bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facilitators and Barriers to Patient-Delivered Partner Therapy Acceptance for Chlamydia trachomatis Among Young African American Men Who Have Sex With Women in a Southern Urban Epicenter
Authors: Lederer Alyssa M. , Hindmarch Grace , Schmidt Norine , Gomes Gérard R. , Scott Glenis , Watson Shannon , Kissinger Patricia J. 
Published: May 2021

Background

Chlamydia trachomatis (Ct) disproportionately affects African American young people living in the Southern United States and can have negative consequences if left untreated. Patient-delivered partner therapy (PDPT) is an evidence-based practice in which individuals diagnosed with Ct can provide treatment directly to their sex partners. However, PDPT acceptance rates need improvement. Although reasons for PDPT acceptance have been explored previously, the facilitators and barriers to expedited partner therapy acceptance among young southern African American men who have sex with women have not yet been examined.

Methods
Twenty semistructured interviews were conducted as part of a community-based Ct screening and treatment intervention among African American men aged 15 to 25 years who had female sex partners. Participants were asked about why they did or did not accept PDPT for their sex partners. Data were transcribed and analyzed in NVivo qualitative software using an inductive thematic approach.

Results
Participants' decision making was multifaceted. Facilitators for PDPT acceptance included being able to cure their partner, convenient access to treatment, believing it was the right thing to do, having a close relationship with a partner, concern for the partner's well-being, and the perceived severity of Ct. Barriers to PDPT acceptance were the belief that a partner did not need treatment, not having a close relationship with the partner, being unable to contact the partner, and fear of conflict.

Conclusions
Findings had similarities to other studies, indicating some universal messaging may be warranted alongside culturally tailored interventions for specific patient populations to increase PDPT acceptance. Implications for patient-provider communication are provided.
Genomic Analysis of the Predominant Strains and Antimicrobial Resistance Determinants Within 1479 Neisseria gonorrhoeae Isolates From the US Gonococcal Isolate Surveillance Project in 2018
Authors: Reimche Jennifer L. , Chivukula Vasanta L. , Schmerer Matthew W. , Joseph Sandeep J. , Pham Cau D. , Schlanger Karen , St Cyr Sancta B. , Weinstock Hillard S. , Raphael Brian H. , Kersh Ellen N. , Gernert Kim M. ,   Antimicrobial-Resistant Neisseria gonorrhoeae Working Group
Published: May 2021

Background
The prevalence of Neisseria gonorrhoeae (GC) isolates with elevated minimum inhibitory concentrations to various antibiotics continues to rise in the United States and globally. Genomic analysis provides a powerful tool for surveillance of circulating strains, antimicrobial resistance determinants, and understanding of transmission through a population.

Methods

Neisseria gonorrhoeae isolates collected from the US Gonococcal Isolate Surveillance Project in 2018 (n = 1479) were sequenced and characterized. Whole-genome sequencing was used to identify sequence types, antimicrobial resistance profiles, and phylogenetic relationships across demographic and geographic populations.

Results
Genetic characterization identified that (1) 80% of the GC isolates were represented in 33 multilocus sequence types, (2) isolates clustered in 23 major phylogenetic clusters with select phenotypic and demographic prevalence, and (3) common antimicrobial resistance determinants associated with low-level or high-level decreased susceptibility or resistance to relevant antibiotics.

Conclusions
Characterization of this 2018 Gonococcal Isolate Surveillance Project genomic data set, which is the largest US whole-genome sequence data set to date, sets the basis for future prospective studies, and establishes a genomic baseline of GC populations for local and national monitoring.
Burden of Mycoplasma genitalium and Bacterial Coinfections in a Population-Based Sample in New Mexico
Authors: Hammer Anne , Gravitt Patti E. , Adcock Rachael , Patterson Nicole , Cuzick Jack , Wheeler Cosette M. ,   on behalf of the New Mexico HPV Pap Registry Steering Committee
Published: May 2021

Abstract
In this population-based US study, the overall prevalence of Mycoplasma genitalium was 1.95% (95% confidence interval [CI], 1.62%–2.34%), declining from 6.12% (95% CI, 4.72%–7.92%) in women aged 21 to 24 years to 0.48% (95% CI, 0.25%–0.94%) in women aged 40 to 64 years. The prevalence of coinfections with Chlamydia trachomatis and Trichomonas vaginalis was low.
Is clinical, musculoskeletal pain associated with poorer logical reasoning?
Authors: Gunnarsson Helena , Agerström Jens 
Published: May 2021

Abstract

Introduction:
It has been hypothesized that pain disrupts system 2 processes (eg, working memory) presumed to underlie logical reasoning. A recent study examining the impact of experimentally induced pain on logical reasoning found no evidence of an effect.

