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Introduction: Despite the negative societal stigma on receptive anal intercourse (RAI), this behavior has a positive influence on individuals' sexual and relationship health. No large studies have previously looked at the sensations experienced during RAI, especially their association with lifelong exposure. Objective: This study aims to quantify commonly reported pelvic sensations during RAI and determine whether their presentation changes with increasing experience to RAI. Methods: An internet survey was conducted on sensations felt during RAI among people with prostates (i.e. cis men and trans women) from July 2022-January 2023. The survey content was developed based on a mixed-methods qualitative study and inquired about demographic and sexual histories as well as sensations (pleasure, pain, urinary, and bowel) experienced during RAI. We used descriptive statistics to describe demographic and sexual histories. All data was stratified by lifetime exposure to RAI. The primary outcomes assessed included both the quantification of the primary sensations experience during RAI and associated bother. Results: 975 participants completed the survey. Nine percent reported less than 10 experiences with RAI, 26% reported 11-50 RAI experiences, 32% reported 51-200 experiences, 16% reported 201-500 experiences, and 18% reported >500 experiences. As the number of experiences with RAI increased (from <10 exposures to >500 exposures), the reported frequency of pleasurable sensation and satisfaction with pleasure at the level of anus increased from 41% to 92% (p<0.0001), whereas severe pain and symptoms of bowel urgency decreased from 39% to 13% and from 21% to 6% respectively (p<0.0001). Urinary urgency sensation did not differ by lifetime RAI experience. Conclusions: Lifetime exposure to RAI is positively associated with pleasure and is negatively associated with pain and bowel urgency. Pelvic sensations experienced during RAI appear to be dependent on lifetime RAI exposure history regardless of age. Lifetime RAI exposure can be readily assessed and correlates not only with pelvic sensation but also many other aspects of sexual health. These results imply that the etiology of dissatisfaction with pleasure or anodyspareunia during RAI may be distinct by lifetime RAI exposure status. This is the first study assessing pelvic sensations experienced during RAI among a large sample of individuals. This is a cross-sectional study, and we cannot conclude how pelvic sensations change overtime among individuals. Internet based participants may not be representative of clinical populations. Disclosure: No. [ABSTRACT FROM AUTHOR]

Sedimentological (line‐logging) analysis of two drill cores, FC77‐3 and FC67‐3, situated, respectively, in the northwestern and southeastern quadrants of the Flynn Creek impact structure's crater‐moat area reveals that the ~27 m thick crater moat‐filling breccia consists of three subequal parts. These parts, which were deposited during early modification stage of this marine‐target impact structure, are distinguished on the basis of vertical trends in sorting, grain size, and counts of clasts per meter in comparison with other well‐known marine‐target impact structures, namely Lockne, Tvären, and Chesapeake Bay. The lower part is interpreted to represent mainly slump deposits, and the middle part is interpreted to represent a stage intermediate between slump and marine resurge, that is, a traction flow driven by overriding suspension flow. The upper part (size graded, and relatively well sorted and fine grained) is interpreted to represent marine resurge flow only. The upper part is capped by a relatively thin and relatively fine‐grained calcarenite to calcisiltite deposit. [ABSTRACT FROM AUTHOR]

This study used the circuit of culture to examine advertisements and websites of U.S.-based industry trade groups representing the energy industries of coal (American Coalition for Clean Coal Electricity) and petroleum (American Petroleum Institute). Using a census of all advertisements available through the trade groups’ websites during spring 2014, the study identified 4 prominent narratives created by the American Coalition for Clean Coal Electricity and American Petroleum Institute to enhance public support for the industries while fostering uncertainty around climate change and reducing concern for climate initiatives. The research reveals the power inequities surrounding climate discourse by suggesting that wealthy industry trade groups employ a discursive practice of distraction and appropriation of U.S cultural values and mores, essentially shifting public dialogue from climate change and potential environmental policies to how these policies would hurt the industries and adversely affect the average U.S. citizen. [ABSTRACT FROM PUBLISHER]

The Open University's circuit of culture model, which comprises a melding of critical or cultural and postmodern perspectives, encompasses 5 central discursive moments: regulation, production, consumption, representation, and identity. Using the World Health Organization's smallpox eradication campaign as a case study, we gathered data from a wide variety and in-depth collection of materials to examine how the moment of identity informs our understanding of international public relations practice and theory by recasting identity as a central, discursive concept within public relations. [ABSTRACT FROM AUTHOR]

In response to growing criticism that the dominant normative theoretical paradigm privileges Western, corporate models of public relations practice, this critical essay proposes the circuit of culture as a basis for developing public relations theory that informs the wide variety of public relations practices found globally. The model merges recent critical-cultural and postmodern perspectives, providing a confluence of institutional and situated factors that recognize the primacy of identity, difference, and power in discursive practice. In this model, public relations practitioners serve as cultural intermediaries operating within the larger cultural economy to structure information at the juncture of production and consumption. [ABSTRACT FROM AUTHOR]

