bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Clinical Manifestations of Penile Gonococcal Cutaneous and Accessory Gland Infections in Men With Gonorrhea
Authors: Fan Wenge , Zhang Qingsong , Zhang Jing , Fan Zhijiang , Jiang Tingwang 
Published: March 2021

Background
No studies have focused on the prevalence and clinical manifestations of penile gonococcal cutaneous and accessory gland infections in men with gonorrhea.

Methods
We enrolled patients with penile gonococcal cutaneous and accessory gland infections and patients with urethral gonorrhea from January 2014 to February 2020. Demographic data, occurrence sites, and manifestations of all patients were recorded.

Results
Fifty-one patients with penile gonococcal cutaneous and accessory gland infections were observed among 1994 (2.6%; 95% confidence interval, 1.9%–3.4%) patients with urethral or penile gonorrhea. Lesions were present at the external urethral orifice in 22 (43%) patients, at the glans in 11 (21%), in the side of the frenulum of the prepuce in 7 (14%), in the penile raphe in 5 (10%), in the inner plate of the prepuce in 1 (2%), in the external urethral orifice and side of the frenulum of the prepuce in 3 (6%), and in the glans and side of the frenulum of the prepuce in 2 (4%). The lesions manifested as sinus-like lesions in 22 (43%) patients, abscesses in 14 (27%), nodules in 10 (20%), pustules in 3 (6%), nodules with sinus tracts in 1 (2%), and ulcers in 1 (2%).

Conclusions
Penile gonococcal cutaneous and accessory gland infections in men probably are more common than previously understood. They mainly involve the paraurethral duct, glans, Tyson's gland, and penile raphe. Lesions mainly present as sinus-like lesions, abscesses, and nodules.
Multifactorial Correlates of Incident Bacterial Sexually Transmitted Infections Among Black Men Who Have Sex With Men Recruited in 6 US Cities (HIV Prevention Trials Network 061)
Authors: Allan-Blitz Lao-Tzu , Menza Timothy W. , Cummings Vanessa , Gaydos Charlotte A. , Wilton Leo , Mayer Kenneth H. 
Published: March 2021

Background
Black men who have sex with men are at a disproportionate risk for sexually transmitted infections (STI). Understanding the drivers of those disparities can lead to culturally tailored interventions. We aimed to characterize the incidence and correlates of STI among Black individuals from HIV Prevention Trials Network 061, a multicity cohort study conducted from 2009 to 2011 in the United States.

Methods
We used Cox proportional hazards regression to estimate adjusted hazard ratios (aHRs) accounting for within-participant correlation over multiple follow-up visits (enrollment, 6 and 12 months). We examined correlates of incident rectal and urethral STI as well as incident syphilis.

Results
Among 1522 individuals, the incidences of urethral and rectal Neisseria gonorrhoeae infection were 1.0 (95% confidence interval, 0.6–1.8) and 4.6 (95% CI, 3.5–6.3) cases per 100 person-years, respectively. The incidences of urethral and rectal Chlamydia trachomatis infection were 2.5 (95% CI, 1.7–3.6) and 2.5 (95% CI, 1.7–3.7) cases per 100 person-years, respectively. The incidence of syphilis was 3.6 (95% CI, 2.7–4.9) cases per 100 person-years. Younger age was associated with increased odds of incident urethral (aHR, 5.1; 95% CI, 2.3–11.1) and rectal (aHR, 2.6; 95% CI, 1.6–4.3) STI. Diagnosis of a rectal STI at baseline (aHR, 2.3; 95% CI, 1.1–4.0) and use of saliva as lubricant (aHR, 1.7; 95% CI, 1.1–2.8) were associated with incident rectal STI. Diagnosis of syphilis at baseline was associated with incident syphilis during follow-up (aHR, 5.6; 95% CI, 2.5–12.2).

Conclusions
Younger participants had the highest STI incidence. Use of saliva as lubricant may be a driver of rectal infection, which deserves further study.
Characteristics and Population Size Estimation of Female Sex Workers in Bhutan
Authors: Khandu Lekey , Tobgay Tashi , Kinley Kinley , Choida Ngawang , Tashi Tshering , Wangdi Tashi , Tashi Ugyen , Dechenmo Dechenmo , Choden Karma Choden , Tsheten Tashi , Gyeltshen Tenzin , Zangmo Kencho , Choden Sonam , McFarland Willi 
Published: March 2021

Background
Knowing the number of persons at risk for sexually transmitted diseases (STDs) and their risk behaviors are needed to allocate limited resources, set targets for prevention and care activities, gauge the reach of programs, and assess their impact. Female sex workers (FSWs) are a population at high risk for STD worldwide; little is known about FSW in Bhutan.