Objectives:
The aim of this study was to examine whether clinical pain, which is qualitatively different from experimental pain, would lower the ability to reason logically.

Methods:
Ninety-six participants completed a questionnaire containing 3 different logical reasoning tasks (the cognitive reflection test, the belief bias syllogisms task, and the conditional inference task), questions about pain variables (present pain intensity, pain intensity during the last 24 hours, the influence of pain on daily activities, pain duration, and pain persistence), questions about other pain-related states (anxiety, depression, and fatigue), and pain-relieving medication. Correlations between the logical reasoning tasks and the pain variables were calculated.

Results:
For 2 of the 3 logical reasoning tasks (the cognitive reflection test and the belief bias syllogisms task), clinical pain was unrelated to logical reasoning. Performance on context-free logical reasoning showed a significant negative correlation with present pain intensity, but not with the other pain variables.

Conclusion:
This finding that logical reasoning ability is largely unrelated to clinical pain is highly consistent with previous research on experimentally induced pain. Pain should probably not constitute a significant barrier to logical reasoning in everyday life.
Construction of a Scale Assessing Patients’ Perceptions Regarding Sanitation and Hygiene in a Clinical Setting
Authors: Asiamah Nestor , Aggrey Mavis , Adu-Gyamfi Kwame , Opuni Frank Frimpong 
Published: May 2021

Objective
This study attempted to develop a scale, hereby called HYGIENICCARE, that assesses patients’ perceptions regarding sanitation and hygiene in a healthcare environment. It also evaluated the relationship between the new measure and a previously validated scale measuring healthcare quality.

Methods
This study was a psychometric test in which we constructed a new survey and administered the survey to patients in wards and the outpatient departments of 5 hospitals in Accra North. A robust procedure, including a review of selected questions by an expert panel, was followed to determine the original bank of items of the instrument. Principal component analysis with varimax rotation was used to select items for the scale, whereas confirmatory factor analysis was used to assess construct validity. Multiple linear regression was used to examine the association between the new scale and an existing measure of healthcare quality.

Results
A bank of 10 items was determined through a systematic review of the literature and the engagement of 7 expert reviewers. Through principal component analysis, the items were reduced to 9. Principal component analysis yielded 2 factors: “environment and equipment” and “personnel and process,” which both explained 82% of the total variance and produced Cronbach α coefficients of 0.912 and 0.86, respectively. Confirmatory factor analysis confirmed the 2-factor solution and produced satisfactory discriminant validity and convergent validity indicators. The 2 domains of the new scale were highly correlated with all dimensions of a scale measuring healthcare quality called HEALTHQUAL (r ≥ 0.76, P < 0.001). In multiple linear regression, each of the 2 domains of HYGIENICCARE explained a total variance of 41% or greater in all domains of HEALTHQUAL (P < 0.001).

Conclusions
We developed a brief scale measuring hospital hygiene and sanitation that correlated well with an existing measure of healthcare quality. This effort shows that the new tool is a valid measure of patient-perceived hospital hygiene and sanitation.
Patient Perceptions of Hospital Experiences: Implications for Innovations in Patient Safety
Authors: Butler Jorie M. , Gibson Bryan , Schnock Kumiko , Bates David , Classen David 
Published: May 2021

Objective
The purpose of this study was to qualitatively examine safety experiences of hospitalized patients and families.

Methods
We conducted 5 focus groups at 2 sites with patients and family members of patients who had been hospitalized at least once within the preceding 2 years. Using a semistructured focus group script, participants were asked to describe hospital experiences, including any safety risks or problems, and to discuss trust in the hospital care team or members of the care team. All focus groups were audiorecorded and transcribed, and transcriptions were qualitatively analyzed using thematic analysis by experienced qualitative analysts and experts in patient safety.