Two receptors for fragments of C3 are described for human monocytes: CR1 and CR3, which bind C3b and iC3b, respectively. Recently a leucocyte receptor that binds C3dg has also been described, designated CR4. We previously reported that IgM-sensitized sheep erythrocytes that are heavily coated with C3d (EAC3d) can bind to human monocytes that have been cultured in fetal calf serum (FCS). Here we determine whether such binding of C3d-coated targets can lead to phagocytosis, and identify the specific monocyte receptor involved in C3d binding. We confirm that EAC3d bearing greater than 10,000 C3d/cell bind to FCS-cultured monocytes. Furthermore, using non-cultured monocytes, we demonstrate that C3d enhances rosette formation of IgG-coated E and, like C3b and iC3b, C3d augments IgG Fc receptor-mediated phagocytosis. Less than 100 C3d/cell are capable of enhancing phagocytosis, whereas 10,000 or more C3d/cell are required for rosette formation with cultured cells. These results indicate that the C3d-binding receptor is present on peripheral blood monocytes but has poor affinity for target particles coated only with C3d. Anti-CR2 monoclonal antibodies, which recognize the C3d receptor of lymphocytes, do not block EAC3d rosette formation with monocytes. In contrast anti-Mol, a monoclonal antibody against CR3, inhibits EAC3d rosettes by approximately 42%. Anti-CR1 increases this effect, but complete inhibition is not achieved. Ethylenediamine tetraacetate also markedly reduces EAC3d rosetting, reducing the numbers to less than 5%. Thus, the C3d-binding receptor on monocytes, unlike CR4, is metal dependent. Together these data indicate that CR3 is predominantly responsible for C3d binding to monocytes. [ABSTRACT FROM AUTHOR]

Chronic granulomatous disease represents a group of disorders of phagocytic cell oxidative metabolism involving recurrent infections with catalase-positive microorganisms and chronic inflammation. Genetic heterogeneity and phagocyte abnormalities, including enzyme deficiencies, abnormal elicited membrane potential changes, abnormal acidification of the phagocytic vacuole, and deficiencies of an electron transport cascade, have been associated with its pathogenesis. In addition, recently we have shown abnormal neutrophil C3b-receptor expression, antibody-dependent cellular cytotoxicity, and abnormal microtubule metabolism (tyrosinolation of the alpha-chain of tubulin). Fourteen patients with the disease who were followed at the National Institutes of Health had life-threatening infections, on average, once every 9.6 months. In most of the 119 febrile episodes seen in these patients, no infectious agent was found. Retrospective studies indicated that prophylactic antibiotic therapy, particularly with trimethoprim-sulfamethoxazole, significantly prolonged disease-free intervals to greater than 40 months (p less than 0.05). In serious, life-threatening infections, leukocyte transfusions have been used in therapy. Transfused leukocytes localize and persist at infectious sites, and the clinical efficacy of leukocyte transfusions has been suggested. [ABSTRACT FROM AUTHOR]