Methods
We conducted a community-based survey and population size exercise of FSW in Bhutan. The survey used a hybrid venue-based/peer-referral sampling method. Population size estimation methods were key informant mapping, census and enumeration, unique object multiplier, and capture-recapture.

Results
Of 517 women surveyed, 67.5% provided sex for money in the last year. Compared with FSWs at venues, FSWs referred by peers were more likely to have sex with alcohol (80.1% vs. 51.5%, P < 0.001) and more paying partners (mean, 3.5 vs. 2.0; P = 0.001), and less likely to have tested for an STD (28.3% vs. 51.0%, P < 0.001) or have outreach worker contact (27.6% vs. 41.5%, P = 0.007). The estimated number of FSWs in the 9 districts was 353 (95% confidence interval, 345–362). Extrapolation to the whole country projected 597 (417–777) FSWs nationally.

Conclusions
Our estimate of the number of FSW in Bhutan corresponds to 0.71% of adult urban women, a figure in line with other countries in South and Southeast Asia. Our data highlight the need for outreach beyond venues where women are employed to reach FSW at higher risk for STD but who have less access to interventions.
Utility of Whole Genome Sequencing in Assessing and Enhancing Partner Notification of Neisseria gonorrhoeae Infection
Authors: Kong Ling Yuan , Wilson Janet D. , Moura Ines B. , Fawley Warren , Kelly Laura , Walker A. Sarah , Eyre David W. , Wilcox Mark H. 
Published: March 2021

Background
Gonorrhea is a sexually transmitted infection of global concern. We investigated whole-genome sequencing (WGS) as a tool to measure and enhance partner notification (PN) in gonorrhea management.

Methods
Between May and November 2018, all N. gonorrhoeae isolated from patients attending Leeds Sexual Health, United Kingdom, underwent WGS. Reports listing sequences within 20 single-nucleotide polymorphisms (SNPs) of study isolates within a database containing select isolates from April 1, 2016, to November 15, 2018, were issued to clinicians. The proportion of cases with a potential transmission partner identified by PN was determined from patient and PN data. The WGS reports were reviewed to identify additional cases within 6 SNPs or less and verified for PN concordance.

Results
Three hundred eighty isolates from 377 cases were successfully sequenced; 292 had traceable/contactable partners and 69 (18%) had a potential transmission partner identified by PN. Concordant PN and WGS links were identified in 47 partner pairs. Of 308 cases with no transmission partner by PN, 185 (60%) had a case within 6 SNPs or less; examination of these cases' PN data identified 7 partner pairs with previously unrecognized PN link, giving a total of 54 pairs; all had 4 or less SNP differences. The WGS clusters confirmed gaps in partner finding, at individual and group levels. Despite the clinic providing sexual health services to the whole city, 35 cases with multiple partners had no genetically related case, suggesting multiple undiagnosed infections.

Conclusions
Whole-genome sequencing could improve gonorrhea PN and control by identifying new links and clusters with significant gaps in partner finding.
Recurrent Sexually Transmitted Infections Among a Cohort of Men Who Have Sex With Men Using Preexposure Prophylaxis in Belgium Are Highly Associated With Sexualized Drug Use
Authors: De Baetselier Irith , Reyniers Thijs , Platteau Tom , Wouters Kristien , Nöstlinger Christiana , Cuylaerts Vicky , Buyze Jozefien , Laga Marie , Kenyon Chris , Crucitti Tania , Vuylsteke Bea 
Published: March 2021

Background
Men who have sex with men (MSM) experiencing recurrent sexually transmitted infections (STIs) may play a crucial role in the STI epidemic. However, there is limited understanding of what kind of behavior leads to recurrent STIs.

Methods
A total of 179 MSM using preexposure prophylaxis were followed up for 18 months and were screened quarterly for chlamydia, gonorrhea, and syphilis from 2015 to 2018 in Belgium. Participants were stratified into 3 different groups (no STI, one STI episode, recurrent STI episodes during the study). Sociodemographic and sexual behavioral characteristics were compared between the 3 groups, and significant associations with recurrent STI were explored using multivariate logistic regression models.

