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The first post-index quarter DiD estimate suggests that CP+Fx accumulated an excess $6462 (95%CI=$3810-$9021) compared with w/oCP+Fx and $17,197 (95%CI=$14,418-$19,833) compared with CPw/oFx. The CP+Fx cohort had higher DiD estimates in the other follow-up quarters, but they were not statistically significant compared with CPw/oFx. When stratified by fracture site, vertebral column fractures for CP+Fx vs. w/oCP+Fx accumulated an excess $25,226 (95%CI=$12,639-$37,417).<br />Fractures, especially of the vertebral column, were associated with high healthcare costs among adults with CP. Studies are needed to identify cost-effective opportunities to utilize available resources to prevent fractures and their costly sequela for CP.<br />Fractures, especially of the vertebral column, were associated with high healthcare costs among adults with CP. Studies are needed to identify cost-effective opportunities to utilize available resources to prevent fractures and their costly sequela for CP.<br />Preliminary research shows a substantial impact of the COVID-19 pandemic on women's sexual health, whereby empirical work on sexual well-being of minoritized sexual identities is still rare.<br />The objective of this study was to explore sexual health in heterosexual, lesbian and bisexual cis women during the first wave of COVID-19 pandemic in Germany.<br />An anonymous nationwide online survey was conducted among cis women during the first nationwide lockdown in Germany from April 20th to July 20th, 2020. The questionnaire was distributed via e-mail, online chats and social-media platforms.<br />Demographic variables and self-report measures from the Sexual Behavior Questionnaire (SBQ-G) "before the pandemic" and "since the pandemic" were collected.<br />A total of 1,368 cis women participants were included heterosexual women (n=844), lesbian women (n=293), bisexual women (n=231). Results indicate overall decrease in frequency of sexual contacts and masturbation during the COVID-19 pandemic. Regarding differences befso there is a possibility of recall bias, and that the results cannot be generalized because of the underrepresentation of women over age 46.<br />This study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises. Batz F, Lermer E, Hatzler L, etal. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022;19907-922.<br />This study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises. Batz F, Lermer E, Hatzler L, et al. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022;19907-922.<br />Among treatments for vulvo-vaginal atrophy (VVA), there is a new kind of energy-based device, the non-ablative CO<br />laser.<br />This study aimed to assess the efficacy and safety of the non-ablative CO<br />laser in menopausal women with VVA as a monotherapy or in association with vaginal estriol or moisturizer.<br />Seventy-five women with VVA received laser treatment (Laser group), laser plus estriol gel (Laser+E) or laser plus moisturizers (Laser+M). The study protocol consisted of 3 monthly laser sessions (t0, t1, t2) and a gynecological examination at baseline and 1 month after last laser treatment (t3). Objective measures included VHI (Vaginal Health Index) and VuHI (Vulvar Health Index); subjective symptoms of VVA (Dryness, Burning, Itching, Dysuria) evaluated via visual analog scales, sexual function evaluated by FSFI (Female Sexual Function Index), FSDS (Female Sexual Distress Score) and MENQOL (Mopause-specific Quality Of Life). Adverse events and discomfort encountered during the procedure were also asses or Moisturizers in Postmenopausal Women with Vulvovaginal Atrophy. J Sex Med 2022;19761-770.<br />Recently, the variability and heterogeneity of gender presentations in transgender youths have gained significant attention worldwide. Alongside this, specialized gender services have reported an increase in referrals of youths reporting non-binary identities. In Italy, studies investigating gender identity and expression in gender non-conforming youths are lacking, as are data regarding the non-binary population.<br />The present study aimed at dimensionally exploring how transgender and non-binary Italian adolescents identify and express their gender.<br />Gender expression in trans binary youths and non-binary youths.<br />The Gender Diversity Questionnaire (GDQ; Twist &amp; de Graaf, 2019) was used to investigate gender identity, gender fluidity, and gender expression in a sample of 125 adolescent patients from the Gender Identity Development Service (SAIFIP) in Rome and the Gender Incongruence Unit of the Careggi Hospital in Florence, between April 2019-June 2021.<br />The majority of participants (74.4%) identified and the specific medical needs of both trans binary and non-binary adolescents. Mirabella M, Piras I, Fortunato A, et al. Gender Identity and Non-Binary Presentations in Adolescents Attending Two Specialized Services in Italy. J Sex Med 2022;191035-1048.<br />The Female Sexual Distress Scale and the Female Sexual Distress Scale-Revised-herein called the Sexual Distress Scale (SDS and SDS-R)-are among the most widely used self-report instruments to assess sexual distress, but no version for use in the Portuguese population is available to date.<br />The current study aimed to validate the Portuguese version of the SDS/SDS-R in samples of women and men with and without distressing sexual problems.<br />A sample of 1,109 participants without distressing sexual problems (761 women) and 382 participants with distressing sexual problems (283 women), ages ranging from 18 to 72 years, were used to examine the psychometric properties of the Portuguese SDS and SDS-R.