Introduction: Masturbation has been associated with a number of health and quality of life benefits, including improved self-esteem, sexual agency, and stress relief. While prior studies have asserted an association between solo masturbation and satisfaction with partnered sex, there is a paucity of literature that assesses specific parameters of masturbatory orgasm function and their potential association with sexual satisfaction. Objective: This study aims to explore the association between satisfaction with partnered sex and six parameters of masturbatory orgasm function/satisfaction. Methods: Respondents were recruited via Qualtrics and completed an anonymous, online questionnaire that assessed sexual satisfaction, based on the New Sexual Satisfaction Scale (NSSS)–a validated, 20-item survey. NSSS scores were calculated by summing the possible 5-point Likert scale ratings across all 20 questions, with a higher NSSS score indicating greater satisfaction with partnered sex. Respondents also completed questions that queried frequency of masturbation and partnered-sexual activity, as well as six parameters of orgasm function measured under the condition of solo-masturbation: lead time to orgasm, duration of orgasm, refractory period between orgasms, location of orgasm experience, experience of orgasm, and satisfaction with orgasm. Statistical analyses were completed using Qualtrics Stats iQ software to assess for an association between NSSS score and the aforementioned variables. Results: A sample of n=178 sexually active cisgender women (mean age = 43.6±14.9 years) completed the study survey. Cisgender women who reported higher NSSS scores were significantly more likely to endorse engaging in partnered sexual activities on a more frequent basis (p<0.05), but there was no statistically significant relationship between NSSS score and frequency of solo-masturbation (p=0.2). A statistically significant relationship existed between NSSS score and 2/6 of the masturbatory orgasm parameters assessed (Figure 1). Cisgender women with higher partnered sexual satisfaction scores reported significantly longer duration of masturbatory orgasm and higher satisfaction with orgasm during masturbation (both p<0.01). There were otherwise no significant associations between NSSS score and lead-time to orgasm, refractory period between orgasms, experience of orgasm as single vs. multiple peaks, or bodily location of orgasm experience under the condition of masturbation. Conclusions: Cisgender women who reported more frequent partnered sexual activity, as well as a longer duration of masturbatory orgasm time and higher satisfaction with orgasm from masturbation, reported significantly greater partnered sexual satisfaction. This association between satisfaction with solo masturbation and satisfaction with partnered sexual activity supports leading theories of masturbation improving body knowledge, self-confidence, and sexual agency. Findings also highlight how variability in orgasm function does not always result in differences in sexual satisfaction, which is more so associated with self-perceived orgasm satisfaction. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: Menopause has been associated with a myriad of genitourinary and sexual function symptoms that revolve around changes to the vulva and vagina. The medical literature at present primarily assesses genitourinary syndromes of menopause, with limited focus on how these physiological changes to the vulva and vagina may impact sexual function and satisfaction. Objective: To describe differences that exist between pre- versus postmenopausal women in erogenous sensation zone (ESZ) maps of the vulva and measured satisfaction with partnered sex. Methods: Sexually active cisgender women were recruited via Qualtrics and completed an anonymous, online questionnaire. Respondents viewed anatomic illustrations of the vulva with nine predefined areas and were instructed to select structures that bring them pleasure when touched during sex with a partner. A map of erogenous sensation of the vulva was then created based on the number of respondents selecting each structure. Respondents also completed the New Sexual Satisfaction Scale (NSSS), a 20-item psychometric survey that assesses sexual satisfaction with partnered sex on a 5-point Likert scale, with potential scores ranging from 20 (minimal sexual satisfaction) to 100 (maximum sexual satisfaction). Results: Pre- and postmenopausal women were equally as likely to select at least one ESZ of the vulva (77% premenopausal women vs 81% postmenopausal women, p=0.4). The vaginal introitus, peri urethra, and clitoris were the three most frequently selected structures out of the nine ESZs of the vulva out of all respondents (Figure 1). Assessment for differences in selection between pre- and postmenopausal women for each structure revealed that significantly more premenopausal women selected the clitoris as erogenous (43% vs 32%, p<0.03). There was no statistically significant difference in the other vulvar ESZs. With respect to partnered sexual satisfaction (as measured by the NSSS), there was no statistically significant difference between groups. Premenopausal women reported an average NSSS score of 69 out of 100 and postmenopausal women 67 out of 100 (p=0.3). Conclusions: While premenopausal women were significantly more likely to report the clitoris as erogenous as compared to postmenopausal women, there was no significant difference between groups in erogenous mapping of the eight other vulvar structures. This finding of reduced clitoral erogeneity is supported by the phenomenon of vulvovaginal atrophy, which is associated with the reduction in estrogen and other sex steroids that occurs during menopause. While menopause has been associated with sexual dysfunction, we found no statistically significant difference in self-reported satisfaction with partnered sexual activities. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: Erogenous sensation zones (ESZs) of the body elicit sexual arousal in response to touch. Prior studies have established general maps of external ESZs, but they did not assess internal surfaces or focus on individual structures of the genitalia. Objective: To develop a topographic map of the ESZs of the vulva and vagina. Methods: A sample of n=451 sexually active cisgender women (mean age 48.9 ± 15.5 years) were administered an anonymous, online questionnaire via Qualtrics. Respondents selected predefined areas from anatomic illustrations of the vulva and vagina that bring them pleasure when touched during sex. Respondents then rated the importance of each zone to their sexual pleasure on a 10-point Likert scale. Results: More respondents selected at least one area of the vulva as an ESZ (82%), as compared to the vagina (59.4%). Of the vulva (Figure 1), the clitoris, peri urethra, and vaginal introitus were the three most frequently selected and highest rated structures. The five ESZs of the vagina (Figure 2) revealed a preference for the superficial anterior region of the vaginal canal. The cervix and posterior areas were selected and rated lower than the superficial aspects. Conclusions: The vulva and vagina were associated with enhanced erogenous sensation not only at (but also in regions immediately peripheral to) the clitoris. These ESZs were also rated as "highly important" to sexual pleasure. Notwithstanding these trends, the wide range of selection-frequency and pleasure-importance ratings emphasizes the subjective and varying experience of sexual arousal between individuals. These ESZ maps may enhance patient education, particularly among individuals who suffer from sexual dysfunction or other factors that lend to diminished sexual arousal. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: Despite the prevalence, relevance, and impact of menopause on people with ovaries, there is a paucity of research on its impact on sexual function and satisfaction. While an association between menopause and sexual dysfunction has been found, no studies assessed objective parameters of orgasm function and many utilized sexual satisfaction surveys that did not include participants' perceptions of their sexual partner(s). Objective: This study aimed to assess differences between pre- versus postmenopausal cisgender women using a six-parameter inventory of orgasm function and a validated sexual satisfaction psychometric scale, using both ego-centered and partner-centered measures. Methods: Respondents were recruited and administered an anonymous, online questionnaire via Qualtrics as part of a larger study on sexual function and erogenous sensation. The questionnaire queried demographic information, menopause status, and six parameters of orgasm function under the controlled scenario of solo masturbation. Satisfaction with sexual activity with a partner was measured by the validated New Sexual Satisfaction Scale (NSSS), a 20-item psychometric survey that measures sexual satisfaction in the past six months across two subscales: the ego-centered and partner-/activity-centered subscale. The 5-point Likert scales for all 20 questions were summated, for a total possible score of 20 (minimum sexual satisfaction) to 100 (maximum sexual satisfaction). Statistical analyses were completed using Qualtrics Stats iQ, utilizing ANOVA and chi-square tests. Results: A total of 283 cisgender women completed the study questionnaire. Premenopausal women were significantly more likely to report a higher average frequency of engaging in sexual activities with a partner and solo masturbation (Table 1). Of the six orgasm parameters (Table 2), the only statistically significant difference existed in the experience of orgasm as peaks, with more postmenopausal women reporting a multi-peaked orgasm versus a single-peak orgasm. The average NSSS score amongst all cisgender women in our sample was 68±20, and there was no statistically significant difference (p<0.8) between pre- versus postmenopausal cisgender women. Of the 20 questions within the NSSS, there was no statistically significant difference in 10/10 and 9/10 of the partner-centered NSSS subscale questions between the two groups. The only statistically significant difference between groups was premenopausal women reported higher satisfaction with the partner-centered measure of "The way I sexually react to my partner" (p<0.05). Conclusions: Contrary to the medical literature, we found no significant difference in total sexual satisfaction between pre- versus postmenopausal cisgender women, as measured by the validated NSSS. Moreover, there was no significant difference in 5/6 of the orgasm parameter measurements. While sexual satisfaction is intrinsically linked to sexual function, it is important to note that self-perception of partner and activities may also play an important role in shaping an individual's pleasure during sex. These findings highlight the importance of considering these nuances when assessing sexual satisfaction and may help to better inform the sexual function/satisfaction expectations of cisgender women as they approach menopause. