, pelvis radiation, or pulmonary hypertension diagnosis at any time. Additional analyses were performed with the same above criteria including men that were and were not hospitalized within 1 month of acute COVID diagnosis and whether men needed vasopressors or not. Cohorts were propensity score matched and compared for differences in new ED diagnosis and/or prescription of phosphodiesterase-5 inhibitors (PDE5i). Variables on which propensity scores were matched are detailed in Table 1. Results A total of 2839 men were included in each cohort after propensity score matching with an average age of 54.5 +/- 16.7 years and 55.1 +/- 17.1 years in the long and acute COVID cohorts, respectively. Men diagnosed with long COVID-19 were more likely to develop ED or be prescribed PDE5i (3.63%) when compared to men with only acute COVID-19 infections (2.61%) [RR 1.39; 95% CI 1.04, 1.87]. There was no statistically significant increased or decreased risk of developing ED or being prescribed PDE5i for individuals who received vasopressors [RR 0.922; 95% CI 0.774,1.098] or were hospitalized [RR 0.933; 95% CI 0.824,1.056]. Conclusions We found that long COVID-19 infection was associated with greater risk for ED diagnosis or PDE5i prescriptions when compared with men diagnosed with only an acute COVID-19 infection, while there was no significantly increased risk for individuals requiring vasopressors or hospitalization. Disclosure No.

(173) Initial Experience with ReSheyP Device for Intraoperative Modeling of Peyronie’s Disease After Placement of a Penile Prosthesis

Abstract Introduction Manual modeling to correct penile curvature associated with Peyronie's disease (PD) during penile prosthesis has been a recognized procedure since the 1st publication by Wilson et al in 1992. A key component to optimizing results and minimizing complications (i.e. distal urethral laceration) with manual modeling is proper technique. Manual modeling can be technically challenging as the inflated prosthesis must be maintained bent in the direction opposite to the curvature for up to 60-90 seconds and repeated several times. This can be challenging for the operating surgeon with respect to hand fatigue or even accomplishing the adequate modeling pressure. The purpose of this report is to present initial results with ReSheyP, a device designed to facilitate manual modeling in a more controlled fashion to make it easier to perform and potentially less risky than when done simply by hand. In addition, the device can be used in the postoperative setting to resolve residual curvature. Objective We present on 5 men who underwent placement of an inflatable penile prosthesis with manual modeling using the ReSheyP device. Pre- and post-modeling curvature measurement was performed with a goniometer. Men who had severe indentation deformity were excluded from the study. Methods A retrospective review was performed on patients who underwent penile prosthesis placement followed by ReSheyP modeling in 2023. During the procedure, the ReSheyP was deployed at least 2-3 times for 60-90 seconds per modeling. Data collection included demographics, pre- and post-operative assessment of penile curvature, adverse events and patient satisfaction with postoperative straightening. Results Mean pre-modeling curvature was 62 degrees (range 50-70 degrees) (Table 1). Direction of curvature was dorsal in 3 patients and lateral in 2 patient. The average intraoperative post ReSheyP modeling curvature was 11 degrees and the average change in curvature was 45 degrees. All men reported satisfaction with post-op curve correction. There were no intraoperative or postoperative complications. No patient has felt that further at home modeling was needed. Penile sensation and prosthesis function was uncompromised. Conclusions This pilot study using the ReSheyP device for intraoperative modeling to correct penile curvature after penile prosthesis placement suggests that this tool may be an effective procedure for correcting penile curvature in men with PD. Further experience is necessary and longer follow-up will be reported. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.

Hepatocellular Carcinoma Epigenetic Patterns Correspond to Differences in Ethnoracial Status and Treatment Response in a Single-Center Retrospective Study