Results
We collected rich descriptions of safety problems in the hospital. We identified 4 main themes from our focus group data. (1) Experiences with safety problems were not unusual among participants, (2) patients and families develop a structured “care story” about their hospital experiences, (3) there is a spectrum of trust between patients and the hospital care team members that can be diminished or enhanced by experiences, and (4) patients believed having someone who could advocate for them during their hospitalization was important.

Conclusions
Our results suggest that acknowledgment of safety problems, clear communication, building trust, and a role for advocacy are impactful pathways health care providers and health care systems can improve patient experiences. Information technology such as patient- and clinician-facing displays can support each of these actions.
Relationships Between Nurses’ Work System, Safety-Related Performance, and Outcomes: A Structural Equation Model
Authors: Hwang Jee-In , Kim Sung Wan , Park Hyeoun-Ae 
Published: May 2021

Objectives
We examined relationships between nurses’ work system, safety-related performance, and outcomes based on a modified Systems Engineering Initiative for Patient Safety model.

Methods
A cross-sectional survey was conducted with 408 nurses from 2 general hospitals. Data on work system factors (person, organization, environment, tools, and task), processes (safety-related performance), and outcomes (staff and clinical outcomes) were collected. Structural equation modeling was used to determine the relationships between nurses’ work system factors, safety-related processes, and outcomes.

Results
Structural equation modeling yielded a comparative fit index of 0.918, standardized root mean square residual of 0.055, and root mean square error of approximation of 0.054, indicating an acceptable model fit. The person factor had a significant positive direct effect on nurses’ safety-related performance, and significant negative direct and indirect effects on the clinical outcome. The organization factor had significant positive direct effects on nurses’ safety-related performance and staff outcome, and a negative indirect effect on the clinical outcome. The task factor had a significant positive direct effect on staff outcome. However, the environment and tools factors had no significant effects on safety-related performance or outcomes.

Conclusions
The findings demonstrated the usefulness of the Systems Engineering Initiative on Patient Safety model to explain safety-related performance and outcomes, indicating differential effects of work system factors. Although the person factor significantly affected safety performance and clinical outcomes, the organization factor was the most influential component for promoting safety-related performance and staff and clinical outcomes. These results can be used to prioritize activities for patient safety.
Neonatal Adverse Events’ Trigger Tool Setup With Random Forest
Authors: Feng Kun , Zhang Li , He Huayun , You Xueqin , Zhang Qiannan , Wei Hong , Hua Ziyu 
Published: May 2021

Objective
This study aimed to develop a trigger tool for detection of neonatal adverse events (AEs) and to validate its effectiveness.

Study Design
Random forest (RF) algorithm was used to build the predictive model by analyzing data from the medical records of 782 neonates in our previous study. Thirteen variables for each patient were used to predict neonatal AEs. Next, the critical variables were selected based on recursive elimination of variables to form the list of triggers. Then, a trigger tool with those triggers was established and tested by reviewing medical records. The positive predictive value of individual triggers and of the entire tool was evaluated.

Results
Data from 782 neonates, including 297 patients with and 485 patients without AEs, were collected to build the original RF model. Then, the 6 most important variables, including diarrhea, antibiotic use, fever, death, skin damage, and suspected necrotizing enterocolitis, were selected to establish a neonate-focused trigger tool. The forest with the 6 variables predicted AEs with a sensitivity of 70.7%, a specificity of 92.0%, and an error rate of 16.1%. In a validation study of the trigger tool, 655 neonates with birth weights ≥1500 g were enrolled, and review of their medical records revealed 1709 triggers and 1172 unique AEs. The 3 most common AEs identified were skin damage, iatrogenic diarrhea, and environmental factor–related fever. The total positive predictive value of the trigger tool was 0.686.

Conclusions
The neonate-focused trigger tool developed using the RF algorithm efficiently and reliably identifies AEs among hospitalized neonates with birth weights ≥1500 g.
Quantitative Neuromuscular Monitoring With Train-of-Four Ratio During Elective Surgery: A Prospective, Observational Study
Authors: Azizoğlu Mustafa , Özdemir Levent 
Published: May 2021

Objectives
Postoperative residual neuromuscular block (PRNB) is a serious problem that can cause death after surgery. It was aimed to evaluate the adequacy of neuromuscular block (NMB) during endotracheal intubation and the adequacy of neuromuscular recovery during clinically extubation decision and follow-up with the train-of-four ratio (TOFR) using quantitative monitoring.