Results
A total of 62.0% (n = 111/179) of participants experienced at least one STI during the study, and more than 1 in 3 became reinfected with an STI at another visit (n = 66/179 [36.9%]). Participants experiencing recurrent STIs reported the highest frequency of sexualized drug use (86.4%) compared with participants experiencing one (60.0%) or no STI (47.1%). Therefore, sexualized drug use was highly associated with recurrent STIs (adjusted odds ratio [aOR]. 4.35). Other factors associated with recurrent STIs were being younger than 40 years (aOR, 3.29), had a high number (>4) of nonsteady partners with whom receptive (aOR, 1.17) or insertive (aOR, 1.12) condomless anal intercourse occurred in the last 3 months.

Conclusions
Sexualized drug use was the greatest risk factor for having recurrent STIs. Tailoring prevention and care, including specialized services tackling problematic drug use in a sexual context, may help to curb the STI epidemic among MSM.
Long-Term Rehabilitation Utilization Pattern Among Stroke Patients Under the National Health Insurance Program
Authors: Yeh Huan-Jui , Chen Ting-An , Cheng Hui-Chen , Chou Yiing-Jenq , Huang Nicole 
Published: March 2021

Objective
The aim of this study was to understand the frequency of patients receiving rehabilitation services at various periods after stroke and the possible medical barriers to receiving rehabilitation.

Design
A retrospective cohort study was conducted using a nationally representative sample in Taiwan. A total of 14,600 stroke patients between 2005 and 2011 were included. Utilization of physical therapy or occupational therapy at different periods after stroke onset was the outcome variable. Individual and geographic characteristics were investigated to determine their effect on patients’ probability of receiving rehabilitation.

Results
More severe stroke or more comorbid diseases increased the odds of receiving physical therapy and occupational therapy; older age was associated with decreased odds. Notably, sex and stroke type influenced the odds of rehabilitation only in the early period. Copayment exemption lowered the odds of rehabilitation in the first 6 mos but increased the odds in later periods. Rural and suburban patients had significantly lower odds of receiving physical therapy and occupational therapy, as did patients living in areas with fewer rehabilitation therapists.

Conclusions
Besides personal factors, geographic factors such as urban-rural gaps and number of therapists were significantly associated with the utilization of post-stroke rehabilitation care. Furthermore, the influence of certain factors, such as sex, stroke type, and copayment exemption type, changed over time.
Research and Industry Partnerships in Physiatry
Authors: Zafonte Ross , Borg-Stein Joanne , Dillingham Timothy , Esquenazi Alberto , Francisco Gerard , Kim Chong , Morgenroth David , Paganoni Sabrina , Rensing Bernadette 
Published: March 2021

Abstract
The Association of Academic Physiatrists, the home of academic physiatry, is interested in advancing industry partnerships in research among academic physiatrists. There are limited existing resources that outline opportunities for academic physiatrists in engaging the translational research continuum through industry partnerships and the skill sets that academic physiatrists need to successfully navigate these partnerships. In 2019, then President of the Association of Academic Physiatrists, John Chae, MD, ME, assembled a group of interested physician-scientists in physical medicine and rehabilitation to form the Research and Industry Partnerships Task Force to address this problem. The Task Force implemented a live educational session titled “Collaborating with industry” at Physiatry ‘19, the Annual Meeting of the Association of Academic Physiatrists held in Puerto Rico. To extend the reach of this valuable information, the Task Force is creating resources that can be easily distributed and accessed by all physiatrists. The goal of this white paper is to provide a roadmap to help academic physiatrists begin to navigate the field of academia-industry relationships with the ultimate goal of accelerating discovery for the benefit of physiatry and rehabilitation patients.
Pivoting in Context
Authors: Gill Simone V. , Shin Danny , Ayoub Maria , Keegan Laura , Desrochers Phillip C. , Helfrich Christine A. 
Published: March 2021

Abstract
With the onset of the COVID-19 pandemic, researchers have been faced with challenges in maintaining interdisciplinary research collaborations. The purpose of this article is to apply and expand a previously introduced model to sustaining new interdisciplinary research collaborations: Forging Alliances in Interdisciplinary Rehabilitation Research (FAIRR). FAIRR is a logic model that can be used as a guide to create interdisciplinary rehabilitation research teams. In this article, the authors propose expanding FAIRR by including strategies for sustaining interdisciplinary rehabilitation research collaborations: modifying inputs (resources needed to assemble a team and to conduct research activities), shifting activities (steps taken to move the interdisciplinary collaboration forward), and examining what impacts the fit between inputs and activities. Two examples are used to highlight the application of the FAIRR model to interdisciplinary collaborations during COVID-19.
An Analysis of the Inclusion of Women, Older Individuals, and Racial/Ethnic Minorities in Rehabilitation Clinical Trials
Authors: Silver Julie K. , Flores Laura E. , Mondriguez González Antonio , Frontera Walter R. 
Published: March 2021

Objective
Our objective was to investigate whether women, people 65 yrs and older, or individuals who identify with racial and/or ethnic minority groups, were underrepresented among participants in rehabilitation clinical trials.