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: Erogenous sensation zones (ESZs) elicit feelings of sexual arousal in response to touch. Prior research has generated whole-body erogenous sensation maps, but they do not differentiate between individual anatomical structures or assess for erogenous sensation of internal surfaces of the body, such as the vagina and anal canal. There is an even greater paucity of literature on the ability to orgasm from vaginal and anal receptive intercourse. Objective: To describe detailed maps of erogenous sensation of the vagina and anal canal amongst cisgender women, and assess for ability to orgasm from receptive intercourse. Methods: Respondents were recruited via Qualtrics and completed an anonymous, online questionnaire. They were instructed to indicate ESZs by selecting from predefined areas that bring them pleasure when touched during sex with a partner from anatomic illustrations of the vagina and anal canal. Respondents were also queried on their ability to orgasm from receptive vaginal and anal intercourse. All statistical analyses were completed using Qualtrics Stats iQ software, with p<0.05 indicating statistical significance. ESZ maps were generated based on the proportion of respondents selecting each anatomical structure as erogenous. Results: A sample of 441 sexually active cisgender women completed the study survey (mean age 48.9±15.6y). Of the five ESZs of the vagina (Figure 1), the superficial anterior (selected by 48% respondents) and superficial posterior (33%) regions were the most frequently selected areas. The four ESZs of the anal canal further revealed greater erogeneity at the superficial anterior (18%) and superficial posterior (11%) walls (Figure 2). With respect to ability to orgasm from receptive intercourse, 35% of cisgender women reported being able to orgasm from vaginal penetration alone while 45% required simultaneous costimulation of another body part and 10% reported an inability to orgasm during receptive vaginal intercourse, regardless of costimulation (Figure 3a). Additionally, 19% of cisgender women reported an ability to orgasm from receptive anal intercourse alone, while 50% required costimulation and 31% reported an inability to orgasm during receptive anal intercourse, regardless of costimulation (Figure 3b). Conclusions: Erogenous sensation of the vagina and anal canal is primarily localized to the superficial walls of both structures, with a greater preference for the superficial anterior zones. These findings support the proposed location of the "G-spot" existing proximal to Skene's glands in the anterior portion of the vaginal canal. Results from this study further highlight the importance of costimulation in achieving orgasm during receptive vaginal and anal intercourse, with only a minority of respondents reporting an ability to orgasm from vaginal or anal penetration alone. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: Erogenous zones (EZ) of the body elicit feelings of sexual arousal in response to tactile stimulation. While previous studies have defined general whole-body maps and detailed maps of the genitalia, there is limited data that defines extragenital structures and compares findings between cisgender men (CM) and cisgender women (CW). Objective: This study aims to describe EZs of the head and neck, and to describe differences in EZs that exist between CM and CW. Methods: A total of 403 CM and 451 CW (mean age 47.2 ± 16.8 and 48.9 ± 15.5y respectively, p>0.05) were recruited and administered an anonymous, online questionnaire via Qualtrics. Standardized anatomic illustrations with 11 predefined areas of the head and neck were presented to respondents, who were instructed to select which structure(s) bring them pleasure when touched during sex. For each EZ selected, the respondent was asked to rate its importance to their sexual pleasure on a 10-point Likert scale, from "1-not at all important" to "10-extremely important." Differences in frequency of selection and importance ratings were analyzed via Qualtrics Stats iQ software using Fisher's exact test and t-tests, with p>0.05 indicating statistical significance. Results: Of the 11 head and neck EZs, the tongue, neck, ear, and lips were the most frequently selected structures (Figure 1). A comparison between CM and CW revealed that CM were significantly more likely to indicate erogeneity of the tongue (51.4% vs 41.3%, p<0.05) and nose (5.2% vs 2.0%, p<0.02). CW were more likely to indicate the posterior neck as erogenous (40.1% vs 30.3%, p<0.01). Statistically significant differences in ratings revealed that CM were more likely to indicate higher levels of importance to sexual pleasure of the cheek (6.3 ± x vs. 5.1 ±, p<0.03) and forehead (5.3 vs. 2.8, p<0.001). Conclusions: EZs of the head and neck were centralized around the mouth, neck, and ears. CM were more likely to select structures around the mouth while CW selected the anterior and posterior neck. While some statistically significant differences were found in EZs between CM and CW, the majority of similarly selected and rated EZs indicate a pattern of comparable overall distributions of extragenital EZs. Findings from this study highlight the presence of extragenital erogeneity, and the importance of prioritizing the preservation of tactile sensation in head and neck surgeries (or communicating these risks to patients during preop consultations). These EZ maps may furthermore be used in future studies to compare pre- versus postoperative changes in erogenous sensation amongst patients who undergo head and neck surgery. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: Sexual satisfaction is an important contributor to quality of life. While it has been documented that cisgender men tend to experience greater sexual satisfaction than cisgender women, there is limited research into the nuanced factors that contribute to sexual satisfaction, such as self- versus partner-centered focuses, and differences that exist between sexual orientation groups. Objective: The aim of this study is to assess for differences in sexual satisfaction that exist between cisgender men (CM) versus cisgender women (CW) and between sexual orientation subgroups using a validated sexual satisfaction survey. Methods: An anonymous, online questionnaire was administered via Qualtrics as part of a larger study on sexual function and pleasure sensation. In addition to providing demographic information, respondents completed the New Sexual Satisfaction Scale (NSSS)- a validated 20-item psychometric scale that assesses sexual satisfaction in the past 6-months across two 10-item subscales: the ego-centered subscale and the partner/sexual activity-centered subscale. Each respondent's 5-point Likert scale for their NSSS was summated across all 20-items (range: 20-100), with higher sum totals indicating greater reported sexual satisfaction. Statistical analyses were completed via Qualtrics Stats iQ software utilizing ANOVA and chi-square tests, with p<0.05 indicating statistical significance. Results: A total of 305 CM and 288 CW were recruited through Qualtrics and completed the NSSS. (Table 1) CM were significantly more likely to report greater total sexual satisfaction than CW, with mean ± SD NSSS scores (out of 100) of 74.5 ± 16.7 and 68.5 ± 19.7, respectively (p<0.0001). With respect to individual measures of the NSSS, CM were significantly more likely to report satisfaction across 14/20 measures (all p<0.05): "My focus/concentration during sexual activity;" "My emotional opening up during sex;" "The frequency of my orgasms;" "The quality of my orgasms;" "My ability to let go and focus on my own pleasure during sex;" "The balance between what I give and receive in sex;" " "My mood after sexual activity;" "The intensity of my sexual arousal;" "My body's ability to perform sexually in a satisfactory way;" "The variety of my sexual activities;" "The way I sexually react to my partner;" "My partner's emotional availability during sex;" "The pleasure I provide my partner;" and "My partner's ability to satisfy my sexual needs". There was no statistically significant difference in total NSSS score between sexual orientation groups of CM and CW (p>0.05). (Figure 1). Conclusions: CM reported significantly greater sexual satisfaction than CW. Notably, CM reported greater satisfaction in 10/10 ego-centered subscale measures relating to their personal pleasure and 4/10 partner/activity-centered subscale measures relating to their perception of their partner during sex. On the otherhand, there was no significant difference in sexual satisfaction between sexual orientation groups. These findings highlight the nuanced differences that exist within the spheres of personal sexual pleasure, with CM experiencing greater ego-centered pleasure. These findings highlight how a variety of self- and partner-centered nuances ultimately contribute to differences in overall sexual pleasure between CM and CW. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: As the average life expectancy increases, so does the need to improve older adults' quality of life. Sexual function and satisfaction have been intimately tied to well-being, and older age has been associated with a decline in sexual activity, sexual function, and desire. However, there is limited research that focuses on the association between age and specific measurements of sexual function, such as orgasm parameters, frequency of sexual activity, and sexual satisfaction. Objective: To describe and compare measures of sexual activity, orgasm quality, and satisfaction between women of different ages. Methods: Respondents were recruited via Qualtrics and administered an anonymous online survey. Respondents were separated into groups based on age ranges: younger adults (<40 years old), middle-aged adults (40 to 59 years old), and older adults (≥60 years old). Additional demographic characteristics and sexuality measures were documented, including sexual orientation, partnership status at the time of survey, ability to orgasm, frequency of masturbation and sexual activity, and sexual satisfaction (as measured by the validated New Sexual Satisfaction Scale (NSSS)). An orgasm quality inventory queried the following six variables, under the control condition of masturbation: (1) time to orgasm; (2) duration of orgasm; (3) refractory period between orgasms; (4) experience of orgasm as a single or multi-peak event; (5) bodily location of orgasm experience; and (6) satisfaction with orgasm quality. Results: A total of 423 sexually active cisgender women (average age ± standard deviation: 48.9 ± 15.6 years old) completed our survey. Older women were significantly more likely to identify as heterosexual and deny dating or being in a current relationship (both p<0.001). Additionally, older women were significantly more likely to deny masturbation and sexual activity with a partner (p<0.001). There was no statistically significant difference in ability to achieve orgasm between age groups (p=0.5). With respect to orgasm parameters (Table 1), younger women reported a significantly lower refractory period between orgasms, as compared to middle-aged and older women. Compared to other age groups, significantly more older women reported their orgasm as a multi-peak event (p<0.04) and were more likely to report the location of orgasm sensation as occurring in their genitals, as opposed to extragenital areas (e.g., arms, thighs, face, back) or whole body (p<0.01). There were no statistically significant differences between age and lead time to orgasm, duration of orgasm, or satisfaction with orgasm. Differences in sexual satisfaction (as measured by the NSSS, with higher scores indicating greater sexual satisfaction) were found to be statistically insignificant as well. Conclusions: While older women reported a significant decrease in frequency of masturbation and sexual activity, they only differed in three out of six measures in our orgasm inventory. While these measures indicate a difference in older women's experience of orgasm, it is important to note that there were no significant differences across multiple measures of sexual satisfaction between women of different ages. Disclosure: No. [ABSTRACT FROM AUTHOR]