Methods
This study has a prospective-observational single-blind study design. A total of 205 adult patients who underwent elective surgery, who had American Society of Anesthesiologists physical statuses I to III, and who were intubated with neuromuscular blocking agent under general anesthesia were included in the study. Train-of-four ratio measurements were provided single-blindly by another anesthesiologist outside the team. The TOFRs were measured at the time of intubation (TOFRind), before reversal agent administration (TOFRpre-rev) and after (TOFRpost-rev), at the time of extubation (TOFRext), and on admission to the postoperative care unit (TOFRPACU). If clinical signs of PRNB appeared, the recovery protocol was applied and then TOFRrec was measured. Postoperative respiratory complications were also evaluated for the first 24 hours after surgery.

Results
Endotracheal intubation was performed in 41.5% of the patients (n = 85) without adequate NMB. In 48.8% (n = 100) of the patients, adequate recovery (TOFRext ˂0.9) was not available at the time of extubation. Adequate TOFRPACU rate was found to be significantly higher in those who did not receive additional neuromuscular blocking agent doses (P < 0.001). In the recovery protocol, low-dose sugammadex administered to patients with clinical signs of PRNB significantly increased the TOFRrec rate compared with neostigmine (P ˂ 0.001). The first 24 hours, postoperative respiratory complication rate was 5.4% (n = 11), and the most common hypoxemia was observed.

Conclusions
Approximately half of the patients are intubated without sufficient NMB and extubated without sufficient neuromuscular recovery. This suggests that routine use of quantitative neuromuscular monitoring is necessary for patient safety.
Evaluation of the Efficiency and Safety of a Safe Label System: A Prospective Simulation Study
Authors: Neo Hong Jye , Sim Ming Ann , Ti Lian Kah , Ang Sophia Bee Leng 
Published: May 2021

Objectives
Our study aims to investigate the safety and efficiency of the Codonics Safe Label System (SLS) in a prospective simulation study.

Methods
Three sets of simulated experiments involving 82 anesthetists were carried out on patient simulator mannequins. The primary outcome assessed through the simulated experiments was the effectiveness of the SLS in avoiding vial swap errors. Secondary outcomes analyzed included the efficacy of the SLS in preventing syringe swap and the difference in time taken to prepare standardized drugs as compared with conventional methods.

Results
The SLS was associated with a significant reduction in all 4 stages of vial swap error. The incidence of wrong ampoule breakage was significantly lower in the SLS group compared with the conventional group (12.1% versus 38.5%, P = 0.007). The number of staff who drew the wrong ampoule was similarly lower in the SLS group compared with the conventional group (4.9% versus 33.3%, P = 0.001). The proportions of staff who eventually wrongly labeled the loaded syringe were 0% in the SLS group and 17.9% in the conventional group (P = 0.005).
Drug preparation time was longer for the SLS group than for the conventional group (239.6 ± 45.9 versus 160.3 ± 46.5 seconds, P < 0.001).
There was no significant difference in the incidence of syringe swap with the use of the SLS.

Conclusions
The use of the SLS is effective in reducing vial swap error, but not syringe swap errors, and is associated with increased time taken for anesthetic drug preparation.
Design and testing of a prototype foot orthosis that uses the principle of granular jamming
Authors: Simonds Emily , Colton Jonathan , Kogler Geza , Chang Young-Hui 
Published: May 2021

Study Design:
A mechanical testing protocol was used to compare the material properties of commercially available foams with that of a newly designed granular jamming orthosis prototypes.

Background:
Foot orthoses have an inherent limitation of predetermined mechanical material properties coupled with a fixed orthotic interface shape that cannot be readily changed.

Objectives:
To develop and test a novel orthotic insole design concept that incorporates principles of granular jamming.

Methods:
Granular media were used in combination with vacuum pressure to create a variable stiffness granular foot orthosis. Four types of granular media (rice, poppy seeds, micropolystyrene, and polystyrene beads) were tested in different prototype configurations varying in volume fill and particulate size. Stress–strain curves were obtained from uniaxial compression tests to characterize granular foot orthosis prototypes in comparison with commercial orthotic foams.