Design
This is a cross-sectional study of completed rehabilitation clinical trials investigating the number and percentage of women, older adults, and racial and/or ethnic minorities enrolled in rehabilitation clinical trials between January 1, 2011, and January 1, 2020. Secondary outcome measures were inclusion by diagnostic group, as well as International Classification of Functioning, Disability and Health category, and intervention by diagnostic group.

Results
Of the 108 studies meeting inclusion criteria, a majority (69%) were based in the United States. Stroke was the most frequent diagnostic group, followed by musculoskeletal conditions. Ninety-six percent of the United States–based trials included at least one female participant in their study, but among specific diagnostic groups, this ranged from 5% to 73%. Age information was reported inconsistently; however, of the trials reporting age, 100% of cardiac trials included older adults, whereas no spinal cord injury (SCI) trials included them. Among trials based in the United States reporting race, 70% of participants were White, followed by 20% Black or African American and 1% Asian. Among trials based in the United States reporting ethnicity, Hispanic or Latino participants were underrepresented overall and among each diagnostic group.

Conclusions
In this study, we found that among participants of rehabilitation clinical trials women, older individuals, and racial/ethnic minorities were generally underrepresented. In contrast, Black or African American participants were overrepresented with the exception of cardiac trials. An important finding was that many trials did not report age and/or race/ethnicity. Investigators should aim to include underrepresented populations and improve reporting.
Role of Telerehabilitation in the Rehabilitation Medicine Training Program of a COVID-19 Referral Center in a Developing Country
Authors: Leochico Carl Froilan D. , Mojica Jose Alvin P. , Rey-Matias Reynaldo R. , Supnet Isabella E. , Ignacio Sharon D. 
Published: March 2021

Abstract
This article describes the impact of the pandemic on physical medicine and rehabilitation in a COVID-19 referral center of a developing country. It describes how telerehabilitation can be leveraged to fill in the gaps in service, training, and research arms of the physical medicine and rehabilitation specialty. The ITAWAG (“to call”) telerehabilitation program is the response of the Department of Rehabilitation Medicine at Philippine General Hospital, which is the country’s national university hospital, to the ongoing COVID-19 crisis that continues to limit face-to-face access to physical medicine and rehabilitation services throughout the country. With the significant decline in the number of patients served since the start of the pandemic, the ITAWAG program aimed to bridge the physical distance between patients and clinicians after a set of eligibility criteria for teleconsultation or teletherapy and a step-by-step process used before, during, and after each virtual encounter. However, because many physical medicine and rehabilitation consultants, residents, and therapists were not trained for the virtual approach to patient care, a telerehabilitation curriculum was developed to help in providing quality and competent services. Finally, despite the growing awareness of telerehabilitation throughout the country, several research gaps about this emerging technology are identified to determine its acceptance, applicability, and cost-effectiveness among others.
Quality Indicators for Prevention of Infection in the Surgical Site: The Israeli National Program for Quality Indicators Experience
Authors: Niv Yaron , Kuniavsky Michael , Bronshtein Olga , Goldschmidt Nethanel , Hanhart Shuli , Levine David , Mahalla Hannah 
Published: March 2021

Background and Objectives:
The Israeli National Program for Quality Indicators (INPQ) sets as its primary goal to promote high-quality health care within selected core areas in the Israeli health system. Surgical site infection is one of the most common types of acquired infections. The INPQ supports 3 distinct indicators concerning suitable antibiotic treatment in colorectal surgery, cesarean sections, and surgery for femoral neck fractures.

Methods:
We measured the number of patients who received prophylactic antibiotics, beginning an hour before the first cut and stopping after 24 hours in 1 of the 3 operations, according to the International Classification of Diseases, Ninth Revision (ICD-9) codes. Goals for success have been established annually according to the results of the previous year. Data computed for each operation included socioeconomic status, dates of hospitalization and release, date of death, date of birth, gender, date of operation, time of beginning and end of the operation, and time of beginning and end of anesthesia.