The finding that C9-deficient sera (C9D) can kill serum sensitive strains of Gram-negative bacteria by us and other investigators, questions the role of C9 in the membrane attack complex as necessary for cell death. In these studies we have demonstrated that C5b-8 complexes generated on E. coli J5 during incubation in C9-depleted and C9-neutralized sera are effective in killing Gram-negative bacteria. In the same study, we extended our investigations to show that the deposition of C5b-7 complexes (from C8-deficient [C8D], C8 depleted and C8-neutralized sera) is also effective in killing Gram-negative bacteria. In all cases, these studies demonstrated that when E. coli J5 was incubated with C8D, C9D and pooled normal human serum [PNHS], deposited C5b-9 complexes from PNHS produced more killing than C5b-7 or C5b-8 complexes alone. These experiments clearly demonstrated that C5b-7 and C5b-8 complexes are bactericidal and that multimeric C9 within C5b-9 is not an absolute requirement for inner membrane damage and cell death of Gram-negative bacteria.

Fc gamma R plays an important role in host defense, triggering and/or facilitating many immunologic responses. Of the three defined Fc gamma Rs, Fc gamma RI (CD64) is not known to be constitutively expressed on normal PMN. We report here that there is markedly increased expression of Fc gamma RI on the PMN of normal, healthy blacks, detected by binding of monoclonal antibody to this receptor. This may have significant implications when multiracial data are pooled in studies of receptor expression as markers of response to various chemotherapeutic agents.