Results:
Increasing vacuum pressure increased prototype stiffness for most configurations. A single granular jamming orthosis could exhibit energy absorption values that spanned the entire commercial foam performance range, and in some cases extended far beyond the upper values of the tested foams.

Conclusion:
The results suggest that granular jamming principles can provide clinicians the capability for rapid selection of mechanical properties over a wide range of orthosis stiffnesses. Importantly, patients could don the orthosis because the clinician makes real-time assessments and adjustments in the clinic.
Serum IgG1 and IgG4 could contribute to partial control of viral rebound in chronically HIV-1-infected patients
Authors: Pastori Claudia , Galli Laura , Siracusano Gabriel , Spagnuolo Vincenzo , Muccini Camilla , Mastrangelo Andrea , Bruzzesi Elena , Ranzenigo Martina , Chiurlo Matteo , Castagna Antonella , Lopalco Lucia 
Published: May 2021

Objectives:
Few studies have investigated chronically infected individuals after antiretroviral therapy (ART) interruption (ATI, analytical therapy interruption); thus, we investigated the association between some HIV-specific antibodies and viral control.

Design:
All enrolled patients were previously described in the APACHE study. Briefly, the study was conducted on HIV-1 chronically infected patients, with HIV-RNA less than 50 copies/ml for at least 10 years, CD4+ cell count greater than 500 cells/μl and HIV-DNA less than 100 copies/106 PBMC. The ART regimen in use at the time of ATI was resumed at confirmed viral rebound (CVR, defined as two consecutive HIV-RNA >50 copies/ml).

Methods:
Collection of sera and analysis of both binding antibodies (BAbs) and neutralizing antibodies (NAbs) was performed at three different time points: ATI, CVR and time of viral re-suppression after ART resumption.

Results:
IgG subclasses (IgG1, IgG2, IgG3 and IgG4) from the four patients with highest levels of neutralization were found to block viral infection. All patients had CVR after ATI at a median time of 21 days (14–56). After ART resumption, all the enrolled patients achieved HIV-RNA less than 50 copies/ml in 42 days (21–98). We observed a strong increase of either BAbs and NAbs titers from ATI to viral re-suppression in one patient, who showed the longest period of virus undetectability during ATI. In this patient, BAbs and NAbs specifically belonged to both IgG1 and IgG4 subclasses, directed to env antigen.

Conclusion:

env-specific NAbs and BAbs belonging to IgG1, IgG4 subclasses could be helpful to monitor long-term responses able to control virus replication and eradicate HIV infection.
Spleen Stiffness Measurement by Using Shear-Wave Elastography as a Predictor of Progression to Secondary Myelofibrosis
Authors: Ekinci Omer , Ozgokce Mesut , Turko Ensar , Merter Mustafa 
Published: May 2021

Objective
Polycythemia vera (PV) and essential thrombocythemia (ET) are chronic myeloproliferative diseases that can transform to secondary myelofibrosis (SMF). In this study, we evaluated spleen stiffness using shear-wave elastography (SWE) as a predictor of progression to SMF.

Methods
Participants were grouped as healthy volunteers (HVs), PV/ET patients, and SMF patients. Participants' spleen sizes, spleen stiffness values, bone marrow fibrosis degrees, and the other parameters were evaluated. Spleen stiffness values and spleen sizes were compared between groups.

Results
Of the 121 participants included in this study, 52 patients were HVs, 52 patients were PV and/or ET patients, and 17 patients were SMF patients. In terms of age and sex, there was no difference between groups. Splenic parenchymal stiffness median values by using SWE were found to be 0.82 m/s in HVs, 1.41 m/s in PV/ET patients, and 2.32 m/s in SMF patients (P < 0.001). In terms of median length of the spleen, the difference between groups was significant (P < 0.001). In addition, we found a significant positive correlation between spleen stiffness and bone marrow fibrosis degree (P < 0.001, r = 0.757). However, in multivariate analysis, there was no strong independent risk factor for spleen stiffness.

Conclusion
In this study, we showed that measurement of spleen stiffness using SWE can distinguish SMF from PV/ET patients and HVs. Therefore, we believe that SWE may be used as a noninvasive and easily accessible method to check the fibrotic progression of bone marrow in PV and ET patients to monitor the transformation to SMF, and enables to detect fibrosis in early phase.