<br />Participants completed a survey that included a sociodemographic and health questionnaire, the Portuguese version of the SDS and SDS-R, and measures of sexual satisfaction, sexual quality of life, sexual function, dyadic adjustment, and psychological distress.<br />Results indicated that the Portuguese SDS and the Ssons between individuals with and without distressing sexual problems should be made with caution, as the scores may be biased against the former.<br />This study provides a validation of the Portuguese version of the SDS/SDS-R that can be used to assess sexual distress in Portuguese women and men and can be used to compare between these 2 groups. Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022;19834-845.<br />This study provides a validation of the Portuguese version of the SDS/SDS-R that can be used to assess sexual distress in Portuguese women and men and can be used to compare between these 2 groups. Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022;19834-845.<br />The utility of penile suspensory ligament release (SLR) in the setting of penile prosthesis implantation (PPI) has received limited attention in the literature.<br />To assess the efficacy and safety of penile SLR release, pubic lipectomy (PL), and the utility of penopubic Z-plasty (ZP) during malleable PPI in improving sexual satisfaction compared to that achieved with the conventional method.<br />Between August 2018 and April 2020, 61 patients with refractory erectile dysfunction were prospectively randomized into 2 groups; group A included 31 patients who underwent PPI with SLR and PL via ZP, and group B included 30 patients who underwent conventional PPI via a penoscrotal incision.<br />Penile length was assessed at 3 months, and sexual satisfaction was assessed up to 1 year after PPI using both validated and non-validated tools.<br />The median operative time was higher in group A than in group B (170 min; interquartile range [IQR] [160-190] vs 97.5 min; IQR [90-110] P &lt; .001).The median pre- to postoperative rolled Trial. J Sex Med 2022;19852-863.<br />Lower urinary tract Symptoms (LUTS) and Sexual dysfunction (SD) are common in women with MS and affect quality of life.<br />The aim of this study was to determine the relationship between sexual dysfunction (SD) and overactive bladder in women with Multiple Sclerosis (MS).<br />From January 2019 to January 2021, we evaluated 89 female MS patients admitted for LUTS in a Neuro-Urology Department. SD was investigated using the Female Sexual Function Index (FSFI). [https://www.selleckchem.com/products/ml390.html ML390 inhibitor] All subjects completed the Urinary Symptom Profile scale (USP) and Hospital Anxiety and Depression Scale (HAD A/HAD D). Neurological impairment was assessed using the Expanded Disability Status Scale (EDSS). All patients underwent neurological examination and urodynamic studies. Univariate analysis and Multivariate logistic regression analysis were performed to identify predictors of SD in women with MS (FSFI &lt;26.55).<br />Primary outcome was to determine the association between sexual dysfunction in women with MS and LUTS (overactive bladder, stress inconMed 2022;19729-737.<br />Previous studies have demonstrated the deleterious effects of pain anxiety (ie, the degree to which one fears pain), stress, and solicitous partner responses (ie, expressions of sympathy and attention to one's partner's pain) on pain and pain-related disability, but little is known about whether these variables moderate the robust pain-pain-related disability relationship in individuals with provoked vestibulodynia (PVD).<br />We investigated whether pain anxiety, stress, and solicitous partner responses moderated the relationship between penetrative pain and pain-related sexual disability in women with PVD symptoms.<br />Participants with PVD symptoms (N=65, age range=18-73 years) completed an online survey assessing pain anxiety (Pain Anxiety Symptoms Scale-20), perceived stress (Perceived Stress Scale), solicitous partner responses (WHYMPI Solicitous Responses Scale), penetrative pain (Female Sexual Function Index), and pain-related sexual disability (Pain Disability Index). Moderated regression analyses were tibulodynia Symptoms. J Sex Med 2022;19809-822.<br />High pain anxiety and frequent solicitous partner responses to an individual's pain predicted higher pain-related sexual disability, suggesting that it may be possible to improve the quality of life of PVD sufferers through interventions that aim to decrease pain anxiety, and solicitous partner responses, in addition to interventions that aim to decrease pain per se. Maunder L, Dargie E, Pukall C. Moderators of the Relationship Between Pain and Pain-Related Sexual Disability in Women with Provoked Vestibulodynia Symptoms. J Sex Med 2022;19809-822.<br />We examined the association between Medicaid expansion (ME) and the diagnosis, treatment, and survival of patients with hepatocellular carcinoma (HCC).<br />We identified patients with HCC &lt;65yrs with Medicaid or without insurance within the National Cancer Database before (2010-2013) or after (2015-2017) ME with early (cT1) or intermediate/advanced (cT2-T4 or M1) disease.<br />We identified 4848 patients with HCC before and 4526 after ME. Prior to ME, there was no association between future ME status and diagnosis of early HCC (34.5% vs. 32.9%). There was no association between future ME status and treating early HCC with ablation, resection, or transplantation. Patients with early HCC in future ME states were less likely to die (HR=0.81, 95% CI 0.67-0.98). After ME, patients in ME states were more likely to be diagnosed with early HCC (39.2% vs. 32.1%). Patients with early disease in ME states were more likely to undergo resection (OR=1.78, 95% CI 1.16-2.75) or transplantation (OR=3.20, 95% CI 1.40-7.33). There was a further associated decrease in the hazard of death (HR=0.