The exact mechanism by which deposited C5b-9 complexes kill Gram-negative bacteria is unclear. It has been proposed that during complement activation the membrane attack complex triggers an energy dependent process in Gram-negative bacteria that mediates destruction of the inner membrane. This observation in part resulted from the survival of Gram-negative bacteria that were incubated with an uncoupler (DNP) or an inhibitor (KCN) of oxidative phosphorylation during complement activation. In a reexamination of this issue we employed potassium cyanide (KCN) to block energy dependent pathways and observed a dose dependent inhibition of C9 uptake on E. coli J5 during serum incubation, suggesting that cyanide was interfering with complement activation. To verify the effect on complement activation we chose specifically to study the effects of KCN on the C3 convertase of the classical pathway. Sensitized sheep erythrocytes were employed as our model system. This system allowed us to construct a series of stable intermediates that were used to test the effect of cyanide on the formation and activity of precursors of the classical pathway C3 convertase. The data illustrate that the concentrations of potassium cyanide that inhibit complement killing of J5 also inhibit C3 convertase activity on sensitized sheep erythrocytes. The results of this study refute the principal observation made by other investigators, that potassium cyanide protects bacteria from complement killing by inhibiting bacterial energy dependent pathways that spark inner membrane destruction. A better scenario is that the organisms survive because cyanide inhibits complement activation.

It has been reported that the Fc gamma R-mediated phagocytic activity of polymorphonuclear leukocytes (PMN) from patients with acute bacterial infections is markedly enhanced when compared with healthy controls. Inasmuch as several potent cytokines are known to be involved in inflammatory and infectious processes, we studied the effects of three such cytokines (IL-1 beta, IL-2, and TNF-alpha) on normal PMN Fc gamma R-mediated phagocytosis. IL-1 beta and TNF alpha both caused a significant increase in the ingestion of EIgG by adherent PMN. In combination, IL-1 beta and TNF-alpha had an additive effect, even when each was used at its optimal concentration. In contrast to the enhancing effects mediated by IL-1 beta and TNF-alpha, IL-2 alone had no significant effect on PMN phagocytosis. Notably, however, IL-2 at a concentration of 10(4) U/ml partially inhibited TNF-alpha-mediated enhancement of phagocytosis by decreasing TNF binding to the PMN cell surface. This inhibitory effect of IL-2 on TNF was reversed by anti-IL-2 antibody and mAb directed against the low affinity IL-2R (anti-Tac), whereas mAb directed against the intermediate affinity receptor (mik-beta 1) had no such effect. These findings may have important physiologic implications, because patients receiving IL-2 therapy have been shown to have increased susceptibility to infection.

Freshly explanted monocytes phagocytosing IgG antibody-coated erythrocyte targets (EIgG) release a factor(s) that stimulates phagocytosis by neighboring monocytes and polymorphonuclear leukocytes (PMN). Culture supernatants obtained after 30-min incubation of adherent monocytes with EIgG, but not unopsonized sheep erythrocytes, markedly up-regulated the extent of PMN phagocytosis and enhanced the rate at which monocytes ingested EIgG. The presence of this factor(s) was first evident in phagocytic studies in which monocytes were prepared by a colloidal silica-based continuous gradient technique (Sepracell-Mn). After introduction of erythrocyte targets, there was a 20- to 30-min delay before initiation of phagocytosis that was not observed with monocytes prepared by the standard Percoll-gradient technique. Experiments suggest that, when compared with monocytes prepared by the Percoll-gradient method, Sepracell-Mn monocytes are closer to a base line state of activation with regard to the expression of Fc gamma RI and the ability to ingest EIgG. The mechanism of PMN upregulation by the monocyte factor(s) was explored. Monocyte supernatants did not induce an increase in the surface expression of PMN Fc gamma RI, II, or III. Neither anti-TNF, anti-IL-2, nor anti-GM-CSF had any significant effect on monocyte supernatant activity. Neutrophil activating protein-1 was not detected by ELISA. In contrast, anti-IL-1 completely blocked the effect of the supernatant on subsequent monocyte phagocytosis, and partially inhibited its effect on PMN phagocytosis. Furthermore, it was shown that RIL-1 as well as TNF markedly enhanced monocyte and PMN ingestion of EIgG. These results suggest that monocytes, after Fc gamma R-mediated phagocytosis, release monokines, including at least IL-1, which enhance the phagocytic function of neighboring PMN and monocytes to augment the host defense process.

Plasma membrane expression as well as phagocytic capability of the C3b receptor (CR1) are under regulatory control. Phorbol esters are one class of agents which have been shown to influence both of these events. In this study, by using radiolabeled Fab fragments of a monoclonal anti-CR1 antibody to tag the receptor and acid elution of surface-bound Fab, we showed that both phorbol myristate acetate and phorbol dibutyrate induced internalization of the C3b receptor; this occurred in a dose- and time-dependent manner in the absence of occupancy of the receptor by ligand. This was shown to occur in neutrophils, monocytes, and macrophages. We also showed that phorbol esters enhanced CR1-dependent phagocytosis despite the presence of two-thirds fewer receptors present on the plasma membrane. However, fibronectin, another agent that influences phagocytosis, had no effect on receptor internalization. Phorbol ester internalization was temperature-dependent and was inhibitable by cytochalasins B and D. Inhibition of internalization was reversible when cytochalasin B was removed. Phorbol esters also induced increased detergent insolubility of CR1 with kinetics similar to those of receptor internalization. It is possible that association of CR1 with the cytoskeleton is important to the process of "activation" of CR1 in phagocytosis.