PurposeTo correlate epigenetic patterns with ethnoracial status and locoregional therapy (LRT) response in patients with hepatocellular carcinoma (HCC). Materials and MethodsDNA and RNA were extracted from 47 distinct formalin-fixed paraffin-embedded tumor samples from 42 patients with HCC (n = 14 Black, n = 19 White, n = 9 Hispanic). LRT response was determined using computed tomography (CT) or magnetic resonance (MR) imaging 3 months posttreatment of 35 tumors (n = 22 complete response, n = 13 retreatment candidates). RNA expression and DNA methylation were used to stratify patients by ethnoracial status and treatment response using partial least-squares discriminant analysis (PLS-DA). Results were validated using hierarchical clustering. Ingenuity pathway analysis was performed to identify upstream regulators and pathways. ResultsPLS-DA identified 100 genes and 12 methylated regions that differentiated tumors from Black from White/Hispanic patients. Hierarchical clustering clustered samples with the top 16 genes or the top 5 methylation regions. Dysregulated pathways included adrenomedullin pathway (P = .030), EIF2 signaling (P = .007), and several metabolic pathways. AGTR1 (log2fold = 1.59) and GSTM3 (log2fold = 2.53) represented potential differentially expressed therapeutic targets. PLS-DA identified 100 genes and 150 methylation regions that differentiated between complete responders and retreatment candidates. Hierarchical clustering clustered samples with the top 30 genes or the top 13 methylation regions. Dysregulated pathways included metabolic and DNA repair–related pathways. ASAP2 (log2fold = 0.29) and RAD50 (log2fold = 0.22) represented potential differentially expressed therapeutic targets. ConclusionsVariation in gene expression and DNA methylation patterns in patients with HCC corresponded to ethnoracial status and LRT response. These initial results suggest tumor profiling has the potential to close ethnoracial disparities and improve treatment stratification.

Safety and efficacy of a new covered stent in hemodialysis vascular access outflow stenosis: A Brazilian multicenter retrospective study.

Vascular stenosis commonly leads to dysfunction in hemodialysis vascular access. Although percutaneous transluminal angioplasty is an established treatment, stent utilization has increased in the last decade as an alternative solution to extend the access function. This study evaluated the safety and initial results of a new impermeable covered stent for treating vascular access outflow stenosis. Investigators retrospectively analyzed 114 hemodialysis patients treated with polytetrafluorethylene-covered stents from September 2018 to September 2022 across four centers. Lesions treated were de novo or restenotic and located in the venous graft anastomosis, outflow segment, cephalic arch, and basilic swing point. Patients were followed by in-person physical examination at 1, 3, and 6 months, and Duplex ultrasound was performed to evaluate the vascular access circuit and in-stent restenosis. The primary efficacy endpoint was target lesion primary patency at 1, 3, and 6 months. Secondary endpoints included access circuit primary patency and secondary patency at 1, 3, and 6 months. The primary safety endpoint was freedom from local or systemic serious adverse events through 30 days post-procedure. Forty-four patients had thrombosed access at the initial presentation, and 41 patients presented with recurrent stenosis. The target lesion primary patency rates at 1, 3, and 6 months were 100%, 89.4%, and 74%, respectively. The access circuit primary patency rates were 100% at 1 month, 85% at 3 months, and 62.7% at 6 months. The secondary patency rates at 1, 3, and 6 months were 100%, 96.4%, and 94.6%, respectively. In the adjusted multivariate Cox regression analysis, only recurrent lesions and female gender were associated with reduced primary patency rates. No serious adverse event was observed through the first 30 days post-procedure. In this retrospective analysis, a new covered stent was shown to be safe and effective for treating peripheral outflow stenosis in vascular access.

Data correlation and causal analysis for traffic flow prediction

Globally, traffic congestion has become a major issue due to several issues, including the rapid urban population increase, deteriorating infrastructure, improper and disorganized traffic signal timing, and a lack of real-time data. According to INRIX, a well-known provider of traffic data and analytics, the effects of this problem on U.S. travelers in 2017 were astronomical, totaling $305 billion in wasted fuel, lost time, and increased transportation costs in congested locations. Given the limitations of building new roads, communities must investigate cutting-edge tactics and technology to ease traffic while taking practical and economical restraints into account. This study employs the Granger causality test on a dataset of 48,120 entries, primarily focusing on the variables: number of VEHICLEs and number of intersection JUNCTIONs. The objective is to ascertain the potential mutual influence between these two variables. Initial results indicate a two-way Granger-causality between the variables, implying a feedback relationship. This discovery is fundamental in understanding traffic data dynamics and could be instrumental in enhancing traffic data prediction models.