Results:
Within 3 to 5 years, we achieved a significant increase in appropriate prophylactic antibiotic use from 78% to 85%, 78% to 95%, and 66% to 88% for colorectal surgery (n = 9404), cesarean sections (n = 141 362), and femoral joint operations (n = 30 728), respectively. The mortality rate was lower, 1.85% versus 0.55% in patients who received proper antibiotic therapy (odds ratio [OR] = 3.141; 95% confidence interval [CI], 1.829-5.394, P < .0001), 0.031% versus 0.006% (OR = 6.741; 95% CI, 1.879-21.187; P = .003), and 5.59% versus 4.51% (OR = 1.253; 95% CI, 1.091-1.439; P = .001), respectively.

Conclusion:
Prophylactic antibiotic treatment is strongly recommended by medical guidelines. The experience of the INPQ supports this approach. We demonstrate a significant lower mortality rate in patients who have been properly treated.
Physiological PSMA Uptake in the Tubarial Salivary Glands and Its Implications in the PARIS Protocol—A First Study of Its Kind!
Authors: Sakthivel Pirabu , Thakar Alok , Arunraj Sreedharan Thankarajan , Prashanth Arun , Kumar Rakesh , Sharma Suresh Chandra , Kumar Rakesh 
Published: March 2021

Objectives
Because prostate-specific membrane antigen (PSMA) expression is universal in juvenile nasal angiofibroma (JNA), PSMA PET/CT is commonly used in the postoperative setting using the postoperative angiofibroma radionuclide imaging study protocol. Our study aims to illustrate physiological PSMA ligand uptake distribution characteristics in the salivary glands, specifically the tubarial glands with tumor, to aid in accurate PSMA PET/CT analysis.

Study Design
Forty-three consecutive patients who underwent a dedicated head and neck spot PSMA PET/CT for JNA were evaluated retrospectively. PSMA SUVmax values in the tumor, tubarial, parotid, submandibular, and sublingual salivary glands were determined visually and quantitatively.

Results
All the tumors and the salivary glands showed increased tracer uptake. The median SUVmax ± SD ratios of the tumor, right and left tubarial gland, right and left parotid gland, right and left submandibular gland, and right and left sublingual gland were 2.7 ± 0.8 (range, 0.5–7.5), 3.8 ± 1.9 (range, 0.9–8.1), 4.7 ± 2.1 (range, 0.8–7.4), 9.5 ± 4.8 (range, 3.2–21.9), 9.2 ± 4.7 (range, 2.9–18.9), 10.4 ± 5.7 (range, 3.5–25.4), 10.4 ± 5.5 (range, 3.7–26.4), 6 ± 4.1 (range, 1.3–20.6), and 6.5 ± 4.2 (range, 1.8–19.7), respectively. The uptake in the tubarial glands was comparable with that of the tumor but less compared with other major salivary glands.

Conclusions
Ours is the first study demonstrating the quantitative uptake of tubarial salivary glands in detail. Because the tubarial glands uptake and the anatomical location are similar to that of the tumor, these physiological uptakes must be borne in mind to circumvent false-positive interpretations and care must be given during the planning of stereotactic radiotherapy for JNAs.
The Appearance of Sjögren Syndrome on 68Ga-PSMA-11 PET/CT
Authors: Li Rou , Li Danni , Li Xiao , Zuo Changjing , Cheng Chao 
Published: March 2021

Abstract
Significant 68Ga-PSMA-11 activity is commonly observed in the lacrimal and salivary glands on PSMA PET/CT. An 80-year-old man after radical prostatectomy was evaluated with 68Ga-PSMA-11 PET/CT. There was no obvious PSMA uptake in the bilateral lacrimal, parotid, and submandibular glands. Subsequently, based on laboratory examination results and 99mTcO4 salivary gland scintigraphy, this patient was diagnosed with Sjögren syndrome, which accounted for the absence of uptake by the glands. This case showed the potential of 68Ga-PSMA-11 PET/CT in the evaluation of the lacrimal glands and major salivary glands.
Quality and Safety in Healthcare, Part LXXXVI
Authors: Harolds Jay A. 
Published: March 2021

Abstract
The Comprehensive Unit-Based Safety Program or CUSP is a methodology to enhance teamwork and improve safety by building on the TeamSTEPPS program, the concepts of a safety culture, knowledge of safety science, engaging patients and their families, and standard change management techniques. It can be used with multiple other approaches to help healthcare organizations achieve high reliability.