We have prepared C3b covalently linked to IgG via a hydroxylamine-sensitive bond between the C3b alpha' chain and sites predominantly, but not exclusively, located in the IgG heavy chain. This C3b species displays relative resistance to inactivation by factors H and I when compared with free C3b. This resistance appears to be due entirely to reduced affinity of C3b-IgG for factor H. Resistance to inactivation is not conferred on C3b by binding to another serum glycoprotein of similar size, ceruloplasmin, and may be a special property of IgG. C3b-IgG demonstrates an enhanced capacity to consume serum C3 relative to C3b. These alterations of the behavior of C3b when bound to IgG may in part explain the augmentation of alternative pathway activity by IgG. In addition, IgG-induced protection of C3b might influence both complement-mediated killing and phagocytosis of bacteria, as well as modify the in vivo handling of IgG-containing soluble immune complexes.

We have developed a quantitative assay for cell surface C3bi using 125I-labeled conglutinin. Conglutinin was purified to homogeneity from bovine serum and radiolabeled with 125I Bolton Hunter reagent. Conditions of time, temperature, ionic strength, and cell concentration that optimized the binding of conglutinin to erythrocytes bearing C3bi were then determined. The interaction between conglutinin and C3bi under these conditions was highly specific, since EAC4b3b, EAC4b3d, EAC4b3b-beta IH, and EAC4b treated with serum did not bind radioconglutinin significance better with EA or EAC4b. Using this assay, was examined the kinetics of inactivation of both human and guinea pig C3b bound to erythrocytes and showed that, for both, maximum conglutinin binding occurred after EAC4b3b had been incubated with a source of beta 1H and C3INA for 10 to 20 min at 37 degrees C.l We showed a linear relationship between the number of molecules of C3bi per erythrocyte and the amount of conglutinin bound for both guinea pig and human C3bi. The affinity of conglutinin for cell-bound C3bi was shown to be independent of C3bi density on the erythrocyte surface, and the Kd for conglutinin binding to erythrocytes bearing human C3bi was determined to be 1.3 X 10(-8) M. The number of conglutinin binding sites per erythrocyte as calculated from Scatchard plots was equal to the number of C3bi molecules on the cell surface as determined by direct assay using 125I-labeled C3. Moreover, for both human and guinea pig C3bi, the plot of log (cell surface C3bi) vs log (conglutinin bound) had a slope of 1. These findings imply that a single molecule of C3bi is capable of binding a molecule of conglutinin under the conditions of our assay.

Cleavage of C3 by purified leukocyte enzymes and crude extracts of human polymorphonuclear leukocyte (PMN) granules has been reported. We demonstrate that viable PMN mediate the cleavage of erythrocyte-bound C3b and C3bi via cell-associated proteases. Greater than 50% of 125IC3(x) was released from EAC43bix during a 5-min incubation with viable PMN at 37 degrees C. More than a 30-min incubation was required for substantial release from EAC43bx. Culture fluids from PMN suspensions had limited cleaving ability; cleavage of cell-bound C3bx and C3bix was only partially reduced when PMN were preincubated with high levels of soluble C3 which completely blocked EAC43b rosettes. Thus, cell-to-cell contact between opsonized erythrocytes and viable PMN with surface-associated proteases are responsible for cleavage of these opsonic sites. The effect of defined protease inhibitors on PMN cleaving activity as well as on purified leukocyte elastase was examined. Phenylmethylsulfonyl fluoride (PMSF) and the leukocyte elastase inhibitor, methoxy-succinate-alanine-alanine-valine-chloromethyl ketone (MeO) each inhibited cleavage of C3b by 90% and C3bi by 60%. In contrast, the cathepsin-G inhibitor, benzyloxy-carbonyl-glycine-leucine-phenylalanine-chloromethyl ketone (Z) inhibited C3b and C3bi cleavage by less than 20 and less than 5%, respectively. Ethylenediaminetetra-acetate (EDTA), which had a minimal effect on soluble leukocyte elastase, also inhibited PMN-related release. Thus, elastase appeared to be the principle but not the only enzyme responsible for cleavage of C3b and C3bi. PMSF and MeO had a minimal effect on the activity of purified C3bINA (Factor I); and PMN-mediated release of C3b fragments was not inhibited by anti-Factor I and anti-beta 1H (Factor H) IgG and Fab. Thus, these control proteins are not involved in the PMN-mediated cleavage under study. PMN-mediated cleavage of C3b was also inhibited when PMSF- and MeO-treated PMN were washed to remove the fluid phase phase protease inhibitor before adding EAC43b. This suggests that proteases localized in the PMN membrane, prior to the adherence of EAC43b, are responsible for C3b cleavage. Normal human serum was effective in blocking PMN-mediated release activity, while serum from alpha 1 antitrypsin-deficient patients was minimally effective. This suggests a mechanism for the in vivo regulation of PMN-mediated release of C3b and C3bi from opsonized particles by the natural plasma protease inhibitors.

C3b receptor (CR1) expression by neutrophils (PMNs) and erythrocytes (Es) from patients with chronic granulomatous disease (CGD) or with hyper-IgE, frequent infection (Job's) syndrome was compared with that of control subjects. The control subjects consisted of one group of patients with infections and a second group of normal, healthy individuals. Three quantitative assays were used: rosette formation with C3b-coated cellular intermediates (EAC43b), binding of radiolabeled monoclonal anti-CR1 ([125I]anti-CR1) to PMN surfaces, and binding of the antibody to nonidet P-40 (NP-40) extracts of PMNs and Es in an immunoradiometric assay. Rosette formation by the PMNs of five male CGD patients was about 50% of that of paired normal control subjects, whereas the rosette formation of three female CGD patients was similar to that of the control subjects. Surface binding of [125I]anti-CR1 to PMNs of 10 CGD patients was about half that of the normal subjects (mean percent binding was 2.33% for the CGD patients vs. 3.86% for the normal subjects, giving a difference of -1.53 +/- 0.22%, P less than 0.001 by the paired-sample t test). The degree of PMN binding was similarly low for both the male and the female CGD patients. Conversely, the binding of anti-CR1 to the PMNs of 11 infected control patients appeared to be similar to that of the normal subjects (4.51% for the patient vs. 4.21% for the paired normal subjects). The infected control group originally included four Job's syndrome patients, and when this subgroup was analyzed separately, their PMNs were shown to bind significantly less anti-CR1 than did the PMNs of the normal subjects (P less than 0.01 by the paired-sample t test). In contrast, the other infected control patients showed higher-than-normal levels of anti-CR1 binding (P less than 0.05). When compared to that of the normal subjects, the total CR1 quantitated in PMN extracts was also lower than normal in CGD patients (P less than 0.01 and in the PMN extracts of eight Job's syndrome patients tested (P less than 0.01). The PMNs of the other infected control subjects were not significantly different from those of the normal subjects in total CR1 expression. Extracts of Es from Job's syndrome patients also had fewer than normal CR1 (P less than 0.02). On the other hand, CR1 levels in E extracts from the CGD patients and the other control patients were similar to those in the normal control subjects. Quantitations of C3, C4, and factor B were normal in CGD.(ABSTRACT TRUNCATED AT 400 WORDS)

Complement receptor (CR) expression in cell lines derived from Burkitt's lymphoma (BL), Epstein Barr virus-transformed cord blood lymphocytes (CB), and peripheral lymphocytes from patients with infectious mononucleosis (IM) was examined. Red cell intermediates bearing various densities of C4b, C3b, C3bi, or C3d were tested for rosette formation with the cell lines. In addition, a series of studies was performed under conditions that precluded the cleavage of cellbound C3b by Factor I (C3bINA). These conditions did not alter rosetting by the cells that were tested. RAJI cells rosetted with EAC3bi greater than EAC3d greater than EAC3b, but not with EAC4b. EAC3b/RAJI rosette formation required much greater quantities of C3b bound to red cells than did CB and IM lines, which unlike RAJI, also bound EAC4b. All of the BL lines failed to bind EAC4b even at a C4b density of 50,000 molecules/cell, but several lines did form rosettes with EAC3b, and most formed rosettes with EAC3bi and EAC3d. Fluid phase C3b blocked RAJI/EAC3b rosetting while having little effect on RAJI/EAC3bi rosette activity. Moreover, fluid phase C3b, as well as C4b, blocked RAJI/EAC3b rosettes more effectively than CB/EAC3b rosettes. The results indicate that the RAJI cell line has a receptor for C3b, with characteristics that differ markedly from the C3b receptor of cell lines derived from CB lymphocytes and of lymphoblastoid cell lines derived from patients with IM. This receptor is capable of interacting with soluble but not cellbound C4b. In these studies, rosette formation was examined under various ionic conditions. RAJI/EAC3b rosette formation was severely reduced as ionic strength was increased, whereas RAJI/EAC3bi binding was only moderately decreased at physiologic ionic strength. In striking contrast, EAC3bi binding to monocytes, PMN, and human erythrocytes was markedly reduced as ionic strength increased, but EAC3b binding to these cells was less sensitive to changes in ionic strength. Under conditions of physiologic ionic strength, the C3bi receptor of phagocytic cells may be at a functional disadvantage in the binding of C3bi-coated particles. This may have major physiologic implications.

Highly purified human third component of complement (C3) was used to coat sheep erythrocytes (E) that were sensitized with IgM antibody (EA), forming EAC3b over a wide range of C3 molecules per cell. EAC3b were converted to EAC3bi by incubation with purified C3b inactivator (factor I) and beta 1H globulin (factor H). EAC3bi were in turn trypsinized to produce the cellular intermediate EAC3d. Each of the cell types was carefully characterized to be certain of the type of C3 determinant expressed. These cellular complement intermediates were used to assess by rosette formation the C3 receptor activity on peripheral blood monocytes under various experimental conditions. Uncultivated monocytes from peripheral blood bound EAC3b and EAC3bi well but did not bind EAC3d significantly. However, upon cultivation on glass surfaces in the presence of fetal calf serum but not bovine serum albumin, monocytes showed a progressive increase in expression of the C3d receptor. The Fab' fragment of anti-C3c blocked binding of EAC3b completely, blocked EAC3bi partially, but failed to block binding of EAC3d to cultivated monocytes. In contrast, the Fab' fragment of anti-C3d blocked EAC3d rosette formation completely. These studies demonstrate that monocytes are capable of expressing receptor activity for a determinant on C3d but that the expression of this receptor depends on the state of activation or differentiation of the cells.